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0000-0002-2259-735X
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UNSW Sydney
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Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2021
DOI: 10.26190/A8E5-5838
Publisher: NDARC, Sydney
Date: 2021
DOI: 10.26190/T6SH-G213
Publisher: Wiley
Date: 20-02-2022
DOI: 10.1111/DAR.13448
Abstract: People who inject drugs may be at higher risk of COVID‐19 transmission and more severe negative health outcomes following COVID‐19 infection. Early research on hypothetical COVID‐19 vaccines suggests this population may be less likely to accept vaccination. This commentary extends this research by presenting vaccine intention data from Illicit Drug Reporting System interviews conducted in June–July 2021, in the early stages of vaccine rollout, with people in Australia who inject drugs ( N = 888). Half the s le (48%, n = 419) reported that they were hesitant to receive the COVID‐19 vaccine, with key barriers relating to vaccine safety and side effect concerns. This level of hesitancy is substantially higher than that of the general population at a similar time. While we note that the subsequent Delta variant‐driven third wave of cases in Australia and efforts to increase population vaccination coverage may have altered intent in this group, this level of hesitancy warrants a targeted strategy to mitigate vaccine‐related concerns and maximise uptake. Ideally, this should comprise an inclusive health response that is peer‐led, with peer‐based organisations ideally positioned to direct immunisation service delivery and provide vaccine‐related messaging.
Publisher: Cambridge University Press (CUP)
Date: 2022
DOI: 10.1017/S0950268822001157
Abstract: Natural infection with the influenza virus is believed to generate cross-protective immunity across both types and subtypes. However, less is known about the persistence of this immunity and thus the susceptibility of in iduals to repeat infection. We used 13 years (2005–2017) of surveillance data from Queensland, Australia, to describe the incidence and distribution of repeat influenza infections. Consecutive infections that occurred within 14 days of prior infection were considered a mixed infection those that occurred more than 14 days later were considered separate (repeat) infections. Kaplan-Meier plots were used to investigate the probability of reinfection over time and the Prentice, Williams and Peterson extension of the Cox proportional hazards model was used to assess the association of age and gender with reinfection. Among the 188 392 notifications received during 2005–2017, 6165 were consecutively notified for the same in idual (3.3% of notifications), and 2958 were mixed infections (1.6%). Overall, the probability of reinfection was low: the cumulative incidence was % after one year, 4.6% after five years, and 9.6% after ten years. The majority of consecutive infections were the result of two type A infections (43%) and were most common among females (adjusted hazard ratio (aHR): 1.15, 95% confidence interval (CI) 1.09–1.21), children aged less than 5 years (relative to adults aged 18–64 years aHR: 1.58, 95% CI 1.47–1.70) and older adults aged at least 65 years (aHR: 1.35 95% CI 1.24–1.47). Our study suggests consecutive infections are possible but rare. These findings have implications for our understanding of population immunity to influenza.
Publisher: Wiley
Date: 21-02-2023
DOI: 10.1111/DAR.13621
Abstract: We aimed to describe COVID‐19 vaccination attitudes and identify potential facilitators for vaccine uptake among people who inject drugs. People who inject drugs were recruited from all eight Australian capital cities ( N = 884 65% male, mean age 44 years) and interviewed face‐to‐face or via telephone in June–July 2021. COVID‐19 and broader vaccination attitudes were used to model latent classes. Correlates of class membership were assessed through multinomial logistic regression. Probability of endorsing potential vaccination facilitators were reported by class. Three classes of participants were identified: ‘vaccine acceptant' (39%), ‘vaccine hesitant' (34%) and ‘vaccine resistant' (27%). Those in the hesitant and resistant groups were younger, more likely to be unstably housed and less likely to have received the current season influenza vaccine than the acceptant group. In addition, hesitant participants were less likely to report a chronic medical condition than acceptant participants. Compared to vaccine acceptant and hesitant participants, vaccine‐resistant participants were more likely to predominantly inject meth hetamine and to inject drugs more frequently in the past month. Both vaccine‐hesitant and resistant participants endorsed financial incentives for vaccination and hesitant participants also endorsed facilitators related to vaccine trust. People who inject drugs who are unstably housed or predominantly inject meth hetamine are subgroups that require targeted interventions to increase COVID‐19 vaccination uptake. Vaccine‐hesitant people may benefit from interventions that build trust in vaccine safety and utility. Financial incentives may improve vaccine uptake among both hesitant and resistant people.
