ORCID Profile
0000-0002-5587-5379
Current Organisations
Burnet Institute
,
Monash University
,
University of Technology Sydney
,
La Trobe University
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Health Policy | Sociology | Applied Sociology, Program Evaluation and Social Impact Assessment | Public Health and Health Services not elsewhere classified | Public Health and Health Services | Criminology not elsewhere classified
ANZSRC Socio-Economic Objective (SEO)
Public Health (excl. Specific Population Health) not elsewhere classified | Health Education and Promotion | Justice and the Law not elsewhere classified | Public Services Policy Advice and Analysis | Health Policy Evaluation |
Related Links
Publications
Comparing profile of people who inject drugs (PWID) accessing different types of needle and syringe programs or secondary distribution in Kermanshah, Iran
Publisher: Informa UK Limited
Date: 06-07-2016
Australians living with and managing hepatitis C
Publisher: Informa UK Limited
Date: 07-2010
DOI: 10.3109/01612841003629532
Abstract: This paper discusses the psychosocial impact of being diagnosed with hepatitis C virus (HCV). The paper clarifies some of the key misconceptions about the virus, especially the impact HCV has on people who have been recently diagnosed. An in idual's reaction to the HCV diagnosis and the subsequent lifestyle challenges to maintain health, well-being, family, and social networks are discussed, particularly the issues surrounding mental health in respect to a recent chronic illness diagnosis and how to manage the trajectory of the illness in the community and in idually. HCV disclosure and its effect on intimacy are also detailed. For people living with both a diagnosed mental illness and HCV, managing the illness can be complicated. Not only are these in iduals concerned about their mental illness, its treatment, and the social stigma and discrimination associated with it, they also may be alarmed over their future physical health. The paper is preliminary to research using the psychotherapeutic approach of Cognitive Behavioural Therapy (CBT) in groups of persons with a dual diagnosis of mental illness and HCV.
BRAFV600E and NRASQ61L/Q61R mutation analysis in metastatic melanoma using immunohistochemistry: a study of 754 cases highlighting potential pitfalls and guidelines
Publisher: Wiley
Date: 15-06-2016
DOI: 10.1111/HIS.12992
Abstract: BRAF or NRAS mutations occur in approximately 60% of cutaneous melanomas, and the identification of such mutations underpins the appropriate selection of patients who may benefit from BRAF and MEK inhibitor targeted therapies. The utility of immunohistochemistry (IHC) to detect NRAS(Q61L) mutations is currently unknown. This study sought to assess the sensitivity and specificity of anti-BRAF(V600E) (VE1), anti-NRAS(Q61R) (SP174) and anti-NRAS(Q61L) (26193) antibodies for mutation detection in a large series of cases. Mutation status was determined using the OncoCarta assay in 754 cutaneous melanomas. IHC with the anti-BRAF(V600E) antibody was performed in all cases, and the anti-NRAS(Q61R) and anti-NRAS(Q61L) antibodies were assessed in a subset of 302 s les utilizing tissue microarrays. The staining with the anti-BRAF(V600E) and anti-NRAS(Q61R) antibodies was diffuse, homogeneous and cytoplasmic. The anti-NRAS(Q61L) antibody displayed variable intensity staining, ranging from weak to strong in NRAS(Q61L) mutant tumours. The sensitivity and specificity for anti-BRAF(V600E) was 100 and 99.3%, anti-NRAS(Q61R) was 100 and 100% and anti-NRAS(Q61L) was 82.6 and 96.2%, respectively. The use of IHC is a fast, efficient and cost-effective method to identify single specific mutations in melanoma patients. BRAF(V600E) and NRAS(Q61R) antibodies have high sensitivity and specificity however, the NRAS(Q61L) antibody appears less sensitive. IHC can help to facilitate the timely, appropriate selection and treatment of metastatic melanoma patients with targeted therapies. Detection of melanoma-associated mutations by IHC may also provide evidence for a diagnosis of melanoma in metastatic undifferentiated neoplasms lacking expression of melanoma antigens.
The Association of Oral Health Status and socio‐economic determinants with Oral Health‐Related Quality of Life among the elderly: A systematic review and meta‐analysis
Publisher: Wiley
Date: 14-02-2021
DOI: 10.1111/IDH.12489
The Medical Treatment Planning and Decisions Act 2016: what is the role for allied health professionals?
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY19212
Abstract: Advance care planning is increasingly common practice in contemporary health care for in iduals living with a chronic condition. Currently, limited research has been conducted into how newly adopted legislation in Victoria, Australia, facilitates advance care planning. The purpose of this study was to explore the uptake of the Medical Treatment Planning and Decisions Act 2016 in the primary care setting. The study also aimed to explore barriers that allied health professionals encounter when practicing advance care planning with patients. Four interdisciplinary focus groups and two in-depth interviews with participants were conducted and thematically analysed using an interpretivist inquiry paradigm. Analysis revealed two key themes: promoting client wellbeing and scope of practice. The data suggest that advance care planning by allied health professionals in the primary care setting is limited. Focussing on enhancing clients’ wellbeing was more important than the development of advanced care directives. Attempting to promote the wellbeing of patients may foster hesitation to commence advance care planning in primary care. This study demonstrated that knowledge of the fundamental legislative changes are evident among allied health professionals which provides a foundation for successful development of advance care planning post implementation of the new Act.
Further research required to determine link between khat consumption and driver impairment.
Publisher: WHO Press
Date: 06-2010
Improving suicide awareness in rural service providers: Some considerations arising from stakeholder consultations.
Publisher: Wiley
Date: 10-11-2021
DOI: 10.1111/AJR.12798
Engagement, reciprocity and advocacy: ethical harm reduction practice in research with injecting drug users
Publisher: Wiley
Date: 09-2006
DOI: 10.1080/09595230600876606
Abstract: In this paper, we contribute to the ethical challenges of harm reduction-based research by describing and reflecting on our experiences of initiating and maintaining relationships with research participants during an innovative neighbourhood-based study of the social and molecular epidemiology of the hepatitis C virus among injecting drug users over a 2-year period. We show through ex les of our work how recruitment to our study had practical value for both researchers and study participants including advocacy and reciprocity. We argue that the recruitment process needed to be flexible, able to cope with the demands of the street drug market, and that we as researchers need to engage participants in their own environments as much as possible. We conclude with a series of recommendations for other researchers such as the need to employ appropriately skilled researchers who are flexible, innovative and comfortable in street settings, and for the setting of realistic time-frames for preliminary research, data collection and feedback and analysis.
Experiences of participation in a longitudinal cohort study of people who inject drugs in Victoria, Australia
Publisher: Informa UK Limited
Date: 24-02-2023
Drug use treatment and harm reduction programs in Iran: A unique model of health in the most populated Persian Gulf country
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.AJP.2015.06.002
Abstract: Because of the proximity of Persian Iran to Afghanistan, the main opium producer in the world, drug use especially opium use has a long history in Iran. Opium and its residues are the traditional drugs while heroin, heroin Kerack, norgesic, temgesic, and meth hetamine use and injection have emerged more recently. In recent decades, heroin smoking and injection have presented challenges to the Persian health policy makers to accept and develop the internationally-approved programs of drug use treatment and harm reduction. The current paper summarizes the overall picture of main drugs used and the history of establishing the nationwide movement of drug use treatment and harm reduction programs after the 1979 revolution until the end of 2014. The paper concludes that Persian Iran has a well-developed healthcare system in the provision of drug use treatment and harm reduction programs in the south-west of Asia especially the Persian Gulf region. These therapeutic and harm reduction-related programs are required to be strengthened by opium supply reduction and eradicating drug production in Afghanistan. The provision of prevention programs, drug education via mass-media, employment and inexpensive leisure activities are required in Iran. In addition, conducting household surveys of the prevalence of drug use and evaluating the clinical effectiveness and treatment outcomes of the provided drug treatment and harm reduction programs are required. National and regional collaborations are rigorously suggested to manage supply reduction along the borders and implement demand reduction inside the borders.
Heroin-gel capsule cocktails and groin injecting practices among ethnic Vietnamese in Melbourne, Australia.
Publisher: Elsevier BV
Date: 07-2008
DOI: 10.1016/J.DRUGPO.2008.05.001
Abstract: Evidence of harms associated with temazepam gel capsule injecting among injecting drug users in Australia led to its withdrawal from manufacture in Australia. Subsequently, diphenhydramine gel capsule injecting was identified among a subset of ethnic Vietnamese injecting drug users. Observational fieldwork around an active street-based illicit drug marketplace together with targeted purposive s ling enabled 66 ethnic Vietnamese injecting drug users to be recruited for in-depth interview. Data revealed that the injection of gel capsules increases exposure to non-viral infections. Analysis of participant interviews show how participants have established their own ways of reducing these harms including thinning the drug solution by jacking regularly during injection. Controversially, femoral vein administration of diphenhydramine-heroin cocktails was also seen as a harm reduction strategy by participants. Health education c aigns to address the potentially negative consequences of gel capsule groin injection will not be successful unless health workers and policy makers work with drug users and incorporate local understandings and meanings of risk in health promotion activities.
“I Lost Me Visits”: A Critical Examination of Prison Drug Policy and Its Effects on Connection to Family for Incarcerated Young Men With Histories of Injecting Drug Use
Publisher: SAGE Publications
Date: 03-06-2018
Abstract: Utilizing Bacchi’s poststructuralist approach, “What’s the problem represented to be?,” we critically examine how the “problem” of drug use in prison is represented within a key initiative—the Identified Drug User program (IDUP)—of prison drug policy in one Australian jurisdiction. We use two data sources for our analysis: interview transcripts of recently incarcerated young men (aged 19–24) with histories of injecting drug use and selected prison drug policy and program documents. We examine how the “problem” of drug use in prison is problematized within the IDUP and question commonly accepted ways of thinking that underpin the program. We explore the discursive and subjectification effects of problem representations which produce young men as “rational” and “choosing” and, at the same time, as “untrustworthy” and “deserving of punishment.” We highlight how these effects have consequences for young men’s connections to family while incarcerated which can work against the very issues the IDUP is trying to address. We make two claims in particular: that the IDUP produces harmful effects for young men and their families and that the harmful effects produced are, paradoxically, those the IDUP aims to avoid. Our analysis offers insights into how drug use in prison could be thought about differently, including suggestions that might reduce at least some of its adverse effects.
