Accessing methadone within Moldovan prisons: Prejudice and myths amplified by peers.

BACKGROUND: The volatile HIV epidemic in Moldova, driven primarily by people who inject drugs (PWIDs), is concentrated in prisons. Although internationally recommended opioid agonist therapy (OAT) is available in Moldovan prisons, coverage remains inadequate and expansion efforts have failed to meet national and international goals. METHODS: To better understand why eligible prisoners are reluctant to initiate OAT, we surveyed recently released prisoners who met criteria for opioid dependence and compared those who had and had not been enrolled in within-prison OAT (N=56) using standardized scales on OAT knowledge and attitudes as well as within-prison harassment experiences. RESULTS: Knowledge about OAT was similar between both groups, but this knowledge and myths about OAT had independent and opposite direct effects on OAT attitudes. Those who were enrolled in OAT in prison were significantly more likely to perceive it as an effective form of treatment and had more tolerable attitudes toward OAT but were also more likely to have been bullied and to express concerns about their personal safety. Prisoners who had not been enrolled in OAT were more likely to endorse negative myths about methadone; only one person among them intended to receive OAT in the future. CONCLUSION: In Moldovan prisons, OAT enrollment and treatment continuation are influenced by ideological biases and myths that are largely formed, amplified, and reinforced behaviorally in restricted prison settings. Future interventions that expand OAT in prisons should target individual-level ideological prejudices and myths, as well as the prison environment.<br/

Deer Meat as the Source for a Sporadic Case of Escherichia coli O157:H7 Infection, Connecticut1

We report a case of Escherichia coli O157:H7, which was acquired by eating wild White-Tailed deer (Odocoileus virginianus). DNA fingerprint analysis verified venison as the source of infection. This pediatric case emphasizes the need for dissemination of information to hunters regarding the safe handling and processing of venison

Consumer Attitudes and Use of Antibiotics

Recent antibiotic use is a risk factor for infection or colonization with resistant bacterial pathogens. Demand for antibiotics can be affected by consumers’ knowledge, attitudes, and practices. In 1998–1999, the Foodborne Diseases Active Surveillance Network (FoodNet) conducted a population-based, random-digit dialing telephone survey, including questions regarding respondents’ knowledge, attitudes, and practices of antibiotic use. Twelve percent had recently taken antibiotics; 27% believed that taking antibiotics when they had a cold made them better more quickly, 32% believed that taking antibiotics when they had a cold prevented more serious illness, and 48% expected a prescription for antibiotics when they were ill enough from a cold to seek medical attention. These misguided beliefs and expectations were associated with a lack of awareness of the dangers of antibiotic use; 58% of patients were not aware of the possible health dangers. National educational efforts are needed to address these issues if patient demand for antibiotics is to be reduced

Women\u27s Discourse on the Homeless Experience: It\u27s About Love and Loss

Physical Health, Abuse, Mental Illness, Loss, Instability, and Substance Use; the lives of homeless women are shaped by multiple interwoven domains. They confront extreme loss and destructive relationships throughout their lives. This dissertation addresses this syndemic (PHAMILIS) through an ethnography of homeless women staying at a rural emergency shelter in Northeastern Connecticut. My aim was to understand, through narratives, the life trajectories of homeless women, the experiences leading to their current state, and their perceptions of homelessness. My research involved interviewing 30 homeless women staying at the emergency shelter and 13 housing service providers throughout Connecticut. The purpose of the interviews was to hear and share the women’s stories and to gain insight into their conceptualization of homelessness. The provider interviews further contextualized the perception of homeless women. My research illuminated predisposing, exacerbating, and intervening factors that the women shared. They led complex, unstable lives growing up in various levels of poverty with dysfunctional families often rife with abuse and frequent relocation. Multiple, complex issues such as physical health problems, mental illness, substance use disorders, and abuse (sexual, physical, or emotional) exacerbated their homeless situation. Other factors intervened to interrupt their lives, including early parenthood, lack of education, Department of Children and Families involvement, custody battles, incarceration, and disability. The PHAMILIS syndemic elucidates the interrelatedness of factors that create the homeless experience and will help to inform how we strive to address the complex issues that affect the health and well-being of homeless women and the issue of homelessness itself

Effect of social relationships on antiretroviral medication adherence for people living with HIV and substance use disorders and transitioning from prison

Background: This paper examines how family and social relations facilitate and inhibit adherence to antiretroviraltherapy (ART) for people living with HIV (PLH) who have underlying substance use disorders and are transitioningto the community post-incarceration. Methods: Combining the methods of inductive close reading and constantcomparison, we analyzed the data from 30 semi-structured interviews of PLH who had recently transitioned to thecommunity within the previous 90 days. Results: Three central themes were anticipated as important socialrelationships post-release: self-reported family, friends and clinicians. Among these, four sub-themes (social isolation, ‘double jeopardy’, search for belonging, and trust and respect) emerged, highlighting how they impacted ART adherence. Post-release, participants returned to resource-poor communities where they experienced socialisolation. ART adherence was enabled by having a purpose in life, which correlated with having robust family support structures. Many former prisoners felt that a chasm between them and their families existed, both because of HIV stigma and their addiction problems. In this context, relationships with untrustworthy friends from their druguse networks led to relapse of drug use and risky behaviors, jeopardizing participants’ ART adherence and persistence. To avoid the double jeopardy, defined as seeking friends for support but who were also the ones who contributed to drug relapse, participants searched for new social anchors, which often included their healthcare providers who represented trusted and respected persons in their life. Conclusions: While some former prisonersperceived doctors as uncaring and their relationships asymmetrical, positive relationships with these providers,when respect and trust was mutual, reinforced the participants’ sense of belonging to what they called ‘the world that don’t do drugs’ and motivated them to adhere to ART

HIV transmission in the health care setting : specialty session transcript

Meeting: International Conference on AIDS, 5th, 4-9 June, 1989, Montreal, QC, CAPresenters: Ruthanne Marcus, Mary E. Chamberland, David N. Cowan, Gabor D. Kelen, V.V. Pokrovsk

HIV transmission in the health care setting : specialty session

Meeting: International Conference on AIDS, 5th, 4-9 June, 1989, Montreal, QC, CAPresenters: Ruthanne Marcus, Mary E. Chamberland, David N. Cowan, Gabor D. Kelen, V.V. Pokrovsk