Conspiracy Beliefs and Knowledge About HIV Origins Among Adolescents in Soweto, South Africa

We examined adolescents\u27 knowledge regarding the origin of HIV/AIDS and correlates of beliefs surrounding conspiracy theories in Soweto, South Africa. Now, a decade post-AIDS denialism, South Africa has the largest antiretroviral therapy roll-out worldwide. However, conspiracy theories stemming from past AIDS denialism may impact HIV prevention and treatment efforts

Effect of Composition on Electrical and Optical Properties of Thin Films of Amorphous GaxSe100−x Nanorods

We report the electrical and optical studies of thin films of a-GaxSe100−x nanorods (x = 3, 6, 9 and 12). Thin films of a-GaxSe100−x nanorods have been synthesized thermal evaporation technique. DC electrical conductivity of deposited thin films of a-GaxSe100−x nanorods is measured as a function of temperature range from 298 to 383 K. An exponential increase in the dc conductivity is observed with the increase in temperature, suggesting thereby a semiconducting behavior. The estimated value of activation energy decreases on incorporation of dopant (Ga) content in the Se system. The calculated value of pre-exponential factor (σ0) is of the order of 101 Ω−1 cm−1, which suggests that the conduction takes place in the band tails of localized states. It is suggested that the conduction is due to thermally assisted tunneling of the carriers in the localized states near the band edges. On the basis of the optical absorption measurements, an indirect optical band gap is observed in this system, and the value of optical band gap decreases on increasing Ga concentration

Lifetime Doctor-Diagnosed Mental Health Conditions and Current Substance Use Among Gay and Bisexual Men Living in Vancouver, Canada

BackgroundStudies have found that gay, bisexual, and other men who have sex with men (GBM) have higher rates of mental health conditions and substance use than heterosexual men, but are limited by issues of representativeness.ObjectivesTo determine the prevalence and correlates of mental health disorders among GBM in Metro Vancouver, Canada.MethodsFrom 2012 to 2014, the Momentum Health Study recruited GBM (≥16 years) via respondent-driven sampling (RDS) to estimate population parameters. Computer-assisted self-interviews (CASI) collected demographic, psychosocial, and behavioral information, while nurse-administered structured interviews asked about mental health diagnoses and treatment. Multivariate logistic regression using manual backward selection was used to identify covariates for any lifetime doctor diagnosed: (1) alcohol/substance use disorder and (2) any other mental health disorder.ResultsOf 719 participants, 17.4% reported a substance use disorder and 35.2% reported any other mental health disorder; 24.0% of all GBM were currently receiving treatment. A lifetime substance use disorder diagnosis was negatively associated with being a student (AOR = 0.52, 95% CI [confidence interval]: 0.27-0.99) and an annual income ≥$30,000 CAD (AOR = 0.38, 95% CI: 0.21-0.67) and positively associated with HIV-positive serostatus (AOR = 2.54, 95% CI: 1.63-3.96), recent crystal methamphetamine use (AOR = 2.73, 95% CI: 1.69-4.40) and recent heroin use (AOR = 5.59, 95% CI: 2.39-13.12). Any other lifetime mental health disorder diagnosis was negatively associated with self-identifying as Latin American (AOR = 0.25, 95% CI: 0.08-0.81), being a refugee or visa holder (AOR = 0.18, 95% CI: 0.05-0.65), and living outside Vancouver (AOR = 0.52, 95% CI: 0.33-0.82), and positively associated with abnormal anxiety symptomology scores (AOR = 3.05, 95% CI: 2.06-4.51).ConclusionsMental health conditions and substance use, which have important implications for clinical and public health practice, were highly prevalent and co-occurring

Methamphetamine use among people who use opioids : longitudinal patterns and the role of opioid agonist therapy