Pharmacies dispensing opioid substitution therapy also play a role in hepatitis C virus elimination
Publisher: Elsevier BV
Date: 05-2018
Clinical and demographic characteristics of people who smoke versus inject crystalline methamphetamine in Australia: Findings from a pharmacotherapy trial
Publisher: Wiley
Date: 06-10-2020
DOI: 10.1111/DAR.13183
Abstract: There has been a rapid increase in smoking crystalline meth hetamine in Australia. We compare the clinical and demographic characteristics of those who smoke versus inject the drug in a cohort of people who use meth hetamine. Participants ( N = 151) were dependent on meth hetamine, aged 18–60 years, enrolled in a pharmacotherapy trial for meth hetamine dependence, and reported either injecting ( n = 54) or smoking ( n = 97) meth hetamine. Measures included the Timeline Followback, Severity of Dependence Scale, Amphetamine Withdrawal Questionnaire, Craving Experience Questionnaire and the Brief Psychiatric Rating Scale (symptoms of depression, hostility, psychosis and suicidality). Simultaneous regression was used to identify independent demographic correlates of smoking meth hetamine and to compare the clinical characteristics of participants who smoked versus injected. Compared to participants who injected meth hetamine, those who smoked meth hetamine were younger and less likely to be unemployed, have a prison history or live alone. Participants who smoked meth hetamine used meth hetamine on more days in the past 4 weeks than participants who injected meth hetamine (26 vs. 19 days, P = 0.001) they did not differ significantly in their severity of meth hetamine dependence, withdrawal, craving or psychiatric symptoms ( P 0.05). After adjustment for demographic differences, participants who smoked had lower craving [b (SE) = −1.1 (0.5), P = 0.021] and were less likely to report psychotic symptoms [b (SE) = −1.8 (0.7), P = 0.013] or antidepressant use [b (SE) = −1.1 (0.5), P = 0.022]. Smoking crystalline meth hetamine is associated with a younger less marginalised demographic profile than injecting meth hetamine, but a similarly severe clinical profile.
Comparing Characteristics of Early-Onset Injection Drug Users to Those With Late-Onset Injection in Kermanshah, Iran.
Publisher: Informa UK Limited
Date: 03-02-2017
DOI: 10.1080/10826084.2016.1263666
Abstract: Characteristics and behaviors of early-onset injection drug users are under studied topics in Iran. This study aimed to identify and compare the demographic characteristics as well as the drug using behaviors of early-onset and late-onset injection drug users in Kermanshah, West Iran. In this cross-sectional study using snowball and convenience s ling, we recruited 450 people during the Fall of 2014 from two drop in centers in Kermanshah, Iran. We collected data through face-to-face interviews. Early-onset injection is defined as whether the person reported their first injection at 22 years of age or younger. Subsequently, late-onset injection is defined as 23 years of age or older. We compared the characteristics of the two groups through both univariate and multiple logistic analyses. Overall, 54% (CI 95%: 44.3%, 62.2%) were early injectors. After controlling for low socioeconomic status, initiation of drug use at a young age, multiple drug use and meth hetamine use were all significantly associated with a higher likelihood of early-onset injection. Additionally, early-onset injection was associated with recent syringe borrowing (OR = 2.6, p = 0.001), recent syringe lending (OR = 1.4, p = 0.01), recent cooker sharing (OR = 3.2, p = 0.01) and injecting two or more times a day (OR = 2.2, p = 0.04). Early-onset injectors were more likely to report a lower socioeconomic status, initiation of first drug use at a younger age, using meth hetamine alongside polydrug use, and engaging in higher risk taking behaviors like borrowing needles. With these associations, the study emphasizes the need for drug-prevention programs to focus on the transition to injection drug use at younger ages.
The long winding road of opioid substitution therapy implementation in South-East Asia: challenges to scale up.
Publisher: SAGE Publications
Date: 26-03-2014
Abstract: The South-East Asia Region contains an estimated 400,000-500,000 people who inject drugs (PWID). HIV prevalence among PWID is commonly 20% or higher in Indonesia, Thailand, Myanmar and some regions of India. Opioid substitution therapy (OST) is an important HIV prevention intervention in this part of the world. However, key challenges and barriers to scale up of OST exist, including: pervasive stigma and discrimination towards PWID criminalisation of drug use overshadowing a public health response lack of political will and national commitment low financial investment focus towards traditional treatment models of detoxification and rehabilitation inadequate dosing of OST and poor monitoring and evaluation of programmes. Our review of local evidence highlights that OST can be successful within the Asian context. Such evidence should be utilised more widely to advocate for policy change and increased political commitment to ensure OST reaches substantially more drug users.
Experiences of liver health related uncertainty and self-reported stress among people who inject drugs living with hepatitis C virus: A qualitative study
Publisher: Springer Science and Business Media LLC
Date: 02-04-2018
Was this a result you were expecting?
Publisher: CSIRO Publishing
Date: 2006
DOI: 10.1071/SH05004
Mental health status, health service utilization, drug use behaviors associated with non-fatal overdose among people who use illicit drugs: A meta-analysis
Publisher: Informa UK Limited
Date: 29-12-2021
No drama: Key elements to the success of an HIV/STI-prevention mass-media campaign
Publisher: SAGE Publications
Date: 03-04-2014
Abstract: We qualitatively examined gay men’s reactions to the national “Drama Downunder” HIV/STI social marketing c aign targeting gay men in Australia to identify key c aign elements that underpinned the demonstrated effectiveness of the c aign. We present findings from six qualitative focus groups held with 49 participants as part of the evaluation of the sexual-health-promotion c aign over 2008–2009. Participants identified attention-grabbing images, a humorous approach, positive and simple tailored messaging, and the use of mainstream media as c aign features crucial in normalizing sexual health testing, driving c aign engagement, and ensuring high message exposure. Our results suggest that designers of future c aigns should strive to balance positive and negative c aign images and messages, and find new ways to engage men with sexual health topics, particularly younger gay men. We discuss the implications of our findings about c aign effectiveness for future health-promotion c aigns and message design.
“I'm obviously not dying so it's not something I need to sort out today”: Considering hepatitis C treatment in the era of direct acting antivirals
Publisher: Elsevier BV
Date: 05-2019
DOI: 10.1016/J.IDH.2018.10.006
Abstract: People who inject drugs are the group at greatest risk of hepatitis C virus (HCV) infection. The advent of new direct-acting antiviral (DAA) treatment provides opportunities for increased uptake of therapy. We conducted in-depth interviews with thirty HCV positive participants from the SuperMIX cohort study. Interviews were transcribed, coded, and analysed for emerging themes and similarities between participants. General descriptions and critical interpretation of themes were generated and selective quotes extracted verbatim to best illustrate the critical themes. Participants described their experiences of living with HCV, their knowledge of HCV treatment accessibility, and information on the types of support ain themes: Understanding the need for treatment Knowledge and framing of treatment access and Support during treatment. The new, highly effective DAAs for the treatment of HCV are heralded as the potential beginning of HCV elimination, especially in settings where scale up is high. Our data from active PWID show that the availability of DAA medications in and of themselves is likely not to be enough to ensure that PWID will come forward for HCV treatment in sufficient numbers to drive elimination.
Factors affecting self-medication practices among people living with type 2 diabetes in India- A systematic review
Publisher: Elsevier BV
Date: 03-2021
Vietnam moves forward with harm reduction: an assessment of progress.
Publisher: Informa UK Limited
Date: 10-02-2011
DOI: 10.1080/17441690903527314
Abstract: Historically, the response of the Vietnamese government to illicit drug use and HIV has been slow and ineffective. However, 2006 saw the government formally endorse harm reduction interventions. This paper examines the views of senior key informants inside Vietnam on the development of an advocacy strategy for harm reduction. Twenty-nine informants were interviewed across public health, public security, social affairs and other international bodies, including United Nations agencies and international non-governmental organisations. Challenges and barriers identified for harm reduction progress included: promoting a nationwide understanding and acceptance of harm reduction and the HIV Law lack of skilled resources, training programmes and technical capacity poor coverage of interventions and gaps in the sharing of information. There is currently a government-led shift in Vietnam in the response to the prevailing HIV epidemic among drug users, but ensuring that the HIV Law can operate unhindered is critical. The implementation of a response to illicit drug use and HIV remains an enormous challenge. With appropriate technical education and training, ongoing advocacy, and a cohesive, coordinated multi-sectoral effort, the capacity of the government and community to adopt, support and promote measures to reduce HIV and other drug-related harms will be markedly strengthened.
Delivering Health Education Curriculum Online in the Wake of COVID-19
Publisher: SAGE Publications
Date: 08-12-2020
Abstract: The core skills taught in the subject “Health Education Development” at La Trobe University are essential for students studying health promotion. As part of this subject, students are supported to adopt the role of a health education and development facilitator in delivering tailored sessions to their peers. In these simulated sessions, students engage in the practice (and teaching) of cooperative learning addressing the needs of vulnerable population groups across different settings. COVID-19 forced the delivery of this subject to an online-only model with little time for preparation. Changes that were introduced as a response to this transition included online workshops replacing face-to-face (F2F), modification of the F2F component of assessments to online, F2F workshop content adapted to online version, implementation of a “coteaching” model for the initial 3 weeks post-COVID-19 lockdown, and weekly online sessions held with the teaching team. The use of innovative activities provided ongoing feedback, which informed timely actions to improve and continue with the successfully delivery of the subject.