Publisher: Wiley
Date: 23-05-2022
DOI: 10.1111/DAR.13468
Abstract: To describe trends in meth hetamine use, markets and harms in Australia from 2003 to 2019. Data comprised patterns of use and price from sentinel s les of people who inject drugs and who use MDMA/other illicit stimulants and population‐level hetamine‐related police seizures, arrests, hospitalisations, treatment episodes and deaths from approximately 2003 to 2019. Bayesian autoregressive time‐series models were analysed for: no change constant rate of change and change over time differing in rate after one to three changepoints. Related indicators were analysed post hoc with identical changepoints. The percentage of people who inject drugs reporting weekly use increased from 2010 to 2013 onwards, while use among s les of people who regularly use ecstasy and other illicit stimulants decreased. Seizures and arrests rose steeply from around 2009/10 to 2014/15 and subsequently plateaued. Price increased ($15.9 [95% credible interval, CrI $9.9, $28.9] per point of crystal per year) from around 2009 to 2011, plateauing and then declining from around 2017. Hospitalisation rates increased steeply from around 2009/10 until 2015/16, with a small subsequent decline. Treatment also increased (19.8 episodes [95% CrI 13.2, 27.6] with hetamines as the principal drug of concern per 100 000 persons per year) from 2010/11 onwards. Deaths involving hetamines increased (0.285 per 100 000 persons per year) from 2012 until 2016. These findings suggest that problematic meth hetamine use and harms escalated from 2010 to 2012 onwards in Australia, with continued demand and a sustained market for meth hetamine. [Correction added on 30 May 2022, after first online publication: In the Abstract under ‘Discussion and Conclusions’ ‘onwards’ has been added after … 2010 to 2012].
Publisher: Elsevier BV
Date: 08-2023
Publisher: NDARC
Date: 2021
DOI: 10.26190/AJDP-3855
Publisher: Cambridge University Press (CUP)
Date: 2019
DOI: 10.1017/S0950268819001055
Abstract: Several studies have reported evidence of interference between respiratory viruses: respiratory viruses rarely reach their epidemic peak concurrently and there appears to be a negative association between infection with one respiratory virus and co-infection with another. We used results spanning 16 years (2002–2017) of a routine diagnostic multiplex panel that tests for nine respiratory viruses to further investigate these interactions in Victoria, Australia. Time series analyses were used to plot the proportion positive for each virus. The seasonality of all viruses included was compared with respiratory syncytial virus (RSV) and influenza A virus using cross-correlations. Logistic regression was used to explore the likelihood of co-infection with one virus given infection with another. Seasonal peaks were observed each year for influenza A and RSV and less frequently for influenza B, coronavirus and parainfluenza virus. RSV circulated an average of 6 weeks before influenza A. Co-infection with another respiratory virus was less common with picornavirus, RSV or influenza A infection. Our findings provide further evidence of a temporal relationship in the circulation of respiratory viruses. A greater understanding of the interaction between respiratory viruses may enable better prediction of the timing and magnitude of respiratory virus epidemics.
Publisher: NDARC, Sydney
Date: 2022
DOI: 10.26190/5CZP-AF24
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.DRUGPO.2021.103334
Abstract: Colorimetric reagent kits can provide information about the compounds present in drug s les. This study aimed to identify patterns and correlates of colorimetric reagent kit use, as well as behavioural outcomes of testing, amongst people who use illegal stimulants in a context that lacks permanent government-sanctioned drug checking services. Australians residing in capital cities who reported regularly using ecstasy/MDMA and/or other illegal stimulants ≥monthly in the past six months were recruited via social media and word-of-mouth from April-July 2019 (N = 792). Participants were asked about testing the contents and/or purity of illegal drugs, and features of last colorimetric reagent kit use. Logistic regression identified correlates of last using a kit (referent: no use of drug checking technology to test drug contents urity in the past year). Over one-third (36%) reported testing drug contents and/or purity of this group, 86% had last used a colorimetric reagent kit. On the last occasion, 52% reported someone else had conducted testing 58% said testing occurred <24 h before planned drug use and 24% reported testing for quantity of a substance. Correlates of drug checking comprised: being younger, male, past six-month use of new psychoactive substances, accessing community-based health services for alcohol or other drug reasons, selling drugs for cash profit, obtaining information from peers who had tried the drug, and searching online for reports of the drug by st /appearance. The majority (84%) tested a substance they had been sold and/or given as MDMA of these, 87% detected MDMA. Of those who expected and detected MDMA, 29% and 11% reported results to their peers and dealer, respectively. People who use ecstasy/MDMA and/or other illegal stimulants seek out objective information about substance contents. In countries that lack permanent government-sanctioned drug checking services, it is important to acknowledge that people already engage in drug checking but with suboptimal technologies and without tailored specialist advice and education.
