26 research outputs found
Transition from First Drug Use to Regular Injection among People Who Inject Drugs in Iran
Background: The study aimed to evaluate the interval between first drug use and regular injection and factors associated with transition from first injection into premature regular injection among people who inject drugs (PWIDs).Methods: In a multicenter cross-sectional study, we recruited 400 PWIDs using snowball sampling. Age of first drug use, age of initiation of regular injection, and demographic and behavioral data were collected using face to face interview. Premature transition to regular injection was defined as initiation of regular injection within the five years of first injection. Data were analyzed using bivariate and multivariate logistic regression survey analysis.Findings: The mean age of first drug use and age of initiation of regular injection was 29.87 ± 6.54 years, respectively. Having history of sexual abuse in childhood [adjusted odds ratio (AOR) = 3.1], history of imprisonment (AOR = 3.4), use of heroin as the first drug (AOR = 4.3), and doing the first injection at friends’ houses (AOR = 2.2) or in ruins (AOR = 2.2) significantly increased the chance of premature transition to regular injection, while being a female decreased the chance of premature transition to regular injection (AOR = 0.4). Compared to curiosity, being friend with a drug user (AOR = 0.4), having withdrawal symptoms (AOR = 0.2), and low cost of injection (AOR = 0.3) at the first occasion of drug injection reduced the chance of premature transition to regular injection.Conclusion: New interventions to prevent injection initiation among drug users are needed and should be integrated in harm reduction programs
Network Location and Risk of Human Immunodeficiency Virus Transmission among ‎Injecting Drug Users: Results of Multiple Membership Multilevel Modeling of Social ‎Networks
Background: Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models. Methods: From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET software’s for the analysis of data. Findings: The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score. Conclusion: Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks
Lead Serum Levels in Opium-Dependent Individuals
Abstract Backgrond: Drug abuse, especially opium abuse, is a major public health problem in Iran. Recent reports suggest that opium sellers cheat their customers by adding lead to the opium. Contaminated opium can threaten the health of consumers. The present study aimed to compare the serum level of lead between opium dependents and a control group. Methods: This was a cross-sectional study in which 50 opium dependents aged 20 to 60 years old were compared with a control group of 43 non-dependents who were matched with the case group in terms of sex and age. The serum level of lead and liver function tests including serum total bilirubin, AST, ALT, Alkaline-phosphatase and hemoglobin were measured for all subjects. Findings: The mean level of serum lead concentration in opium dependents and controls was 3929.358 ± 147.67 and 3532.721 ± 1141.53, respectively and the difference was not statistically significant. There was no significant correlation between serum level of lead and age, duration of opium dependency, serum total bilirubin, hemoglobin, AST, ALT, and Alkaline-phosphate. Conclusion: Although there was no significant relationship between opium consumption and serum level of lead, the concentration of lead in dependents' serum was higher than controls. Further studies are needed to approve this relationship to be used for screening and on time diagnosis of opium dependents. Keywords: Opium, Addiction, Lead poisoning, Serum level
An Investigation of the Risk Factors of Osteoporosis and the Correlation between Opium Consumption and Osteoporosis in Adults
Background: Osteoporosis and osteopenia are the most common metabolic bone diseases making the patients vulnerable to bone fragility and fracture. In this study, the association of opium consumption and osteoporosis adjusted for other risk factors was studied.Methods: In this cross-sectional study, 619 cases including 73 men and 546 women referred to densitometry center in Kerman, Iran, were studied. Demographic information, history of opium consumption, medications, and other risk factors were collected using a structured questionnaire.Findings: In a univariate analysis, opium consumption, aging, and having a body mass index (BMI) lower than 24 accompanied an increased chance of osteoporosis, while taking physical exercises on a daily basis reduces the chance of osteoporosis. Through multivariable analysis, the two variables of age group and BMI group turned out to be of significance; that is, the chance of osteoporosis or osteopenia in the age group of higher than 60 years and 45-60 years being placed in one of the levels of osteoporosis or osteopenia was 4.9 and 3.1 times higher than the age groups lower than 45 years, respectively, after being adjusted to the other variables.Conclusion: Considering the results of this study, though the risk of bone density reduction in the individuals consuming opium was higher, due to the disparity between opium consumption in the two sexes, the difference was not significant between the two groups, and it is proposed that studies on larger samples and in the both sexes be conducted to determine the impacts of opium on the bone density
Potential of Human Umbilical Cord Matrix and Rabbit Bone Marrow–Derived Mesenchymal Stem Cells in Repair of Surgically Incised Rabbit External Anal Sphincter
PURPOSE: Anal sphincter defects and fecal incontinence
are complicated surgical problems. We investigated the
ability of human umbilical cord matrix (hUCM) and
rabbit bone marrow (rBM) stem cells to improve anal
sphincter incontinence due to induced sphincter defects
without surgical repair.