“A spray bottle and a lollipop stick”: An examination of policy prohibiting sterile injecting equipment in prison and effects on young men with injecting drug use histories
Publisher: Elsevier BV
Date: 06-2020
DOI: 10.1016/J.DRUGPO.2019.07.027
Abstract: Australian young male prisoners with histories of injecting drug use are more likely to report injecting in prison, to do so more frequently, and to be involved in more un-safe injecting-related practices than their older counterparts. Despite international evidence that prison needle and syringe programs are both feasible and effective in reducing the harms associated with injecting drug use in prison, these young men do not have access to such equipment. We critically analyse the interview transcripts of 28 young men with histories of injecting drug use who were recently released from adult prisons in Victoria, Australia, and prison drug policy text. We use Bacchi's 'What's the problem represented to be?' approach to examine how the 'problem' of injecting drug use in prison is represented in prison drug policy, including the assumptions that underpin these problematisations, and the subjectification and lived effects that are produced for the young men in our study. Our analysis reveals how prison drug policy enables the creation and re-use of homemade injecting equipment crafted from unsterile items found in prison, and that in doing so the policy produces a range of stigmatising subjectification effects and other harmful material effects (such as hepatitis C virus transmission and injecting related injury and harms). Findings highlight, how injecting drug use is represented in policy silences other ways of understanding the 'problem' that may have less harmful effects for incarcerated young men who inject drugs. We argue that somewhat paradoxically, the approach of prohibiting access to sterile injecting equipment in prison-which is constituted as a solution for addressing such harms-in fact helps to produce them.
A response to: Self-reported and actual hepatitis C virus infection status.
Publisher: Wiley
Date: 11-2012
DOI: 10.1111/DAR.12001
Injecting drug use and related health behaviours in a small case series of East African migrants in Melbourne.
Publisher: Elsevier BV
Date: 12-2012
Social Media and Online Digital Technology Use Among Muslim Young People and Parents: Qualitative Focus Group Study
Publisher: JMIR Publications Inc.
Date: 10-05-2022
DOI: 10.2196/36858
Abstract: Digital technology and social media use are common among young people in Australia and worldwide. Research suggests that young people have both positive and negative experiences online, but we know little about the experiences of Muslim communities. This study aims to explore the positive and negative experiences of digital technology and social media use among young people and parents from Muslim backgrounds in Melbourne, Victoria, Australia. This study involved a partnership between researchers and a not-for-profit organization that work with culturally and linguistically erse communities. We adopted a participatory and qualitative approach and designed the research in consultation with young people from Muslim backgrounds. Data were collected through in-person and online focus groups with 33 young people aged 16-22 years and 15 parents aged 40-57 years. Data were thematically analyzed. We generated 3 themes: (1) maintaining local and global connections, (2) a paradoxical space: identity, belonging and discrimination, and (3) the digital ide between young Muslims and parents. Results highlighted that social media was an important extension of social and cultural connections, particularly during COVID-19, when people were unable to connect through school or places of worship. Young participants perceived social media as a space where they could establish their identity and feel a sense of belonging. However, participants were also at risk of being exposed to discrimination and unrealistic standards of beauty and success. Although parents and young people shared some similar concerns, there was a large digital ide in online experiences. Both groups implemented strategies to reduce social media use, with young people believing that having short technology-free breaks during prayer and quality family time was beneficial for their mental well-being. Programs that address technology-related harms must acknowledge the benefits of social media for young Muslims across identity, belonging, representation, and social connection. Further research is required to understand how parents and young people can create environments that foster technology-free breaks to support mental well-being.
Modelling antiviral treatment to prevent hepatitis C infection among people who inject drugs in Victoria, Australia
Publisher: AMPCo
Date: 06-2012
DOI: 10.5694/MJA11.10981
Abstract: To develop a mathematical model to project the potential impact of hepatitis C virus (HCV) treatment on HCV infection prevalence among people who inject drugs (PWID). An existing model of HCV transmission among PWID was parameterised using data from Victoria, Australia, including specific parameter estimates of the number of people who are currently active injecting drug users, average duration of injecting, chronic HCV infection prevalence among PWID, annual mortality, and annual HCV treatment rate. We also explored the impact of prevalence uncertainty, program scale-up, and new treatments. Prevalence of chronic HCV infection among people who are currently active injecting drug users. With annual treatment rates of 13, 17, or 25 per 1000 PWID, the model predicts relative prevalence reductions of 20%, 30%, and 50%, respectively, within 30 years. If new treatments giving higher sustained viral response rates are available in 5 years, estimated impact is increased by 21%–23% at 15 years, and 17%–38% at 30 years, depending on treatment rates. This model suggests that modest rates of current HCV treatment among PWID in Victoria, Australia could halve HCV infection prevalence among PWID in 30 years. This finding suggests that interventions aimed at increasing access to HCV treatment in community clinics will benefit in idual PWID and reduce HCV infection prevalence.
Adequate Analgesia and Oral Care Attendance in Opiate Dependent Individuals.
Publisher: SAGE Publications
Date: 05-08-2020
Health service utilisation and access for people who inject drugs during COVID‐19
Publisher: Wiley
Date: 09-03-2022
DOI: 10.1111/DAR.13456
Abstract: The wide‐spread implementation of interventions to limit transmission and public health consequences of COVID‐19 in the Australian state of Victoria had flow‐on consequences for people who use and inject drugs. Consequences included the interruption of illicit drug supply and drug procurement, and the disruption to the delivery of health services. To inform strategies that can minimise the adverse outcomes of similar future disruptive events, this study explored how COVID‐19 restrictions impacted access to harm reduction and drug treatment services for people who inject drugs in Melbourne, Victoria. Qualitative semi‐structured interviews were conducted via an online calling app, with 11 participants of a broader cohort study (the SuperMIX study) in April 2020. Interviews were focused on participants experiences of accessing and using harm reduction and drug treatment services. Data were thematically analysed using a process of blended coding. Findings revealed how disruptions in the delivery of harm reduction and drug treatment services—in response to COVID‐19 restrictions—created barriers accessing sterile injecting equipment, increased risk of arrest by police and exacerbated social isolation. Participants reported difficulties adapting to changes in services access, with some increases in injecting risk behaviours. However, improvements in opioid agonist therapy prescriptions were noted as a beneficial outcome. By examining the impacts of COVID‐19 and the resultant restrictions on people who inject drugs' access to health services in Melbourne, Victoria, findings provide guidance for future responses to the unanticipated large‐scale effects of the COVID‐19 pandemic, and similar disruptive events.
Supramolecular Nucleic Acid-Based Organosilica Nanoparticles Responsive to Physical and Biological Inputs
Publisher: American Chemical Society (ACS)
Date: 16-10-2023
DOI: 10.1021/JACS.3C04345
Patterns of, and Factors Associated With, Illicit Pharmaceutical Opioid Analgesic Use in a Prospective Cohort of People Who Inject Drugs in Melbourne, Australia.
Publisher: Informa UK Limited
Date: 10-11-2015
DOI: 10.3109/10826084.2015.1027928
Abstract: People who inject drugs (PWID) are a key population engaging in pharmaceutical opioid analgesic (PO) use, yet little is known about patterns of illicit PO use among this group. The aims of this research were to measure the prevalence and frequency of lifetime and past-month illicit PO use and injection in a s le of regular PWID, to examine patterns of past-month illicit PO use within in iduals over time, and to identify factors independently associated with past-month illicit PO use. Data were drawn from a prospective cohort study of regular PWID (N = 666) in Melbourne, Australia. Data from five waves of annual data collection (including baseline) were analyzed descriptively and using generalized estimating equations (GEE). At baseline, 59% of participants reported lifetime illicit PO use and 20% reported past-month use, predominantly through injecting. Most illicit PO users at baseline transitioned to nonuse of illicit POs across the study period. In multivariable GEE analysis, factors associated with past-month illicit PO use included past-year arrest [adjusted odds ratio (AOR): 1.39], opioids other than heroin as drug of choice (AOR: 5.14), experiencing poorer physical health (AOR: 0.98) and a range of other drug use variables. We found little evidence of ongoing illicit PO use among those followed up, with illicit PO use linked to polydrug use more broadly. Nonetheless, trends in illicit PO use among PWID should continue to be monitored and harm reduction interventions implemented to reduce the associated public health risks.
A cross-sectional study of emergency department visits by people who inject drugs.
Publisher: BMJ
Date: 16-07-2012
DOI: 10.1136/EMERMED-2012-201170
Abstract: People who inject drugs (PWID) have worse health than non-injectors and are at heightened risk of incidents that necessitate hospital emergency department (ED) visits. To describe ED visits by PWIDs in Melbourne, Australia, and compare reasons with those given in Vancouver, Canada. In 2008-2010, 688 Melbourne PWIDs were interviewed about their ED visits these data were contrasted with published data about ED visits by PWIDs in Vancouver. Participants reported 132 ED visits in the month preceding interview--27.3% drug-related, 20.5% trauma-related (principally physical assault), 13.6% for psychiatric problems. Melbourne PWIDs are less likely to attend ED for soft-tissue injuries, and more likely to attend after physical assault than PWIDs in Vancouver. PWID in Melbourne and Vancouver attend EDs for different reasons information about PWID visits can help EDs cater for them and provide insights for prevention.
Improving hepatitis C direct-acting antiviral access and uptake: A role for patient-reported outcomes and lived experience
Publisher: Wiley
Date: 06-11-2019
DOI: 10.1111/JVH.13020
Abstract: Hepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon-free direct-acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for "hard-to-reach" populations. Treatment advances and cure will also likely alter the in idual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population-level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient-reported outcome measures.