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2021
DOI: 10.26190/JPXH-T685
Publisher: SAGE Publications
Date: 2019
Abstract: Vaccination is the most practical means available for preventing influenza. Influenza vaccines require frequent updates to keep pace with antigenic drift of the virus, and the effectiveness, and sometimes the safety, of the vaccine can therefore vary from season to season. Three key populations that the World Health Organization recommends should be prioritized for influenza vaccination are pregnant women, children younger than 5 years of age and the elderly. This review discusses the burden of influenza and the safety and effectiveness profile of influenza vaccines recommended for these groups.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Australian Government Department of Health
Date: 16-03-2020
Abstract: As part of its role in the World Health Organization’s (WHO) Global Influenza Surveillance and Response System (GISRS), the WHO Collaborating Centre for Reference and Research on Influenza in Melbourne received a total of 3993 human influenza-positive s les during 2018. Viruses were analysed for their antigenic, genetic and antiviral susceptibility properties. Selected viruses were propagated in qualified cells or hens’ eggs for use as potential seasonal influenza vaccine virus candidates. In 2018, influenza A(H1)pdm09 viruses predominated over influenza A(H3) and B viruses, accounting for a total of 53% of all viruses analysed. The majority of A(H1)pdm09, A(H3) and influenza B viruses analysed at the Centre were found to be antigenically similar to the respective WHO-recommended vaccine strains for the Southern Hemisphere in 2018. However, phylogenetic analysis indicated that a significant proportion of circulating A(H3) viruses had undergone genetic drift relative to the WHO-recommended vaccine strain for 2018. Of 2864 s les tested for susceptibility to the neuraminidase inhibitors oseltamivir and zanamivir, three A(H1)pdm09 viruses showed highly reduced inhibition by oseltamivir, while one B/Victoria virus showed highly reduced inhibition by both oseltamivir and zanamivir.
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2020
Publisher: NDARC, Sydney
Date: 2021
DOI: 10.26190/4P6R-JQ88
Publisher: Wiley
Date: 24-02-2021
DOI: 10.1111/DAR.13252
Abstract: This paper aims to describe cocaine use, markets and harms in Australia from 2003 to 2019. Outcome indicators comprised prevalence of use from triennial household surveys patterns of use from annual surveys of sentinel s les who use stimulants and cocaine‐related seizures, arrests, hospitalisations, deaths and treatment episodes. Bayesian autoregressive time‐series analyses were conducted to estimate trend over time: Model 1, no change Model 2, constant rate of change and Model 3, change over time differing in rate after one change point. Past‐year population prevalence of use increased over time. The percentage reporting recent use in sentinel s les increased by 6.1% (95% credible interval [CrI 95% ] 1.2%,16.9% Model 3) per year from around 2017 (48%) until the end of the series (2019: 67%). There was a constant annual increase in number of seizures (count ratio: 1.1, CrI 95% 1.1,1.2) and arrests (1.2, CrI 95% 1.1,1.2), and percentage reporting cocaine as easy to obtain in the sentinel s les (percent increase 1.2%, CrI 95% 0.5%,1.8% Model 2). Cocaine‐related hospitalisation rate increased from 5.1 to 15.6 per 100 000 people from around 2011–2012 to 2017–2018: an annual increase of 1.3 per 100 000 people (CrI 95% 0.8,1.8 Model 3). While the death rate was low (0.23 cocaine‐related deaths per 100 000 people in 2018 Model 2), treatment episodes increased from 3.2 to 5.9 per 100 000 people from around 2016–2017 to 2017–2018: an annual increase of 2.9 per 100 000 people (CrI 95% 1.6,3.7 Model 3). Cocaine use, availability and harm have increased, concentrated in recent years, and accompanied by increased treatment engagement.
