Breaking News
October 16, 2018 - New research identifies modifiable dementia risk factor in elderly people
October 16, 2018 - Zebrafish study uncovers molecular ‘brake’ that helps control eye lens development
October 16, 2018 - Overlapping copy number variations underlie autism and schizophrenia in Japanese patients
October 16, 2018 - Majority of Americans’ ancestry can be traced through existing DNA databases
October 16, 2018 - Patients coerced into mental health care less likely to perceive treatment as effective
October 16, 2018 - What you need to know about autism spectrum disorder
October 16, 2018 - Antidepressants can be used to treat Alzheimer’s disease
October 16, 2018 - Study uncovers important role of PRMT1 in dilated cardiomyopathy
October 16, 2018 - Nutritional quality of breakfast linked to cardiovascular and metabolic risk factors in children
October 16, 2018 - Study uses novel approach to investigate genetic origins of mental illnesses
October 16, 2018 - Scientists develop dual anthrax-plague vaccine
October 16, 2018 - Poor Outcomes for Hispanic Infants With Congenital Heart Dz
October 16, 2018 - Global study finds youngest in class more likely to be diagnosed with ADHD
October 16, 2018 - Researchers sequence two selfish genes in the fungus Neurospora intermedia
October 16, 2018 - Survey results highlight the need for better communication between patients and HCPs about bacterial vaginosis
October 16, 2018 - Researchers develop fibrin-targeting immunotherapy to protect against neurodegeneration
October 16, 2018 - Researchers create open access database on healthy immunity
October 16, 2018 - Rice University chemist wins big award to study small surfaces
October 16, 2018 - Study finds 43% drop in stroke rate
October 16, 2018 - Researchers identify basic relationships of cell cycle and cellular senescence in the placenta
October 16, 2018 - UA professor receives NSF grant to develop antifouling materials for medical implants
October 16, 2018 - Obesity Doubles Odds for Colon Cancer in Younger Women
October 16, 2018 - Adults with ADHD not constrained in creativity
October 16, 2018 - Raising visibility for people and students with chronic illness and disability
October 16, 2018 - Allele awarded NIH grant to develop nanoantibody therapies for treatment of sepsis
October 16, 2018 - Only 59% of young adults undergoing surgery are fluid responsive
October 16, 2018 - Research points to potential new treatment for hearing loss
October 16, 2018 - MDI Biological Laboratory receives $1.2 million SEPA grant to promote data literacy
October 16, 2018 - Vast majority of dementia cases may arise from spontaneous genetic errors
October 16, 2018 - New project aims to deliver fast, effective treatment for autoimmune rheumatic diseases
October 16, 2018 - Study identifies molecular switch that controls fate of milk-producing breast cells
October 16, 2018 - Research shows diet has little influence on precursor to gout
October 16, 2018 - “Without Dr. Shumway doing his miracle work, three generations would not be here”: A Stanford heart transplant patient’s story
October 16, 2018 - Non-invasive brain stimulation sheds light on neurobiology underlying implicit bias
October 16, 2018 - Researchers demonstrate integrated technique to control production of cell therapeutics
October 16, 2018 - Breast tomosynthesis detects 34% more tumors than traditional mammography
October 16, 2018 - Rhode Island Hospital, Brown receive $800,000 grant to keep up fight against opioid epidemic
October 16, 2018 - UVA partners with health systems in AVIA network’s Medicaid Transformation Project
October 16, 2018 - Trevena Announces Oliceridine FDA Advisory Committee Meeting Outcome
October 16, 2018 - Study reveals early warning signs of heart problems in patients with newly diagnosed lupus