Background: Methamphetamine use is on the rise among people who use opioids (PWUO), which brings additional complexity to the landscape of opioid agonist therapy (OAT). However, the circumstances surrounding methamphetamine use among PWUO and the role of OAT in this context remain under-explored. The overarching aims of this dissertation were to: 1) understand the social context surrounding methamphetamine use among PWUO and 2) explore the interplay between methamphetamine use and OAT among PWUO. Methods: I first conducted a systematic review to synthesize the studies characterizing the trend of and factors associated with methamphetamine use among PWUO. Then, using empirical data obtained from two prospective cohorts of people who use drugs in Vancouver, Canada, between 2005 and 2020, I conducted multivariable generalized estimating equation (GEE) analyses to identify predictors of methamphetamine use initiation among individuals on OAT and examine the relationship between OAT engagement and methamphetamine use frequency among PWUO. Last, I employed repeated measures latent class analysis (RMLCA) to identify longitudinal substance use patterns among people receiving OAT, and used marginal structural Cox modeling to estimate their association with OAT discontinuation. Results: The systematic review found a wide range of individual, microsocial, and macrosocial factors associated with methamphetamine use among PWUO. The multivariable GEE analyses identified factors associated with methamphetamine initiation among individuals on OAT, including younger age, unstable housing, unprotected sex, previous methamphetamine use, recent cocaine use, and recent non-medical opioid use. Among PWUO, OAT engagement was associated with a lower methamphetamine use frequency in the absence of ongoing non-medical opioid use, while OAT initiation was associated with a greater methamphetamine use frequency. The RMLCA analysis identified four distinct substance use classes among people receiving OAT, with the opioid and stimulant use classes exhibiting a higher risk of OAT discontinuation. Conclusion: Addressing the ongoing overdose crisis requires comprehensive strategies encompassing prevention, intervention, and harm reduction efforts that consider both opioid and methamphetamine use. Care providers should adopt person-centred treatment approaches to meet the individualized needs of patients. Future research is needed to actively explore integrated treatment approaches and develop effective pharmaceutical interventions targeting concurrent opioid and methamphetamine use.Medicine, Faculty ofPopulation and Public Health (SPPH), School ofGraduat

Crystal Methamphetamine Use and Methadone Maintenance Treatment Dissatisfaction : A Prospective Cohort Study in Vancouver, Canada

Background: Patient satisfaction is key to the success of methadone maintenance treatment (MMT), and yet how MMT satisfaction is affected by the increasingly common use of crystal methamphetamine among people receiving opioid treatment remains poorly understood. We aimed to assess the association between crystal methamphetamine use and MMT dissatisfaction. Methods: We employed generalized estimating equations to examine the relationship between crystal methamphetamine use and MMT dissatisfaction among patients receiving MMT within two prospective cohorts in Vancouver, Canada between December 2016 and March 2020. Results: Of the 836 participants receiving MMT, the median age was 47 years, and 55.3% self-identified as male at baseline. In a multivariable model, those reporting more than weekly crystal methamphetamine use were more likely to report MMT dissatisfaction (Odds ratio: 1.40, 95% confidence interval: 1.05 – 1.86) compared to those reporting less than monthly crystal methamphetamine use. Conclusions: Among our sample of people receiving MMT, we noted a positive association of frequent crystal methamphetamine use with MMT dissatisfaction. Our study suggests a need for novel strategies to better understand and address frequent methamphetamine use among those receiving MMT, particularly given recent shifts in substance use patterns involving the rising co-use of methamphetamines and opioids.Medicine, Faculty ofNon UBCMedicine, Department ofPopulation and Public Health (SPPH), School ofReviewedFacultyResearche

Predictors of Crystal Methamphetamine Use Initiation or Re-initiation among People receiving Opioid Agonist Therapy : A Prospective Cohort Study