Publisher: Elsevier BV
Date: 09-2021
Publisher: NDARC
Date: 2021
DOI: 10.26190/3ZKA-N925
Publisher: NDARC
Date: 2021
DOI: 10.26190/T5TS-XE27
Publisher: Wiley
Date: 03-2021
DOI: 10.1111/DAR.13273
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2020
Publisher: NDARC
Date: 2021
DOI: 10.26190/JH3S-V404
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2019
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2020
Publisher: Wiley
Date: 09-11-2022
DOI: 10.1111/DAR.13399
Abstract: Vaccine acceptability is a key determinant of vaccination uptake. Despite being at risk of adverse outcomes from coronavirus‐19 disease (COVID‐19), COVID‐19 vaccine acceptability among people who inject drugs is unknown. We surveyed people who inject drugs in Melbourne, Australia to assess potential uptake of COVID‐19 vaccines prior to distribution. Cross‐sectional study, comprising interviewer‐administered structured telephone interviews completed from 30 November to 22 December 2020 in Melbourne, Australia. Participants were people aged 18 years or older who injected drugs at least monthly in the past 6 months and had resided in Melbourne in the past 12 months recruited via needle‐syringe programs and word‐of‐mouth. COVID‐19 hypothetical vaccine acceptability, participants' demographic, drug use and drug treatment characteristics. Fifty‐eight percent (57/99) of the s le reported that they would definitely or probably be vaccinated for COVID‐19, with the remainder indicating that they would not (22%) or were undecided (20%). Among those who indicated that they would definitely or probably not be vaccinated or were undecided ( n = 42), safety concerns were most often cited as a reason for not wanting to be vaccinated. Although a majority of s led people who inject drugs indicated that they would definitely or probably be vaccinated, efforts to reduce hesitancy and allay COVID‐19 vaccine safety concerns will be necessary to optimise vaccine uptake among this population.
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2019
Publisher: Wiley
Date: 30-11-2022
DOI: 10.1111/IRV.13072
Abstract: In Australia, seasonal inactivated influenza vaccine is typically offered in April. However, the onset, peak and end of a typical influenza season vary, and optimal timing for vaccination remains unclear. Here, we investigated vaccine‐induced antibody response kinetics over 6 months in different age groups. We conducted a prospective serosurvey among 71 adults aged 18–50 years, 15 community‐dwelling (‘healthy’) and 16 aged‐care facility resident (‘frail’) older adults aged ≥65 years who received the 2018 southern hemisphere vaccines. Sera were collected at baseline, and 1, 2, 4, and 6 months post‐vaccination. Antibody titres were measured by haemagglutination inhibition or microneutralisation assays. Geometric mean titres were estimated using random effects regression modelling and superimposed on 2014–2018 influenza season epidemic curves. Antibody titres peaked 1.2–1.3 months post‐vaccination for all viruses, declined by 3 months post‐vaccination but, notably, persisted above baseline after 6 months in all age groups by 1.3‐ to 1.5‐fold against A(H1N1)pdm09, 1.7‐ to 2‐fold against A(H3N2), 1.7‐ to 2.1‐fold against B/Yamagata and 1.8‐fold against B/Victoria. Antibody kinetics were similar among different age groups. Antibody responses were poor against cell‐culture grown compared to egg‐grown viruses. These results suggest subtype‐specific antibody‐mediated protection persists for at least 6 months, which corresponds to the duration of a typical influenza season.
Publisher: NDARC
Date: 2021
DOI: 10.26190/PTDX-8X52
Publisher: Australian Government Department of Health and Aged Care
Date: 15-05-2019
Abstract: Background The precision of vaccine effectiveness (VE) estimates is dependent on s le size and s ling methods. In Victoria, participating general practitioners (GPs) are not limited by the number of influenza-like illness (ILI) patients they collect respiratory s les (swabs) from in sentinel surveillance. However, in the context of scarce resources it is of interest to determine the minimum s le size needed for reliable estimates. Methods Following the test-negative design, patients with ILI were recruited by GPs and tested for influenza. Descriptive analyses were conducted to assess possible selection bias introduced by GPs. VE was calculated by logistic regression as [1 – odds ratio] x 100% and adjusted for week of presentation and age. Random 20% and 50% s les were selected without replacement to estimate the effect of swab rates on VE estimates. Results GPs swabbed a smaller proportion of patients aged ≥65 years (45.9%, n=238) than those (75.6%, n=288), 5–17 (67.9%, n=547) and 18–64 (75.6%, n=2662) years. Decreasing the swab rate did not alter VE point estimates significantly. However, it reduced the precision of estimates and in some instances resulted in too small a s le size to estimate VE. Conclusion Imposing a 20% or 50% swabbing rate produces less robust VE estimates. The number of swabs required per year to produce precise estimates should be dictated by seasonal severity, rather than an arbitrary rate. It would be beneficial for GPs to swab patients systematically by age group to ensure there are sufficient data to investigate VE against a particular subtype in a given age group.