October 16, 2018 - Connecting the dots of Alzheimer’s disease
October 16, 2018 - New publication offers evidence-based content for global breast imaging medical community
October 16, 2018 - ‘EinsteinVision’ that improves hand-eye coordination of surgeons introduced at Harefield Hospital
October 16, 2018 - WRAIR clinical study evaluates safety and immunogenicity of Marburg vaccine
October 16, 2018 - Ketamine can be considered as alternative to opioids for short-term pain control in ED
October 16, 2018 - Endurance exercise training beneficially alters gut microbiota composition
October 15, 2018 - FDA Approves Yutiq (fluocinolone acetonide intravitreal implant) for Chronic Non-Infectious Posterior Segment Uveitis
October 15, 2018 - Birthing Options for Full-Term Pregnancy
October 15, 2018 - Stressed, toxic, zombie cells seen for first time in Alzheimer’s
October 15, 2018 - Concussion researchers study head motion in high school football hits | News Center
October 15, 2018 - Neuropsychiatric symptoms related to earliest stages of Alzheimer’s brain pathology
October 15, 2018 - Neck collar device may help protect the brain of female high school soccer players
October 15, 2018 - Research reveals how the inner ear processes speech
October 15, 2018 - Many parents still skeptical about safety and effectiveness of flu shot, survey finds
October 15, 2018 - Payer Policies May Discourage Non-Pharma Tx for Low Back Pain
October 15, 2018 - Exercise may delay cognitive decline in people with rare Alzheimer’s disease
October 15, 2018 - Researchers modify CRISPR to reorganize genome | News Center
October 15, 2018 - Innovative brain tumor operation set to tailor to patients’ needs
October 15, 2018 - Findings offer new insight into early changes that occur during AD pathology
October 15, 2018 - Neurons regulating reproductive hormone release have different activity in epileptic mice
October 15, 2018 - More parents are concerned about taking babies swimming in public pools
October 15, 2018 - Health Tip: Know the Risk Factors for Lower Back Pain
October 15, 2018 - Study shows cigarillo flavors enhanced by high-intensity sweeteners
October 15, 2018 - Study traces hospital-acquired bloodstream infections to patients’ own bodies | News Center
October 15, 2018 - Abnormal vision in childhood can affect development of brain areas responsible for attention
October 15, 2018 - Study highlights need for increased support for alcohol-related liver disease patients
October 15, 2018 - Color-changing contact lens could help doctors to monitor eye disease medications
October 15, 2018 - Tobacco heating products cause less staining to teeth than conventional cigarettes
October 15, 2018 - Young adults who are obese can expect to lose up to 10 years in life expectancy
October 15, 2018 - Scientists uncover how proteins meet on the cell membrane
October 15, 2018 - Affordable housing with supportive social services for senior citizens can reduce hospital use
October 15, 2018 - Schiller Easy Pulse Saves Lives
October 15, 2018 - The latest ECG device from Schiller
October 15, 2018 - Following a Tissue Sample
October 15, 2018 - Prisoners need drug and alcohol treatments but AA programs aren’t the answer
October 15, 2018 - Andrea Califano and Jordan Orange Elected to National Academy of Medicine
October 15, 2018 - The impending risk of African Swine Fever Virus
October 15, 2018 - Breastfeeding reduces the number of antibiotic-resistant bacteria in infant gut
October 15, 2018 - Researchers develop comprehensive molecular atlas of postnatal mouse heart development
October 15, 2018 - ObsEva SA Presents Clinical Data from Phase III IMPLANT 2 Trial of Nolasiban in IVF at the American Society of Reproductive Medicine (ASRM) Annual Meeting
HIV and a tale of a few cities