Background: In the context of the ongoing opioid crisis in the United States and Canada, opioid agonist therapy (OAT) is the first-line treatment for opioid use disorder. However, there is growing concern regarding the increasing methamphetamine use among those on OAT, as well as the impact of such use may have on OAT retention and outcomes. We sought to identify the predictors of crystal methamphetamine initiation or re-initiation among people on OAT, in order to facilitate the development of effective preventive strategies. Methods: We employed multivariable generalized estimate equations to identify the predictors of crystal methamphetamine use initiation or re-initiation among those who were on OAT within two prospective cohorts in Vancouver, Canada between 2005 and 2020. Results: Of the 1281 participants receiving OAT, the median age was 43 years, and 59.2% were male at baseline. During study follow-up, 564 (44.0%) initiated or re-initiated crystal methamphetamine use while receiving OAT. In a multivariable model, a higher crystal methamphetamine use initiation or re-initiation rate was positively associated with younger age, unstable housing, unprotected sex, history of crystal methamphetamine use, as well as recent cocaine, prescription opioid, and unregulated opioid use (all p < 0.05). Conclusions: We identified high and increasing rates of crystal methamphetamine use initiation or re-initiation among our sample of people on OAT. Intervention strategies including housing program referral, sexual risk reduction, and integrated treatment approaches targeting polysubstance use are urgently needed to reduce the risks associated with methamphetamine use as well as the co-use of methamphetamine and opioids.Medicine, Faculty ofNon UBCMedicine, Department ofPopulation and Public Health (SPPH), School ofReviewedFacultyPostdoctoralGraduat

The impact of the COVID-19 pandemic on access to supervised consumption programs

Background: Supervised consumption sites (SCS) and overdose prevention sites (OPS) have been increasingly implemented in response to the ongoing overdose epidemic in Canada. Although there has been a dramatic increase in overdose deaths since the start of the SARS-CoV 2 (COVID-19) pandemic, little is known about how SCS access may have been affected by this pandemic. Therefore, we sought to characterize potential changes in access to SCS during the COVID-19 pandemic among people who use drugs (PWUD) in Vancouver, Canada. Methods: Between June and December 2020, data were collected through the Vancouver Injection Drug Users Study (VIDUS) and the AIDS Care Cohort to Evaluate Exposure to Survival Services (ACCESS), two cohort studies involving people who use drugs. Multivariable logistic regression was used to examine individual, social and structural factors associated with self-reported reduced frequency of SCS/OPS use since COVID-19. Results: Among 428 participants, 223 (54.7%) self-identified as male. Among all individuals surveyed, 63 (14.8%) reported a decreased frequency of use of SCS/OPS since COVID-19. However, 281 (66%) reported that they “did not want to” access SCS in the last 6 months. In multivariable analyses, younger age, self-reported fentanyl contamination of drugs used and reduced ease of access to SCS/OPS since COVID-19 were positively associated with a decreased frequency of use of SCS/OPS since COVID-19 (all p < 0.05). Conclusions: Approximately 15% of PWUD who accessed SCS/OPS reported reduced use of these programs during the COVID-19 pandemic, including those at heightened risk of overdose due to fentanyl exposure. Given the ongoing overdose epidemic, efforts must be made to remove barriers to SCS access throughout public health crises.Health and Social Development, Faculty of (Okanagan)Medicine, Faculty ofOther UBCMedicine, Department ofSocial Work, School of (Okanagan)ReviewedFacultyResearche

Trends in cocaine and crystal methamphetamine injection over time in a Canadian setting between 2008 and 2018

Objective: Unregulated stimulant use is rising globally, though trends in use of cocaine and crystal methamphetamine (CM), the two most commonly used unregulated stimulants in North America, are poorly characterized in many settings. In this study we examined patterns and associations between the injection of cocaine and CM over time in an urban Canadian setting. Methods: Data were collected from two prospective cohorts of people who inject drugs in Vancouver, Canada, between 2008-2018. We applied a time series analysis, using multivariable linear regression to detect relationships between reported CM and cocaine injection and year, controlling for covariates. Cross-correlation was used to evaluate the relative trajectories of each substance over time. Results: Among 2056 participants, per annum rates of reported injection cocaine use declined significantly over the duration of this study from 45% to 18% (p < 0.001), while rates of CM injection increased from 17% to 32% (p < 0.001). Multivariable linear regression showed that recent CM injection was negatively associated with recent cocaine injection (β = -0.609, 95% CI = -0.750, -0.467). Cross-correlation demonstrated that injection CM use was associated with a decrease in the likelihood of cocaine injection 12 months later (p = 0.002). Conclusions: These findings demonstrate an epidemiological shift in patterns of injection stimulant use, with rising CM injection associated with a corresponding decrease in cocaine injection over time. The development of strategies to help treat and reduce harm among the growing population of people who inject CM is urgently required.Medicine, Faculty ofNon UBCMedicine, Department ofUnreviewedFacultyGraduat