The social production of substance abuse and HIV/HCV risk: an exploratory study of opioid-using immigrants from the former Soviet Union living in New York City

<p>Abstract</p> <p>Background</p> <p>Several former Soviet countries have witnessed the rapid emergence of major epidemics of injection drug use (IDU) and associated HIV/HCV, suggesting that immigrants from the former Soviet Union (FSU) may be at heightened risk for similar problems. This exploratory study examines substance use patterns among the understudied population of opioid-using FSU immigrants in the U.S., as well as social contextual factors that may increase these immigrants' susceptibility to opioid abuse and HIV/HCV infection.</p> <p>Methods</p> <p>In-depth interviews were conducted with 10 FSU immigrants living in New York City who initiated opioid use in adolescence or young adulthood, and with 6 drug treatment providers working with this population. Informed by a grounded theory approach, interview transcripts were inductively coded and analyzed to identify key themes.</p> <p>Results</p> <p>The "trauma" of the immigration/acculturation experience was emphasized by participants as playing a critical role in motivating opioid use. Interview data suggest that substance use patterns formed in the high-risk environment of the FSU may persist as behavioral norms within New York City FSU immigrant communities - including a predilection for heroin use among youth, a high prevalence of injection, and a tolerance for syringe sharing within substance-using peer networks. Multiple levels of social context may reproduce FSU immigrants' vulnerability to substance abuse and disease such as: peer-based interactional contexts in which participants typically used opioids; community workplace settings in which some participants were introduced to and obtained opioids; and cultural norms, with roots in Soviet-era social policies, stigmatizing substance abuse which may contribute to immigrants' reluctance to seek disease prevention and drug treatment services.</p> <p>Conclusion</p> <p>Several behavioral and contextual factors appear to increase FSU immigrants' risk for opioid abuse, IDU and infectious disease. Further research on opioid-using FSU immigrants is warranted and may help prevent increases in HIV/HCV prevalence from occurring within these communities.</p

The Pharmacological Examination of D-Cycloserine and Abilify following Chronic MK801 Administration in Mice

Although mental illnesses are common problems in today’s society, there are few effective treatments for the multiple symptoms of schizophrenia and anxiety. Both mental illnesses have been shown to result in cognitive deficits in learning and memory, and decreased activity levels. The only current treatments for these illnesses are antipsychotic medicine for schizophrenia, and CBT, Exposure Therapy, and anti-anxiety medicine for anxiety. However, a newly discovered antibiotic, D-Cycloserine, and Abilify, are thought to be effective treatments. These drugs can be tested easily on mice that have been given MK801, a drug that induces the cognitive deficits seen in these disorders. The purpose of this study is to find out if DCS reduces cognitive deficits and increases activity levels associated with anxiety and schizophrenia-like symptoms in mice and to determine if Abilify will enhance the treatment of these disorders when combined with DCS in mice. Methodology included testing the mice in a maze and an activity chamber. Data collected included errors and time in the maze, and moves and move time, jumps, stereotypy, and rest time in the activity chamber. Data was analyzed through a series of ANOVAs and T-Tests. It was found that neither drug had a significant effect on activity levels or cognitive functioning separately. However, when combined, the drugs significantly improved cognitive functioning and increased activity levels, indicating that the drugs appear to only work in combination, and are not helpful alone

An emerging HIV risk environment: a preliminary epidemiological profile of an MSM POZ Party in New York City

Objective: To develop a preliminary epidemiological description of a men who have sex with men (MSM) "POZ Party," an emerging sex environment for HIV+ MSM. Methods: As part of a pilot study in New York City in 2003, data were collected using a brief, behavioural intercept survey at entry to POZ Party events. Domains include demographic characteristics, history of HIV infection, motivations for attending POZ parties, lifetime and recent exposure to drugs (including use during POZ Party events), and recent sexual practices (both within both POZ Party venues as well as in non-POZ Party venues). Results: Predominantly white and over the age of 30, subjects in the sample include a broad range of years living with HIV infection. Motivations for using a POZ Party venue for sexual partnering include relief from burdens for serostatus disclosure, an interest in not infecting others, and opportunities for unprotected sexual exchange. High rates of unprotected sex with multiple partners are prevalent in the venue. Although the sample evidences high rates of lifetime exposure to illicit drugs, relatively little drug use was reported in these sexual environments. These reports are consistent with evidence from direct observation at the venues themselves, in which no drug use was apparent. Conclusion: Serosorting among HIV+ MSM may reduce new HIV infections, a stated interest of both POZ Party organisers and participants alike. However, high rates of unprotected anal intercourse within these venues signal continued risk for STIs. Additionally, unprotected sexual contact with HIV partners and status unknown partners outside POZ Party venues heightens concern for diffusion of HIV superinfection

Emotional distress among frontline research staff.