“Like a pickle that’s been unpickled”: Emotional, identity and behavioural transformations throughout hepatitis C treatment
Publisher: Public Library of Science (PLoS)
Date: 12-12-2022
DOI: 10.1371/JOURNAL.PONE.0272401
Abstract: Little is known about the emotional experience and benefits of undertaking direct acting antiviral (DAA) treatment for hepatitis C. A better understanding of in idual treatment outcomes can inform acceptable treatment delivery and promotion. We aimed to explore participant-perceived emotional benefits and transformations throughout DAA treatment among people who inject drugs, who were initiating treatment. Participants were recruited from either a community based clinical trial or community health clinics. Semi structured interviews were conducted with each participant before, during and following treatment. Interviews focussed on treatment perceptions, physical and mental wellbeing and modifiable health behaviours. Interviews were recorded, transcribed verbatim and thematically analysed. Participant and cohort matrices were produced to assess at which time point themes were present and whether themes changed or remained stable over time. This paper presents analysis from 19 participants interviewed between 2017–2019. Most participants were male, with no or mild fibrosis. At baseline, all but one participant had injected drugs in the past month. Three themes relating to the emotional wellbeing and behaviour change described a common treatment experience ‘hopes for better wellbeing’, ‘lifting the weight’ and ‘closing the chapter’. Participants were hopeful treatment would improve their emotional wellbeing. Hopes were actualised during treatment as participants began to feel uncertainty and stress easing. Completing treatment improved some participants perceptions of self. Some participants consciously changed their injecting behaviours during treatment. Undertaking and completing treatment was an emotionally and behaviourally transformative period. Participant perceived benefits should be used to inform how treatment benefit is conceptualised and how treatment is promoted in primary care settings.
Going tobacco free in Australian prisons – increasing tattooing harm?
Publisher: Emerald
Date: 21-12-2015
Trust and service engagement among people who inject drugs after release from prison
Publisher: Elsevier BV
Date: 2023
Severe vein damage caused by Temezepam injecting
Publisher: Elsevier BV
Date: 02-2002
Injection drug network characteristics as a predictor of injection behaviour.
Publisher: Cambridge University Press (CUP)
Date: 2019
DOI: 10.1017/S095026881900061X
Abstract: Social network characteristics of people who inject drugs (PWID) have previously been flagged as potential risk factors for HCV transmission such as increased injection frequency. To understand the role of the injecting network on injection frequency, we investigated how changes in an injecting network over time can modulate injecting risk behaviour. PWID were sourced from the Networks 2 Study, a longitudinal cohort study of PWID recruited from illicit drug street markets across Melbourne, Australia. Network-related correlates of injection frequency and the change in frequency over time were analysed using adjusted Cox Proportional Hazards and Generalised Estimating Equations modelling. Two-hundred and eighteen PWID followed up for a mean ( s.d. ) of 2.8 (1.7) years were included in the analysis. A greater number of injecting partners, network closeness centrality and eigenvector centrality over time were associated with an increased rate of infection frequency. Every additional injection drug partner was associated with an increase in monthly injection frequency. Similarly, increased network connectivity and centrality over time was also associated with an increase in injection frequency. This study observed that baseline network measures of connectivity and centrality may be associated with changes in injection frequency and, by extension, may predict subsequent HCV transmission risk. Longitudinal changes in network position were observed to correlate with changes in injection frequency, with PWID who migrate from the densely-connected network centre out to the less-connected periphery were associated with a decreased rate of injection frequency.
Substance use concerns among Punjabi‐Indian communities in Australia: Kamini and alcohol
Publisher: Wiley
Date: 10-10-2022
DOI: 10.1111/DAR.13560
Harm reduction and drug users of Vietnamese ethnicity
Publisher: Wiley
Date: 06-2001
Barriers to women's disclosure of and treatment for substance use during pregnancy: A qualitative study
Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.WOMBI.2021.12.009
Abstract: The use of alcohol and or illicit drugs during pregnancy is a complex public health issue. There are many adverse short- and long-term health implications of substance use during pregnancy that can potentially affect the mother-foetal dyad. Although prevention and treatment options - such as counselling, pharmacotherapy, rehabilitation, support and case management and withdrawal management - are available, a range of barriers impedes women's ability to disclose their substance use, which limits access and engagement with available services. This research explored barriers women encountered in disclosing substance use and accessing substance use treatment in pregnancy. Participants were recruited from a longitudinal cohort study of people with a history of injecting drug use from metropolitan Melbourne. One-on-one in-depth interviews with 15 participants were conducted using a semi-structured interview guide. To be included in this study, participants must have reported a history of substance use during one or more of their pregnancies. The fear of losing child custody associated with the involvement of the child protection services was one of the main barriers to disclosing substance use during pregnancy and accessing treatment and rehabilitation services. Other barriers including stigma and perceived limited treatment options impacted women in various ways. Pregnancy is an important time for women and offers opportunities for service providers to support women who are using substances. While not all barriers can be removed, careful consideration of in idual cases and circumstances may help service providers to tailor interventions that are likely to be more successful.
Responsive Nucleic Acid-Based Organosilica Nanoparticles
Publisher: American Chemical Society (ACS)
Date: 21-09-2023
DOI: 10.1021/JACS.3C00393
Vulnerability among Vietnamese illicit drug users in Australia: Challenges for change
Publisher: Elsevier BV
Date: 06-2002
The development of peer educator-based harm reduction programmes in northern Vietnam
Publisher: Wiley
Date: 03-2008
DOI: 10.1080/09595230701829348
Abstract: Injecting drug use remains an important risk factor for transmission in Vietnam, with an estimated 50% of the 290 000 people living with HIV/AIDS reporting injecting drug use as a risk factor. Despite this, effective harm reduction interventions are generally lacking. This paper describes the implementation of peer-based harm reduction programmes in two rural provinces of Vietnam. Peer educators were trained in basic HIV prevention, including harm reduction. After significant preparation work with the Provincial AIDS Committees of Bac Giang and Thanh Hoa and other relevant national, provincial and local authorities, the interventions were commenced. Harm reduction interventions were delivered through outreach as well as on-site. This included needle and syringe distribution and collection. Community advocacy occurred throughout the life of the project. Local authorities and peers believed that while there was a general reduction in stigma and discrimination, legal barriers associated particularly with the carrying of injecting equipment remained. This impacted upon the ability of peer educators to work with their clients. Peer-based delivery of harm reduction intervention is acceptable. Harm reduction interventions, including needle and syringe programmes, are feasible and acceptable in these two rural Vietnamese provinces. Community acceptance and uptake of these interventions is key to successful expansion across the region. Active participation by families of drug users seems crucial. This initiative demonstrates that despite a difficult policy environment, peer-delivered needle and syringe programmes are feasible within a rural Asian environment as long as there is adequate local political and community support.
Highlighting the palliative care needs of people using drugs
Publisher: Elsevier BV
Date: 10-2020
Urbanisation and sexual health: understanding bisexually active men in Hanoi, Vietnam.
Publisher: Informa UK Limited
Date: 2014
HIV risk perception and risk taking among people who inject drugs in Saveh, in Central Iran: findings from a national study
Publisher: Informa UK Limited
Date: 11-11-2022
Oral health-related quality of life among an Australian sample of people who inject drugs.
Publisher: Wiley
Date: 10-03-2015
DOI: 10.1111/JPHD.12092
Abstract: People who inject drugs (PWID) have poor oral health. However, their oral health-related quality of life (OHRQoL) is unknown. Our study was designed to measure the OHRQoL of PWID. The Oral Health Impact Profile-14 (OHIP-14) was administered to 794 PWID recruited in Australian capital cities as part of the 2013 Illicit Drug Reporting System (IDRS). Three OHIP-14 summary indicators were examined: "Prevalence" (proportion reporting ≥1 item at least "fairly often"), "severity" (mean total OHIP-14 score), and "extent" (number of impacts reported at least "fairly often"). Associations between "prevalence" and "extent" and variables drawn from the health, drug use, and social domains were investigated. All OHIP-14 summary indicators among IDRS participants were significantly higher than in the general Australian population. In multivariate analysis, the "prevalence" indicator was significantly and positively associated with female gender [adjusted odds ratio (AOR) = 1.75, 95% CI 1.27-2.38], those born in Australia (AOR = 2, 95% CI 1.25-3.23), not completing Year 10 compared with those who had completed Year 12 or a higher qualification (AOR = 1.59, 95% CI 1.03-2.44), and methadone treatment (AOR = 1.61, 95% CI 1.14-2.29). The "extent" indicator was significantly and positively associated with female gender [adjusted incidence rate ratio (AIRR) = 1.56, 95% CI 1.19-2.08], unemployment (AIRR = 1.59, 95% CI 1.01-2.44), and having an injecting career of 10-20 years (AIRR = 1.76, 95% CI 1.03-3.01). PWID have poorer OHRQoL than the Australian general population. Poor OHRQoL was particularly common in female PWID and those with longer injecting careers. Interventions to improve the oral health of PWID may improve their OHRQoL.
Factors influencing a self-limiting HIV outbreak among ethnic vietnamese injecting drug users in Melbourne, Australia
Publisher: SAGE Publications
Date: 30-11-2009
Abstract: Successful HIV prevention programs—such as sterile needle and syringe programs—have ensured that incidence and prevalence of HIV among people who inject drugs remains low in Australia. However, between 1999 and 2006, 20 of the 46 injecting-related HIV notifications in Melbourne (Australia’s second-largest city) were ethnic Vietnamese heroin users. Through in-depth interviews we explored and documented the coping tactics and strategies of 9 ethnic Vietnamese heroin injectors. We explored their experiences of living with HIV, and in this article identify factors that appear to have contributed to limiting the spread of HIV beyond this cluster of people. The data reveal factors associated with this self-limiting outbreak, including consciously avoiding opioid withdrawal and having closed injecting networks. Early and effective engagement with participants by health care workers also appears to have played an important role in containing the transmission of HIV within this group of ethnic Vietnamese heroin injectors.
An evaluation of a heroin overdose prevention and education campaign.