HIV and a tale of a few cities

image_pdfDownload PDFimage_print
HIV and a tale of a few cities
Limited drug law reform has had minimal effect on HIV infection rates among people who inject drugs, say researchers. Credit: Chris Brava

While global incidence rates of HIV have declined notably in recent years, the virus that causes AIDS remains a major and, in some ways largely unmitigated, public health threat in some countries and regions.

In a pair of new modeling studies, researchers at University of California San Diego School of Medicine, with international colleagues, examined how policy reform in terms of drug decriminalization (in Mexico) and access to drug treatment (in Russia) might affect two regions hard hit by the HIV pandemic: Tijuana, Mexico and the Russian cities of Omsk and Ekaterinburg.

In the most recent study, published August 16 in the journal Lancet Public Health, first author Annick Borquez, Ph.D., and senior author Natasha K. Martin, DPhil, in the Division of Infectious Diseases and Global Public Health at UC San Diego School of Medicine, and their collaborators evaluated the impact of public health-oriented drug law reforms on HIV incidence among people who inject drugs in Tijuana, Mexico.

In 2012, Mexico reformed its drug laws, decriminalizing possession of small amounts of specified drugs and instituting drug treatment instead of incarceration. However, implementation of the reforms has been uneven and limited. Borquez and colleagues looked at the specific impact of the reforms on HIV incidence among people who inject drugs in Tijuana, Mexico, a city adjacent to San Diego, California on the US-Mexico border and a major international drug trafficking route.

Modeling estimated that the limited reform implementation due to a lack of reform dissemination and operationalization prevented only 2 percent of new HIV infections between 2012 and 2017. “But going forward, if implementation reduced incarceration among people who inject drugs by 80 percent and instead diverted these individuals to evidence-based opioid agonist drug treatment, 21 percent of new HIV infections among people who inject drugs could be prevented between 2018 and 2030,” said Martin.

The study also highlighted the potential harms of inappropriate implementation.

“Unfortunately, the predominant type of drug ‘rehabilitation’ available in Tijuana is compulsory drug abstinence, which our modeling showed could potentially increase HIV transmission, underscoring the need for affordable evidence-based opioid agonist treatment which is effective at preventing HIV and other health harms,” said co-author Steffanie Strathdee, Ph.D., Harold Simon Professor in the Department of Medicine at UC San Diego School of Medicine and associate dean of global health sciences.

Said Borquez: “Monitoring and evaluation of public health-oriented drug law reforms is essential to inform their implementation at the local and global levels if we are to successfully guide this shift in drug policy.”

In the second study, published July 19 in Lancet HIV, first author Javier Cepeda, Ph.D., senior author Martin and colleagues employed epidemic modeling to determine the detrimental impact of Russian government policy prohibiting access to opiate agonist therapy, a key intervention used to prevent the risk of HIV and fatal overdose.

The study also explored how the potential benefits of scaled-up opiate agonist therapy, needle/syringe programs and antiretroviral therapy (ART) might have on preventing new HIV infections and fatal overdoses among people who inject drugs in Russia.

“Russia has one of the fastest growing HIV epidemics in the world. Data from the Joint United Nations Programme on HIV/AIDS estimates that 80 percent of new infections in Eastern Europe and central Asia occurred in Russia in 2015, fueled by injection drug use. And people who inject drugs in Russia have a very high risk of overdose,” said Martin.

“Opiate agonist therapy, which uses drugs like methadone to treat addiction and is highly effective at reducing the risk of HIV and overdose, is prohibited. Needle exchange programs are scarce and access to ART is very, very limited.”

The researchers found that without intervention, HIV prevalence among people who inject drugs in Omsk could increase to 34 percent by 2028 and remain even higher in Ekaterinburg at 61 percent. However, scaling up opiate agonist therapy and needle exchange programs to half of people who inject drugs and tripling ART recruitment (thus reaching approximately 65 percent of HIV-positive people who inject drugs) could prevent 53 percent of new HIV infections among people who inject drugs in Omsk and 38 percent of new HIV infections in Ekaterinburg by 2028. Additionally, these programs could prevent roughly 30 percent of fatal overdoses over this time period.

“The data are unequivocal,” said Martin. “Without intervention, modeling shows the burden of HIV among people who inject drugs in Russia will worsen, escalating in places like Omsk and remaining endemically high in places like Ekaterinburg. However, by implementing already known and proven interventions, HIV and overdose rates can be significantly reduced and many lives saved. The Russian government urgently needs to reverse its policies towards harm reduction access.”

These findings were also highlighted in a Lancet Commission report published July 19.


Explore further:
New research: High burden of hepatitis C among people who inject drugs

More information:
Annick Borquez et al. The effect of public health-oriented drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico: an epidemic modelling study, The Lancet Public Health (2018). DOI: 10.1016/S2468-2667(18)30097-5

Provided by:
University of California – San Diego

Tagged with:

About author

Related Articles