Public health research frequently deals with sensitive topics. A growing body of evidence suggests that frontline researchers who elicit or process participants traumatic experiences are themselves at risk of developing emotional distress or secondary trauma from daily immersion in these data. This both threatens a studys data quality and calls into question how the harms and benefits of conducting research are distributed across a study team. The objective of this study was to explore how frontline research staff in Eswatini experience and process emotional distress as part of their daily work and to describe potential strategies for resilience and coping using qualitative research methods. We conducted 21 in-depth interviews with informants who had worked in data collection, data entry, and transcription on a number of sensitive topics, including HIV, sex work, and LGBT health. We found that emotional distress is a salient experience among frontline research staff working in Eswatini. This distress stems from conducting research against a generalized backdrop of high rates of HIV, violence, and poverty, particularly since research staff are drawn from affected communities and have their own firsthand knowledge of the phenomena they are studying. Moreover, the qualities study staff are often hired for - empathy, compassion, and emotional intelligence - are also traits that may increase their likelihood of feeling distressed by the narratives they encounter in their work. The workplace can serve as a prism, exacerbating or potentially mitigating these risks into harm at the individual, interpersonal, and community level. While not all study teams may have access to formal mental health services, several informants recommended incorporating regular meetings with a trained counselor as part of the overall project. Others recommended building time for team-building or debriefing conversations into the normal workweek, a strategy that would address both the issue of workload and could bolster the already existent strategy of relying on team members for mental health support

Epigenetic dysregulation in advanced kidney cancer: Opportunities for therapeutic interventions

Understanding the complex epigenome of advanced renal cell carcinoma may lead to novel epigenomic-based pharmaceutical strategies and identify new targets for therapeutic interventions. Epigenetic changes, such as DNA methylation and histone acetylation, modulate the activity of significant oncogenic signaling pathways by regulating gene expression. Such pathways include the WNT-ß-catenin pathway, the von Hippel-Lindau-hypoxia-inducible factor pathway, and epithelial-mesenchymal transition pathway. Common genetic alterations in histone modifier genes in renal cell carcinoma may not only be responsible for the pathogenesis of this disease but also represent potential biomarkers of response to immunotherapies. Rational combinations strategies with histone deacetylase inhibitors are being tested in clinic trials. Renal cell carcinoma represents an ideal setting to dissect the epigenetic-driven changes in the tumor microenvironment that modulate the response to targeted therapies

Effectiveness of self-testing kits availability on improving HIV testing frequency for chinese men who have sex with men and their sexual partners: a protocol for a multicenter randomised controlled trial.

INTRODUCTION:HIV epidemic is increasing among men who have sex with men (MSM) in China, yet HIV testing uptake remains low. As an emerging approach, HIV self-testing (HIVST) has the potential to promote HIV testing coverage and frequency in this population. However, evidence of the effectiveness on implementation of HIVST among Chinese MSM and their sexual partners is scarce. METHODS AND ANALYSIS:The randomised controlled trial will be performed in Changsha, Changde, Shaoyang and Yiyang, Hunan province, China, recruiting 184 recent testers (men who had at least one HIV test within the past 2 years) and 26 non-recent testers (men who did not have HIV tests within 2 years or never had an HIV test). Eligible men will be randomly divided 1:1 into two groups: intervention (with free HIVST kits plus site-based HIV testing services) and control (site-based HIV testing services only). Participants in the intervention group will be provided with two free finger-prick-based HIVST kits, and can apply for two to four kits every 3 months for 1 year.Participants in both groups will complete questionnaires via WeChat at five separate times: baseline, third, sixth, ninth and twelfth month. The primary outcome is the mean number of HIV tests for MSM over the 12-month study period. The secondary outcome is the mean number of HIV tests for sexual partners of MSM over the 12-month study period. The tertiary outcomes are the self-reported proportion of consistent condom usage for anal sex, and the numbers of sexual partners during the 12-month study period. ETHICS AND DISSEMINATION:The study has been approved by the Institutional Review Board of Behavioural and Nursing Research in Xiangya School of Nursing of Central South University, China (2018002). Study results will be disseminated through conferences and academic journals. TRIAL REGISTRATION NUMBER:ChiCTR1800015584; Pre-results