Publisher: Wiley
Date: 2010
DOI: 10.1111/J.1465-3362.2009.00083.X
Abstract: Following detection of an upward trend in the frequency of fatal heroin overdoses in Victoria between 2001 and 2003, Victoria's Department of Human Services planned a c aign aimed at increasing injecting drug users' (IDU) awareness of overdose risks and prevention strategies. Stickers, wallet cards and posters featuring five key messages were distributed via needle and syringe programs (NSP) and other drug and alcohol services between November 2005 and April 2006. An evaluation of the c aign was commissioned to be conducted in late 2006. The evaluation consisted of analysis of three independent data sets--quantitative data collected from IDU during the c aign period (n = 855 at baseline and a range of 146-656 at follow up) qualitative interviews with IDU who were NSP clients during the c aign period (n = 16) and qualitative interviews with NSP staff and other key stakeholders (n = 9). While key experts felt that the c aign messages had engendered lasting impact for at least some IDU, these positive impressions were not borne out by the NSP client data, with less than one quarter of all c aign messages being mentioned by a significantly higher proportion of clients during the post-c aign period compared with baseline. Key experts perceived the greatest weakness of the c aign to be the delay between issue identification and the introduction of c aign materials. While IDU are generally responsive to health promotion c aigns, future initiatives in this domain should be designed and implemented rapidly and in ways that are sufficiently flexible to cope with shifts in drug markets which could influence the reception of key messages.
Just not all ice users do that: investigating perceptions and potential harms of Australia's Ice Destroys Lives campaign in two studies.
Publisher: Springer Science and Business Media LLC
Date: 14-07-2017
Drug injection in Iranian prisons: evidence from the National Rapid Assessment and Response (RAR) survey, 2017
Publisher: Informa UK Limited
Date: 21-06-2021
Blood-borne virus transmission in an urban, culturally diverse neighbourhood: results from a cross-sectional bio-behavioural survey using innovative outreach methods in a hard-to-reach population.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/SH16219
Abstract: Background Following a HIV outbreak among Aboriginal people in a culturally erse inner-city suburb of Melbourne, a blood-borne virus (BBV) screening program was conducted to inform public health interventions to prevent transmission and facilitate timely diagnosis and linkage to care. Methods: In August–September 2014, community health workers recruited people who inject drugs (PWID) from a local needle and syringe program. Participants were tested for hepatitis C virus (HCV), hepatitis B virus (HBV), HIV and syphilis and completed a bio-behavioural questionnaire. Results: In total, 128 PWID participated in the study. Serological evidence of exposure to HCV and HBV was detected among 118 (93%) and 57 participants (45%) respectively. Five participants were HIV positive. Independent risk factors for needle sharing were Aboriginality (AOR = 6.21, P 0.001), attending health care for mental health problems (AOR = 2.79, P = 0.023) and inability to access drug treatment in the previous 6 months (AOR = 4.34, P = 0.023). Conclusions: BBV prevalence in this s le was much higher than reported in other recent Australian studies. This local population is at high risk of further BBV transmission, particularly Aboriginal PWID. In idual and service-related factors associated with risk in the context of a dynamic urban drug culture and HIV outbreak suggest an urgent need for tailored harm-reduction measures.
HIV Risk Perception and Risky Behavior Among People Who Inject Drugs in Kermanshah, Western Iran
Publisher: Springer Science and Business Media LLC
Date: 25-01-2017
DOI: 10.1007/S12529-017-9634-7
Abstract: Understanding and increasing awareness on in idual risk for HIV infection as well as HIV risk perception's effects on different behavioral outcomes for people who inject drugs (PWID) is important for policymaking and planning purposes. The objectives of the present study were to determine whether HIV risk perception was associated with greater injection and sexual risk-taking behaviors among PWIDs. We surveyed 460 PWID in Kermanshah regarding their demographic characteristics, sexual risk behaviors, HIV risk perception, and drug-related risk behaviors in the month prior to the study. Three classes of HIV risk perception were identified using ordinal regression to determine factors associated with HIV risk perception. Study participants were categorized as follows: "low" (n = 100, 22%), "moderate" (n = 150, 32%), and "high" (n = 210, 46%) risk perception for becoming infected with HIV. The odds of categorizing as "high" risk for HIV was significantly greater in PWID that reported unprotected sex (adjusted odds ratio (AOR) 2.4, p value 0.02), receptive syringe sharing (AOR 1.8, p value 0.01), and multiple sex partners (AOR 1.4, p value 0.03). PWID who reported unprotected sex had 2.7 times the odds of "high" risk perception when compared to PWID with "low" risk perception. Findings show that PWID could rate their HIV risk with acceptable accuracy. Additionally, perceived HIV risk was associated with many risk factors for transmission of HIV, emphasizing the importance of developing targeted prevention and harm reduction programs for all domains of risk behaviors, both sexual and drug-related use.
Integrating enhanced hepatitis C testing and counselling in research
Publisher: Elsevier BV
Date: 02-2008
DOI: 10.1016/J.DRUGPO.2007.04.002
Abstract: The hepatitis C virus (HCV) affects over 170 million people worldwide. In Australia, over 225,000 people have been diagnosed with HCV infection with 13,000 infections reported annually 90% are attributed to injecting drug use. Burnet Institute (BI) researchers have been studying the HCV epidemic since the virus was identified in 1989 including community based cohort studies (1990-1995), numerous studies involving Vietnamese-Australian people who inject drugs (PWID) (1996-2004) and social network studies (2000-2002, 2005-2007). Through this work the BI has developed a model of research practice for HCV and PWID, developed in recognition that much research relating to BBV infections - and HCV in particular - could be improved in terms of provision of test results to study participants. Our model endeavours to provide all participants with the highest quality HCV test results, delivered in accordance with best practice for pre- and post-test counselling by engaging participants in environments in which they are comfortable, building trust and rapport and being available throughout and beyond the research study. This paper will discuss the benefits and lessons learned over numerous studies in providing pre- and post-test counselling to PWID in an outreach capacity.
Heavy alcohol consumption among marginalised African refugee young people in Melbourne, Australia: motivations for drinking, experiences of alcohol-related problems and strategies for managing drinking.
Publisher: Informa UK Limited
Date: 14-07-2015
DOI: 10.1080/13557858.2015.1061105
Abstract: Little is known about substance use among resettled refugee populations. This study aimed to describe motivations for drinking, experiences of alcohol-related problems and strategies for managing drinking among marginalised African refugee young people in Melbourne, Australia. Face-to-face interviews were conducted with 16 self-identified African refugees recruited from street-based settings in 2012-2013. Interview transcripts were analysed inductively to identify key themes. Participants gathered in public spaces to consume alcohol on a daily or near-daily basis. Three key motivations for heavy alcohol consumption were identified: drinking to cope with trauma, drinking to cope with boredom and frustration and drinking as a social experience. Participants reported experiencing a range of health and social consequences of their alcohol consumption, including breakdown of family relationships, homelessness, interpersonal violence, contact with the justice system and poor health. Strategies for managing drinking included attending counselling or residential detoxification programmes, self-imposed physical isolation and intentionally committing crime in order to be incarcerated. These findings highlight the urgent need for targeted harm reduction education for African young people who consume alcohol. Given the importance of social relationships within this community, use of peer-based strategies are likely to be particularly effective. Development and implementation of programmes that address the underlying health and psychosocial causes and consequences of heavy alcohol use are also needed.
Motivations for crystal methamphetamine-opioid co-injection/co-use amongst community-recruited people who inject drugs: a qualitative study.
Publisher: Springer Science and Business Media LLC
Date: 27-02-2020
DOI: 10.1186/S12954-020-00360-9
Abstract: We report on motivations for crystal meth hetamine-opioid co-use/co-injection through narratives of people who inject drugs during a period of increased crystal meth hetamine use reporting in Australia. Fourteen in-depth interviews were undertaken with selected participants (12 male, 2 female) from the Melbourne Injecting Drug User Cohort Study, including those in and out of opioid substitution therapy (OST). The main motivations for co-use reported by participants were as follows: (1) that heroin could be used to reduce the negative side effects of heavy crystal meth hetamine use, particularly during the ‘comedown’ phase (2) that small quantities of crystal meth hetamine used with heroin could prolong the intoxication effect of heroin, and hence the time before opioid withdrawal (3) that co-injection of crystal meth hetamine and heroin produced a more desirable intoxication effect than using either substance on its own and (4) that crystal meth hetamine provided a substitute ‘high’ for heroin after commencing OST treatment. Co-use of meth hetamine and opioids has been used by people who inject drugs to facilitate intoxication, sometimes as the result of ineffective opioid substitution therapy (OST) treatment and perceived lack of pleasure after stabilisation on OST treatment.
Longitudinal changes in personal wellbeing in a cohort of people who inject drugs.
Publisher: Public Library of Science (PLoS)
Date: 31-05-2017
Behavioural research to inform understanding of hepatitis C resistance
Publisher: Elsevier BV
Date: 11-2015
Increasing amphetamine use and forensic involvement among clients of three residential Indigenous alcohol and other drug services in Victoria, Australia
Publisher: Wiley
Date: 21-03-2018
DOI: 10.1111/DAR.12692
Abstract: Indigenous people seeking residential alcohol and other drug (AOD) rehabilitation in Victoria are most frequently referred to the Ngwala Willumbong Co-operative (Ngwala). This study aimed to describe socio-demographic changes in clients of Ngwala's residential rehabilitation services between 2015 and 2016. Self-assessment surveys completed upon screening for rehabilitation between May 2015 and November 2016 (n = 117) were analysed for socio-demographic data, AOD use and mental health status. Ngwala's monthly summary reports from January 2015 to December 2016 were analysed to compare primary drugs of concern, proportion of forensic clients assessed and admitted across 2015-2016. Independent t-tests and tests of two proportions were used to compare variables between years, with differences considered significant when P < 0.05. Clients were predominantly Indigenous (n = 100, 91%), male (n = 92, 71%) and unemployed (n = 106, 93%). Most clients (n = 92, 88%) were at high risk of serious mental illness (by Kessler Psychological Distress Scale). A significantly higher proportion of forensic clients were admitted in 2016 (n = 221, 60%) compared to 2015 (n = 158, 43% P < 0.001 95% confidence interval -0.24, -0.10). The mean monthly number of clients listing hetamines as their primary drug of concern upon assessment was greater in 2016 (21 ± 7.19 people) compared to 2015 (12 ± 2.78 people P = 0.01 95% confidence interval 3.13, 15.37). These findings suggest the proportion of Indigenous people in AOD treatment with hetamine use problems or forensic involvement is increasing. These trends should be considered in service design and funding decisions.