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2020
Publisher: Wiley
Date: 16-07-2022
DOI: 10.1111/ADD.15620
Abstract: To describe (i) self‐reported changes in drug use and (ii) trends in price, perceived availability, and perceived purity of illicit drugs, among people who regularly use ecstasy/ 3,4‐methylenedioxymeth hetamine (MDMA) and other illicit stimulants in Australia following COVID‐19 and associated restrictions. Annual interviews with cross‐sectional sentinel s les conducted face‐to‐face in 2016–19 and via video conferencing or telephone in 2020. Data were collected via an interviewer‐administered structured questionnaire. Australian capital cities. Australians aged 16 years or older who used ecstasy/MDMA and other illicit stimulants on a monthly or more frequent basis and resided in a capital city, recruited via social media and word‐of‐mouth ( n ~ 800 each year). Key outcome measures were self‐reported illicit drug market indicators (price, purity and availability) and, in 2020 only, perceived change in drug use (including alcohol and tobacco) since March 2020 and reasons for this change. For most drugs, participants reported either no change or a reduction in their use since COVID‐19 restrictions were introduced. Ecstasy/MDMA was the drug most frequently cited as reduced in use ( n = 552, 70% of those reporting recent use), mainly due to reduced opportunities for socialization. While market indicators were largely stable across most drugs, the odds of perceiving MDMA capsules as ‘high’ in purity decreased compared with 2016–19 [adjusted odds ratio (aOR) = 0.72, 95% confidence interval (CI) = 0.53–0.99], as did perceiving them as ‘easy’ to obtain (aOR = 0.42, CI = 0.26–0.67). The odds of perceiving cocaine and meth hetamine crystal as ‘easy’ to obtain also decreased (aOR = 0.67, CI = 0.46–0.96 and aOR = 0.12, CI = 0.04–0.41, respectively). After COVID‐19‐related restrictions were introduced in Australia, use of ecstasy/MDMA, related stimulants and other licit and illicit drugs mainly appeared to remain stable or decrease, primarily due to impediments to socialization.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Elsevier BV
Date: 11-2021
DOI: 10.1016/J.DRUGALCDEP.2021.109050
Abstract: Understanding factors associated with engagement across the hepatitis C virus (HCV) cascade of care (CoC) among people who inject drugs (PWID) is critical for developing targeted interventions to enhance engagement and further HCV elimination efforts. We describe the CoC among Australian PWID, and identify factors associated with engagement at each stage. As part of the 2018 and 2019 Illicit Drug Reporting System, Australians who regularly inject drugs reported lifetime HCV antibody and RNA testing, treatment uptake and completion. Multivariable logistic regression identified characteristics associated with outcomes. Of 1499 participants, 87% reported antibody testing. Of those, 70% reported RNA testing, of whom 60% reported being RNA positive. Among those, 76% reported initiating treatment, 78% of whom completed. Incarceration history (adjusted odds ratio 1.90 95% confidence interval 1.28-2.82), current opioid agonist treatment (OAT) (1.99 1.14-3.47), and recent alcohol and other drug (AOD) counselling (2.22 1.27-3.88) were associated with antibody testing. Incarceration history (1.42 1.07-1.87), and current OAT (2.07 1.51-2.86) were associated with RNA testing. Current OAT (1.92 1.22-3.03) and recent AOD counselling (1.91 1.16-3.13) were associated with treatment uptake. Meth hetamine as drug injected most often in the last month was associated with reduced odds of antibody (0.41 0.25-0.66) and RNA testing (0.54 0.40-0.74), compared to heroin. CoC engagement amongst Australian PWID is encouraging, with AOD service engagement associated with testing and treatment. Further efforts to reach those not service engaged, particularly those not receiving OAT or who predominantly inject meth hetamine, are needed to achieve HCV elimination targets.
Publisher: NDARC, Sydney
Date: 2022
DOI: 10.26190/HBQT-9D09
Publisher: National Drug and Alcohol Research Centre, UNSW Sydney, Sydney
Date: 2021
DOI: 10.26190/BD8K-6879
Location: Australia
Start Date: 2022
End Date: End date not available
Funder: National Health and Medical Research Council
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