METHODS: We harvested hUCM cells from human
Wharton’s jelly and rBM stem cells from rabbit femurs
and tibias. To induce sphincter defects, we made an
incision in the external anal sphincter. Rabbits were
randomly allocated to 5 groups to receive either no
intervention (n � 3) or injections of 104 hUCM cells in
medium (10 �L RPMI-1640), rBM cells in medium,
medium only, or normal saline (n � 7 per group), 2
weeks after sphincterotomy. Transplanted cells were
tracked in the injured sphincters by prelabeling with
bromodeoxyuridine. Electromyography was performed
before and 2 weeks after the external anal
sphincterotomy, and 2 weeks after cell transplantation.
We also evaluated the proliferation and differentiation of
injected cells with histopathologic techniques.
RESULTS: Electromyography showed significant
improvement in sphincter function 2 weeks after local
injection of rBM stem cells compared with pretreatment
values and controls. Moderate, nonsignificant
improvement was observed with hUCM cell injection.
Cells with incorporated bromodeoxyuridine were
detected at the site of injury after transplantation of
hUCM and rBM. Histopathologic evaluation showed
normal or muscle-dominant sphincter structure in all
animals receiving rBM and fibrous-dominant sphincter
structure in most animals receiving hUCM.
CONCLUSIONS: Stem cell injection at the site of injury
can enhance contractile function of the anal sphincter
without surgical repair. Transplantation of stem cells,
particularly bone marrow mesenchymal cells, may
provide an effective tool for treating anal sphincter
injuries in humans
National population size estimation of illicit drug users through the network scale-up method in 2013 in Iran
Background: For a better understanding of the current situation of drug use in Iran, we utilized the
network scale-up approach to estimate the prevalence of illicit drug use in the entire country.
Methods: We implemented a self-administered, street-based questionnaire to 7535 passersby from the
general public over 18 years of age by street based random walk quota sampling (based on gender, age
and socio-economic status) from 31 provinces in Iran. The sample size in each province was
approximately 400, ranging from 200 to 1000. In each province 75% of sample was recruited from the
capital and the remaining 25% was recruited from one of the large cities of that province through
stratified sampling. The questionnaire comprised questions on demographic information as well as
questions to measure the total network size of participants as well as the network size in each of seven
drug use groups including Opium, Shire (combination of Opium residue and pure opium), Crystal
Methamphetamine, heroin/crack (which in Iranian context is a cocaine-free drug that mostly contains
heroin, codeine, morphine and caffeine with or without other drugs), Hashish, Methamphetamine/LSD/
ecstasy, and injecting drugs. The estimated size for each group was adjusted for transmission and barrier
ratios.
Results: The most common type of illicit drug used was opium with the prevalence of 1500 per 100,000
population followed by shire (660), crystal methamphetamine (590), hashish (470), heroin/crack (350),
methamphetamine, LSD and ecstasy (300) and injecting drugs (280). All types of substances were more
common among men than women. The use of opium, shire and injecting drugs was more common in
individuals over 30 whereas the use of stimulants and hashish was largest among individuals between
18 and 30 years of age.
Conclusion: It seems that younger individuals and women are more desired to use new synthetic drugs
such as crystal methamphetamine. Extending the preventive programs especially in youth as like as
scaling up harm reduction services would be the main priorities in prevention and control of substance
use in Iran. Because of poor service coverage and high stigma in women, more targeted programs in this
affected population are needed
HIV prevalence and continuum of care among incarcerated people in Iran from 2010 to 2017.
Symptom-Based Versus Laboratory-Based Diagnosis of Five Sexually Transmitted Infections in Female Sex Workers in Iran.
Network Location and Risk of Human Immunodeficiency Virus Transmission among Injecting Drug Users: Results of Multiple Membership Multilevel Modeling of Social Networks
Abstract
Background: Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models.
Methods: From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET software’s for the analysis of data.
Findings: The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score.
Conclusion: Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks.
Keywords: Social network analysis, Injecting drug users, Human immunodeficiency virus transmission risk, Network location, Ira
Relationship between a network’s indicators and basic factors with high-risk behavior of injection among injecting drug users (IDU) via the multiple membership multilevel model
Background: Among various methods and types of drug abuse, injection receives a great deal of importance
because of its related dangerous behavior and health consequences. It seemed that some of the network's
indicators affect dangerous behavior of injection.
Objective: To determine the relationship between a network's indicators and basic factors with high-risk
behavior of injection among injecting drug users (IDU) via the multiple memberships multilevel model.
Methods: In this cross-sectional study, the data related to 147 IDUs in Kerman province, who were interviewed
from October 2013 through March 2014, were used, and these addicts were chosen for interview from specific
resorts used for common injection. In this study, for analyzing data, multiple membership multilevel model and
MLwiN 2.02 software were used.
Results: In this study, the mean age of people, who were mostly men, was 37.2±9.02. Based on the result, it
becomes obvious that variables of in-degree with OR=1.49 (p=0.006) and the whole number of people related to
the person with OR=1.18 (p=0.003) influences the high-risk behavior of injection. Also, none of the demographic
variables influenced the high-risk behavior of injection.
Conclusion: Totally based on the results of this study, one can find a suitable method in the social network of
IDUs in order to create essential strategies, reducing the risk throughout the country. In addition, in minimum
time with fewer expenses, aggravation of dangerous behavior especially high-risk behavior of injection can be
prevented