Longitudinal changes in psychological distress in a cohort of people who inject drugs in Melbourne, Australia.
Publisher: Elsevier BV
Date: 11-2016
DOI: 10.1016/J.DRUGALCDEP.2016.08.638
Abstract: Previous research into psychological distress among people who inject drugs (PWID) is predominantly cross-sectional we determined longitudinal predictors of change in psychological distress among a cohort of PWID. We examined Kessler Psychological Distress Scale (K10) scores from 564 PWID (66% male) enrolled in the Melbourne Injecting Drug User Cohort Study. Gender-stratified linear models with fixed effects for each participant were used to examine correlates of change in in idual K10 scores. Further linear regressions of adjusted K10 scores were used to measure correlations between demographic variables. Participants reported higher K10 scores (higher psychological distress) than the general Australian population (mean K10 scores 23.4 (95%CI 22.6-24.2) and 14.5 (95%CI 14.3-14.7) respectively). The cohort's mean K10 score did not significantly differ over time, but in idual variations were common. Women reported higher K10 scores than men (mean baseline K10 scores 25.2 (95%CI 23.9-26.6) and 22.4 (95%CI 21.5-23.3) respectively), however no significant differences remained after controlling for temporal factors. Key predictors of increases in K10 scores were being the victim of an assault in the past six months (P<0.001 for women and men) and intentionally overdosing in the past 12 months (P=.010 for women and P<0.001 for men). PWID experience higher levels of psychological distress than the general population. Temporal rather than in idual factors may account for the higher levels of psychological distress reported among women. Interventions to reduce rates of assault and/or intentional overdose should be explored to reduce high levels of psychological distress among PWID.
High Rates of Hepatitis C Virus Reinfection and Spontaneous Clearance of Reinfection in People Who Inject Drugs: A Prospective Cohort Study
Publisher: Public Library of Science (PLoS)
Date: 07-11-2013
The effect of on-site and outreach-based needle and syringe programs in people who inject drugs in Kermanshah, Iran
Publisher: Elsevier BV
Date: 2016
DOI: 10.1016/J.DRUGPO.2015.10.011
Abstract: Needle and syringe programs (NSPs) are widely used to reduce harms associated with drug injecting. This study assessed the effect of facility-based (on-site services at drop-in centre) and outreach models of NSP on injection risk behaviours. Self-reported data from 455 people who injected drugs (PWID) during 2014 in Kermanshah, Iran, were examined to measure demographic characteristics and risk behaviors. Self-reported and program data were also assessed to identify their main source of injection equipment. Participants were ided into three sub-groups: facility-based NSP users, outreach NSP users and non-users (comparison group). Coarsened exact matching was used to make the three groups statistically equivalent based on age, place of residence, education and income, and groups were compared regarding the proportion of borrowing or lending of syringes/cookers, reusing syringes and recent HIV testing. Overall, 76% of participants reported any NSP service use during the two months prior to interview. Only 23% (95%CI: 17-27) reported outreach NSP as their main source of syringes. Using facility-based NSP significantly decreased recent syringe borrowing (OR: 0.27, 95%CI: 0.10-0.70), recent syringe reuse (OR: 0.38, 95%CI: 0.23-0.68) and increased recent HIV testing (OR: 2.60, 95%CI: 1.48-4.56). Similar effects were observed among outreach NSP users in addition, the outreach NSP model significantly reduced the chance of lending syringes (OR: 0.31, 95%CI: 0.15-0.60), compared to facility-based NSP (OR: 1.25, 95%CI: 0.74-2.17). These findings suggest that the outreach NSP model is as effective as facility-based NSP in reducing injection risk behaviours and increasing the rate of HIV testing. Outreach NSP was even more effective than facility-based in reducing the lending of syringes to others. Scaling up outreach NSP is an effective intervention to further reduce transmission of HIV via needle sharing.
It stops with us: Peer responses increase availability of sterile injecting equipment.
Publisher: Elsevier BV
Date: 03-2016
Recognition of hepatitis C virus coinfection in HIV-positive injecting drug users in Asia [3]
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2007
Risk behaviours of young Indo-Chinese injecting drug users in Sydney and Melbourne.
Publisher: Elsevier BV
Date: 02-2001
DOI: 10.1111/J.1467-842X.2001.TB00550.X
Abstract: To investigate patterns of drug use and injection-related risk behaviours among young Indo-Chinese injecting drug users (IDUs). Cross-sectional survey. A structured questionnaire was administered to 184 Indo-Chinese IDUs aged 15 to 24 in Sydney and Melbourne. Participants were recruited using snowball s ling techniques measures included patterns of heroin and other drug use, injection-related risk behaviours, perceived susceptibility to HIV and HCV infection and access to services. Despite perceived high availability of sterile injecting equipment, 36% had ever shared a needle and syringe and 22% had done so in the preceding month. Lifetime sharing was significantly associated with duration of injecting, history of incarceration and residence in Sydney. Sharing of injecting paraphernalia other than needles and syringes was also common, with young women and Sydney residents significantly more likely to report sharing equipment in the preceding month. Young Indo-Chinese IDUs are at high risk of infection with hepatitis C and other blood-borne viruses. Results indicate an urgent need for culturally appropriate and sustainable risk reduction programs which specifically target this population. Health services must respond swiftly to implement effective blood-borne virus prevention programs for young Indo-Chinese IDUs. Failure to do so may sustain the current epidemic of hepatitis C among IDUs.
Presumptive analysis of 4-methylmethcathinone (mephedrone) using Desorption Electrospray Ionisation - Mass Spectrometry (DESI-MS)
Publisher: Informa UK Limited
Date: 05-02-2014
Prevalence and correlates of simultaneous, multiple substance injection (co-injection) among people who inject drugs in Melbourne, Australia.
Publisher: Wiley
Date: 27-08-2020
DOI: 10.1111/ADD.15217
Factors associated with HIV testing among people who inject drugs Tehran
Publisher: Informa UK Limited
Date: 27-11-2017
The impact of injecting networks on hepatitis C transmission and treatment in people who inject drugs
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-10-2014
DOI: 10.1002/HEP.27403
Abstract: With the development of new highly efficacious direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV), the concept of treatment as prevention is gaining credence. To date, the majority of mathematical models assume perfect mixing, with injectors having equal contact with all other injectors. This article explores how using a networks-based approach to treat people who inject drugs (PWID) with DAAs affects HCV prevalence. Using observational data, we parameterized an exponential random graph model containing 524 nodes. We simulated transmission of HCV through this network using a discrete time, stochastic transmission model. The effect of five treatment strategies on the prevalence of HCV was investigated two of these strategies were (1) treat randomly selected nodes and (2) "treat your friends," where an in idual is chosen at random for treatment and all their infected neighbors are treated. As treatment coverage increases, HCV prevalence at 10 years reduces for both the high- and low-efficacy treatment. Within each set of parameters, the treat your friends strategy performed better than the random strategy being most marked for higher-efficacy treatment. For ex le, over 10 years of treating 25 per 1,000 PWID, the prevalence drops from 50% to 40% for the random strategy and to 33% for the treat your friends strategy (6.5% difference 95% confidence interval: 5.1-8.1). Treat your friends is a feasible means of utilizing network strategies to improve treatment efficiency. In an era of highly efficacious and highly tolerable treatment, such an approach will benefit not just the in idual, but also the community more broadly by reducing the prevalence of HCV among PWID.
Establishing the Melbourne Injecting Drug User Cohort Study (MIX): rationale, methods, and baseline and twelve-month follow-up results.
Publisher: Springer Science and Business Media LLC
Date: 2013
Experiences of and attitudes toward injecting drug use among marginalized African migrant and refugee youth in Melbourne, Australia.
Publisher: Informa UK Limited
Date: 02-10-2014
DOI: 10.1080/15332640.2014.958639
Abstract: Little is known about injecting drug use (IDU) among people from culturally and linguistically erse backgrounds in Australia. We interviewed 18 young people of African ethnicity (6 current/former injectors, 12 never injectors) about exposure and attitudes to IDU. Exposure to IDU was common, with IDU characterized as unnatural, risky and immoral. IDU was highly stigmatized and hidden from family and friends. There is a need for culturally appropriate programs to promote open dialogue about substance use to reduce stigma and prevent African youth who may use illicit drugs from becoming further marginalized.
