HIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg, Russian Federation

We examined the prevalence of HIV disclosure to sexual partners by HIV-positive drug injectors (IDUs) in St. Petersburg, Russia and compared the magnitude and direction of associations of condom use with awareness of one’s HIV infection and disclosure to partners. Among 157 HIV-infected participants, awareness of infection at time of last intercourse was associated with condom use with partners perceived to be HIV-negative (aOR 6.68, 95% CI 1.60–27.88). Among the 70 participants aware of their infection prior to enrolment, disclosure to potentially uninfected sexual partners was independently and negatively associated with condom use (aOR 0.13, 95% CI 0.02–0.66). Disclosure was independently associated with having injected ≥9 years (aOR 6.04, 95% CI 1.53–23.77) and partnership with another IDU (aOR 3.61, 95% CI 1.44–9.06) or HIV-seropositive (aOR 45.12, 95% CI 2.79–730.46). Scaling up HIV testing services and interventions that increase the likelihood of individuals receiving their test results is recommended

A Scoping Review of Home Produced Heroin and Amphetamine Type Stimulant Substitutes: Implications for Prevention, Treatment and Policy

Several home-produced substances such as krokodil and boltushka are prevalent in many Eastern European countries. Anecdotal reports of its use have been circulating in Germany and Norway; however, this has not been confirmed. Its use has also been reported by the media in the USA, although only one confirmed report of its use exists. Home-produced drugs are associated with high levels of morbidity and a number of complex health issues such as the spread of blood borne viruses, gangrene, and internal organ damage. The high incidence of HIV rates amongst people who inject home-produced substances is a public health concern. The resulting physical health consequences of injecting these crude substances are very severe in comparison to heroin or amphetamine acquired in black markets. Due to this fact and the increased mortality associated with these substances, professionals in the area of prevention, treatment, and policy development need to be cognisant of the presentation, harms, and the dangers associated with home-produced substances globally. This scoping review aimed to examine existing literature on the subject of home-produced heroin and amphetamine-type stimulant substitutes. The review discussed the many implications such research may have in the areas of policy and practice. Data were gathered through the use of qualitative secondary resources such as journal articles, reports, reviews, case studies, and media reports. The home production of these substances relies on the utilisation of precursor drugs such as less potent stimulants, tranquillizers, analgesics, and sedatives or natural plant ingredients. The Internet underpins the facilitation of this practice as recipes, and diverted pharmaceutical sales are available widely online, and currently, ease of access to the Internet is evident worldwide. This review highlights the necessity of prevention, education, and also harm reduction related to home-produced drugs and also recommends consistent monitoring of online drug fora, online drug marketplaces, and unregulated pharmacies

Experimental data and analysis to support the design of an ion-exchange process for the treatment of Hanford tank waste supernatant liquids

Hanford`s 177 underground storage tanks contain a mixture of sludge, salt cake, and alkaline supernatant liquids. Disposal options for these wastes are high-level waste (HLW) glass for disposal in a repository or low-level waste (LLW) glass for onsite disposal. Systems-engineering studies show that economic and environmental considerations preclude disposal of these wastes without further treatment. Difficulties inherent in transportation and disposal of relatively large volumes of HLW make it impossible to vitrify all of the tank waste as HLW. Potential environmental impacts make direct disposal of all of the tank waste as LLW glass unacceptable. Although the pretreatment and disposal requirements are still being defined, most pretreatment scenarios include retrieval of the aqueous liquids, dissolution of the salt cakes, and washing of the sludges to remove soluble components. Most of the cesium is expected to be in the aqueous liquids, which are the focus of this report on cesium removal by ion exchange. The main objectives of the ion-exchange process are removing cesium from the bulk of the tank waste (i.e., decontamination) and concentrating the separated cesium for vitrification. Because exact requirements for removal of {sup 137}Cs have not yet been defined, a range of removal requirements will be considered. This study addresses requirements to achieve {sup 137}Cs levels in LLW glass between (1) the Nuclear Regulatory Commission (NRC) Class C (10 CFR 61) limit of 4600 Ci/m{sup 3} and (2) 1/10th of the NRC Class A limit of 1 Ci/m{sup 3} i.e., 0.1/m{sup 3}. The required degrees of separation of cesium from other waste components is a complex function involving interactions between the design of the vitrification process, waste form considerations, and other HLW stream components that are to be vitrified