Access to needle and syringe programs and the relationship to equipment sharing among people who inject drugs in Kermanshah, Iran
Publisher: Informa UK Limited
Date: 28-10-2016
Direct-acting antiviral treatment for HCV
Publisher: Elsevier BV
Date: 12-2016
Qualitative evaluation of a peer-based needle syringe programme in Vietnam
Publisher: Elsevier BV
Date: 03-2009
DOI: 10.1016/J.DRUGPO.2007.12.009
Abstract: Harm reduction has been identified as an important HIV prevention strategy for injecting drug users (IDUs) in Vietnam. However, to date only small geographically limited formal needle syringe programmes (NSPs) have been implemented and little attention has been given to assessing the effectiveness of the piloted models. Using data from a qualitative evaluation of an NSP in northern Vietnam, this paper assesses the effectiveness of the intervention, examines barriers to the NSP, and documents lessons which can be applied to replicate and scale up interventions across Vietnam. Data were gathered using key informant interviews, focus group discussions, in-depth interviews, observation and intercept interviews with IDUs and other project stakeholders. IDUs were introduced to the evaluation by peer educators (PEs). The project contributed to a shift toward safe injecting practices and safe disposal of used needles and syringes (N&S) among IDUs. Collection of used N&S positively influenced community attitudes toward PEs and IDUs. Reduced community discrimination, achieved as a result of project advocacy activities, encouraged IDU to access free needle syringes and other project services provided by PEs. Resistance from the local government officials and community members was turned into support for the programme through intensive advocacy activities. The project highlighted the importance of involving law enforcement in the programme and promoted a public health approach toward working with IDU. However, periodic police c aigns against drug use continued to be an obstacle to successful programme implementation and demonstrated the need for continued efforts to address the issue. Programme success is dependent upon community support. Resistance to NSPs can be overcome through a programme of intensive advocacy with community stakeholders including local government, mass organizations, local residents, IDUs and their families. Garnering the support of law enforcement officials requires a sustained effort.
Patterns of HIV Risks and Related Factors among People Who Inject Drugs in Kermanshah, Iran: A Latent Class Analysis
Publisher: Informa UK Limited
Date: 12-12-2016
Drug type and high risk behaviors associated with health-care utilization among people who inject drugs: a systematic review and meta-analysis
Publisher: Informa UK Limited
Date: 06-09-2022
Jugular venipuncture and other innovative approaches to phlebotomy among people who inject drugs
Publisher: Wiley
Date: 26-08-2015
DOI: 10.1111/NHS.12231
Abstract: In their recent paper on patient experiences of accessing phlebotomy services in hospital outpatient clinics, Clements and colleagues state that there is a real need to better understand the responses of people who inject drugs to phlebotomy. They discuss the reasons why people who inject drugs might not be accessing healthcare services, especially in relation to treatment for hepatitis C. Their research is a welcome addition to the literature that emphasizes the stigma and discrimination faced by people who inject drugs, including within healthcare settings, and outlines the need to promote effective partnerships between healthcare workers and patients so as to deliver the best health outcomes.
Gender, culture and harm: an exploratory study of female heroin users of Vietnamese ethnicity.
Publisher: Informa UK Limited
Date: 10-2008
DOI: 10.1080/13691050802203838
Abstract: Previous quantitative cross sectional studies of ethnic Vietnamese drug users in Melbourne have been overwhelmingly drawn from s les of men. In this qualitative investigation, 24 women aged between 18 and 33 years were interviewed. This exploratory study sought: to identify issues surrounding heroin initiation and drug use career to examine relationships with family and primary sex partners and to reveal participants' attitudes to drug treatment. Data reveal that for the women in this study the initiation and continued use of heroin was heavily influenced by men, especially their primary sex partners. The women interviewed reported strategies to minimise their risk taking including enrolling in pharmacotherapy treatment programmes, but they remained particularly vulnerable - especially to blood borne viruses - through both injecting and sexual risk behaviour. The data suggest that interventions which focus on the gendered nature of injecting practices within personal relationships may go some way to both reducing harm and increasing control for the women involved.
The introduction of CCTV and associated changes in heroin purchase and injection settings in Footscray, Victoria, Australia
Publisher: Springer Science and Business Media LLC
Date: 21-04-2016
Community-based provision of direct-acting antiviral therapy for hepatitis C: Study protocol and challenges of a randomized controlled trial
Publisher: Springer Science and Business Media LLC
Date: 16-07-2018
“We Might Get Some Free Beers”: Experience and Motivation for Transactional Sex Among Behaviorally Bisexual Men in Vientiane, Laos
Publisher: Springer Science and Business Media LLC
Date: 23-03-2016
DOI: 10.1007/S10508-016-0705-7
Abstract: People engaging in transactional sex are considered a key population for HIV prevention. Prior quantitative surveys demonstrated that behaviorally bisexual men in Vientiane, Laos commonly transact sex. In 2013, we conducted a qualitative study to explore behaviorally bisexual men's experience, motivations, and perceptions related to transactional sex in Vientiane. Behaviorally bisexual men were recruited from bars, nightclubs, and dormitories for five focus group discussions (FGDs) and 11 in-depth interviews (n = 31). Additionally, young women were recruited from a university, garment factory, and nightclub for four FGDs (n = 22). Transcripts were translated and thematically coded. Bisexual male participants most commonly described being paid for sex by male-to-female transgender people and buying sex from women. Both male and female participants reported that older, single women pay younger men for sex. Negotiation and direction of sexual transactions are influenced by age, attraction, and wealth. Common motivations for selling sex included the need for money to support family or fund school fees, material gain, or physical pleasure. Transactional sex was often opportunistic. Some behaviorally bisexual men reported selling sex in order to pay another more desirable sex partner or to buy gifts for their regular sex partner. Participants perceived high risk associated with intercourse with female sex workers but not with other transactional sex partners. Health interventions are needed to improve knowledge, risk perception, and health behaviors, but must recognize the ersity of transactional sex in Vientiane. Both physical and virtual settings may be appropriate for reaching behaviorally bisexual men and their partners.
Footpath traders in a Hanoi neighbourhood
Publisher: Routledge
Date: 25-07-2003
Synthesis of iron fertilization experiments: From the Iron Age in the Age of Enlightenment
Publisher: American Geophysical Union (AGU)
Date: 09-2005
DOI: 10.1029/2004JC002601
Hepatitis C Virus Seroprevalence and Associated Risk Factors Among Male Drug Injectors in Kermanshah, Iran
Publisher: Briefland
Date: 25-10-2017
Injecting drug use continues in older drug users too.
Publisher: BMJ
Date: 17-10-2017
DOI: 10.1136/BMJ.J4738
New hepatitis C antiviral treatments eliminate the virus
Publisher: Elsevier BV
Date: 07-2017
The effects of needle-sharing and opioid substitution therapy on incidence of hepatitis C virus infection and reinfection in people who inject drugs.
Publisher: Cambridge University Press (CUP)
Date: 08-12-2016
DOI: 10.1017/S0950268816002892
Abstract: Although high hepatitis C virus (HCV) prevalence has been observed in people who inject drugs (PWID) for decades, research suggests incidence is falling. We examined whether PWIDs’ use of opioid substitution therapy (OST) and their needle-and-syringe sharing behaviour explained HCV incidence. We assessed HCV incidence in 235 PWID in Melbourne, Australia, and performed discrete-time survival with needle-sharing and OST status as independent variables. HCV infection, reinfection and combined infection/reinfection incidences were 7·6 [95% confidence interval (CI) 4·8–11·9], 12·4 (95% CI 9·1–17·0) and 9·7 (95% CI 7·4–12·6) per 100 person-years, respectively. Needle-sharing was significantly associated with higher incidence of naive HCV infection [hazard ratio (HR) 4·9, 95% CI 1·3–17·7] but not reinfection (HR 1·85, 95% CI 0·79–4·32) however, a cross-model test suggested this difference was s le specific. Past month use of OST had non-significant protective effects against naive HCV infection and reinfection. Our data confirm previous evidence of greatly reduced HCV incidence in PWID, but not the significant protective effect of OST on HCV incidence detected in recent studies. Our findings reinforce the need for greater access to HCV testing and prevention services to accelerate the decline in incidence, and HCV treatment, management and support to limit reinfection.
Social Media and Online Digital Technology Use Among Muslim Young People and Parents: Qualitative Focus Group Study (Preprint)
Publisher: JMIR Publications Inc.
Date: 02-2022
Abstract: igital technology and social media use are common among young people in Australia and worldwide. Research suggests that young people have both positive and negative experiences online, but we know little about the experiences of Muslim communities. his study aims to explore the positive and negative experiences of digital technology and social media use among young people and parents from Muslim backgrounds in Melbourne, Victoria, Australia. his study involved a partnership between researchers and a not-for-profit organization that work with culturally and linguistically erse communities. We adopted a participatory and qualitative approach and designed the research in consultation with young people from Muslim backgrounds. Data were collected through in-person and online focus groups with 33 young people aged 16-22 years and 15 parents aged 40-57 years. Data were thematically analyzed. e generated 3 themes: (1) maintaining local and global connections, (2) a paradoxical space: identity, belonging and discrimination, and (3) the digital ide between young Muslims and parents. Results highlighted that social media was an important extension of social and cultural connections, particularly during COVID-19, when people were unable to connect through school or places of worship. Young participants perceived social media as a space where they could establish their identity and feel a sense of belonging. However, participants were also at risk of being exposed to discrimination and unrealistic standards of beauty and success. Although parents and young people shared some similar concerns, there was a large digital ide in online experiences. Both groups implemented strategies to reduce social media use, with young people believing that having short technology-free breaks during prayer and quality family time was beneficial for their mental well-being. rograms that address technology-related harms must acknowledge the benefits of social media for young Muslims across identity, belonging, representation, and social connection. Further research is required to understand how parents and young people can create environments that foster technology-free breaks to support mental well-being.
Letter: New treatments for hepatitis C have implications for quality of life in people who inject drugs
Publisher: Wiley
Date: 02-03-2016
DOI: 10.1111/APT.13538
Risk behaviours and blood borne virus exposure for transient workers in rural Victoria
Publisher: Wiley
Date: 07-05-2008
DOI: 10.1111/J.1440-1584.2008.00964.X
Abstract: To investigate risk behaviours associated with the transmission of blood borne viruses (BBVs) and sexually transmitted infections (STIs) among transient rural workers in Victoria. Cross-sectional study using a convenience s ling frame. Between June and August 2006, 89 participants were recruited from sites located in three rural centres in Victoria's Loddon and Mallee regions. Data were collected using a short questionnaire that asked about history of transient work, sexual history, condom use, alcohol and illicit drug use, and BBV history and testing. Finger-prick blood s les were collected in order to determine prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) exposure. Eighty-nine in iduals completed a questionnaire, and 85 (96%) provided a finger-prick blood s le for antibody testing. Twenty-seven participants (30%) were consuming alcohol at levels risky to health. Thirty per cent of participants with new partners reported infrequent condom use. Illicit drug use (mainly marijuana) was widespread with more than 46% of the s le reporting recent use of illicit drugs. An HCV exposure prevalence of 2.4% was measured no s les tested reactive for HIV antibodies. Compared with nationally representative data, our study s le reported high rates of alcohol consumption at levels risky to health, illicit drug use and infrequent use of condoms. These results suggest that transient workers and their contacts would benefit from the targeted provision of harm-reduction services, with a particular focus on sexual behaviour and alcohol and drug use.
Molecular Epidemiology of Hepatitis C Virus in a Social Network of Injection Drug Users
Publisher: Oxford University Press (OUP)
Date: 11-2004
DOI: 10.1086/424678
Abstract: We aimed to measure the overlap between the social networks of injection drug users (IDUs) and the patterns of related hepatitis C virus (HCV) infections among IDUs. A cohort of 199 IDUs (138 of whom were HCV RNA positive) was recruited from a local drug scene in Melbourne, Australia, and was studied using social network analysis and molecular phylogenetic analysis of 2 regions of the HCV genome. Eighteen clusters of related infections involving 51 IDUs (37.0% of HCV RNA-positive IDUs) were detected these clusters could be separated into 66 discrete pairs. Twelve (18.2%) of the 66 IDU pairs with related infections reported having previously injected drugs together conversely, only 12 (3.8%) of the 313 pairs of HCV RNA-positive IDUs who were injection partners had strong molecular evidence of related infections. The social and genetic distances that separated IDUs with identical genotypes were weakly associated. Significant clusters of phylogenetically related sequences identified from core region analysis persisted in the analysis of the nonstructural 5a protein region. Genotyping and sequence analysis revealed 2 mixed-genotype infections. Static social network methods are likely to gather information about a minority of patterns of HCV transmission, because of the difficulty of determining historical infection pathways in an established social network of IDUs. Nevertheless, molecular epidemiological methods identified clusters of IDUs with related viruses and provided information about mixed-genotype infection status.
What is the alcohol, tobacco, and other drug prevalence among culturally and linguistically diverse groups in the Australian population? A national study of prevalence, harms, and attitudes
Publisher: Informa UK Limited
Date: 31-07-2018
DOI: 10.1080/15332640.2018.1484310
Abstract: In Australia, one in three people are born overseas, and one in five households speak languages other than English. This study explores substance use prevalence, related harms, and attitudes among these large groups in the population. Analysis was conducted using cross-sectional data (
Further research required to determine unique factors associated with dental care access among deprived populations.
Publisher: Elsevier BV
Date: 12-2014
Reducing alcohol-related harm in people recently treated for hepatitis C
Publisher: CSIRO Publishing
Date: 2019
DOI: 10.1071/PY19074
Hepatitis C transmission and treatment as prevention - The role of the injecting network
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1016/J.DRUGPO.2015.05.006
Abstract: The hepatitis C virus (HCV) epidemic is a major health issue in most developed countries it is driven by people who inject drugs (PWID). Injecting networks powerfully influence HCV transmission. In this paper we provide an overview of 10 years of research into injecting networks and HCV, culminating in a network-based approach to provision of direct-acting antiviral therapy. Between 2005 and 2010 we followed a cohort of 413 PWID, measuring HCV incidence, prevalence and injecting risk, including network-related factors. We developed an in idual-based HCV transmission model, using it to simulate the spread of HCV through the empirical social network of PWID. In addition, we created an empirically grounded network model of injecting relationships using exponential random graph models (ERGMs), allowing simulation of realistic networks for investigating HCV treatment and intervention strategies. Our empirical work and modelling underpins the TAP Study, which is examining the feasibility of community-based treatment of PWID with DAAs. We observed incidence rates of HCV primary infection and reinfection of 12.8 per 100 person-years (PY) (95%CI: 7.7-20.0) and 28.8 per 100 PY (95%CI: 15.0-55.4), respectively, and determined that HCV transmission clusters correlated with reported injecting relationships. Transmission modelling showed that the empirical network provided some protective effect, slowing HCV transmission compared to a fully connected, homogenous PWID population. Our ERGMs revealed that treating PWID and all their contacts was the most effective strategy and targeting treatment to infected PWID with the most contacts the least effective. Networks-based approaches greatly increase understanding of HCV transmission and will inform the implementation of treatment as prevention using DAAs.
'It's always just there in your face': Young people's views on porn
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/SH14225
Abstract: Background Young people’s exposure to pornography has increased, as has the violent and sexist nature of mainstream porn. Contemporary content means young people are exposed to violent porn whether they like it or not, and it is no longer a question of whether they will be exposed, but rather when. Methods: Using purposive s ling, 33 in-depth interviews were conducted with young people aged 15–20 years in 2010–11, to explore the phenomenon of sexting. During initial interviews, participants raised the topic of pornography exposure as a secondary, unexpected finding. Discussions highlighted an important link between sexting and pornography. The inductive nature of the research meant this new and important area of inquiry was able to be explored. Results: Data was thematically coded and analysed using a grounded theory approach. Findings highlight that many young people are exposed to porn both intentionally and unintentionally. Furthermore, they are concerned about gendered norms that reinforce men’s power and subordination over women. A link between porn exposure, young men’s sexual expectations and young women’s pressure to conform to what is being viewed, has been exposed. Conclusions: Results are significant given this is one of few recent qualitative Australian studies to explore the issue of pornography exposure from the perspective of young people. Important implications for educators, parents and health providers have been revealed, including the need to create opportunities for young people to challenge the messages expressed in porn, and for their views to be heard in academic and public debate.
Buprenorphine injection in Melbourne, Australia - an update
Publisher: Wiley
Date: 03-2008
DOI: 10.1080/09595230701829553
Abstract: To investigate the prevalence and associations of buprenorphine injection among a field-recruited cohort of injecting drug users. Cross-sectional data from a prospective longitudinal cohort. Setting. Metropolitan Melbourne, Australia. Current injecting drug users (IDUs). Prevalence of buprenorphine injection, associations with location, buprenorphine as prescribed pharmacotherapy, markers of hepatitis C virus (HCV) exposure and risk behaviours for HCV. More than 10% of our 316 participants reported buprenorphine as the drug they had most often injected, and 32% had injected buprenorphine at least once in the 3 months prior to interview. Primary buprenorphine injection was significantly more likely to be reported by IDUs recruited at one of our three research sites, and by those being prescribed buprenorphine for opioid dependence. Frequency of sharing a used needle was also associated with buprenorphine injection, but HCV exposure was not. Buprenorphine injection has become entrenched among some groups of Victorian IDUs. The practice carries serious risks to health, including some related to microbiological contamination of buprenorphine during ersion. While measures can be taken to reduce the occurrence of buprenorphine ersion and injection and the associated harm, an alternative harm reduction measure would be to provide IDUs with an injectable pharmacotherapy.
Limits to Relying on Expert Information: The Delphi Technique in a Study of Ethnic Vietnamese Injection Drug Users in Melbourne, Australia
Publisher: Informa UK Limited
Date: 03-09-2009
DOI: 10.1080/19371910802672197
Abstract: Information from experts, or "key informants," is often used when estimating the prevalence of a disease, the numbers in particular risk groups, or the frequency of particular risk behaviors. This study aimed to better understand and describe the usefulness of key informants in informing an area such as injection drug use, where the populations are often marginalized and difficult to identify and the illnesses (HIV and hepatitis C virus) associated with the risk behavior can lead to discrimination by the general community. Our study results highlight the limitations of relying upon key informant information alone to provide specific information or accurate data about ethnic Vietnamese injection drug users. While exercises such as the Delphi technique can be used to generate the broad views and opinions of experts around a particular issue, we argue that care must be taken when using such information as evidence on which to base the direction and design of social and public health policy and resources, particularly in relation to marginalized populations.
Preventing hepatitis C virus transmission among young people in the justice system
Publisher: Elsevier BV
Date: 05-2013
Harm Reduction Is Not Just About Low Threshold Services for People Using Drugs
Publisher: Springer Science and Business Media LLC
Date: 09-02-2023
A review of qualitative research in Drug and Alcohol Review
Publisher: Wiley
Date: 11-2018
DOI: 10.1111/DAR.12307
Injecting buprenorphine‐naloxone film: Findings from an explorative qualitative study
Publisher: Wiley
Date: 14-07-2015
DOI: 10.1111/DAR.12308
Abstract: Experiences of buprenorphine-naloxone (BNX) sublingual film injection are not well documented or understood. We examined how people who inject BNX film seek and share information about this practice, document the methods used to prepare BNX film for injection, and report participants' experiences of this practice. Interviews were (n = 16) conducted with people who indicated that they had injected BNX film since its introduction onto the Australian market. Semistructured interviews were recorded and transcribed. NVivo10 program (QSR International) was used to analyse the data using qualitative description methodology. Participants largely reported similar BNX film preparation techniques, although the texture of BNX film during preparation to inject was reported to be unusual (gluggy), and there were many varied accounts associated with the amount of water used. Physical harms reported as associated with injecting BNX film were described (including local and systemic issues) participants reported injecting the film to enhance its immediate effects, yet generally reported that sublingual administration provided longer-lasting effects. Understanding knowledge acquisition about injecting new formulations of opioid substitution therapy is crucial in developing more effective harm-reduction strategies. Dissemination by peer networks to those who are currently or planning to inject BNX film regarding the 'gelatine like' texture when mixing, using only cold water and double filtering is important to ensure safer injecting practices. Findings from this study highlight the importance of peer networks for the dissemination of harm-reduction information. Introduction of new formulations internationally requires more qualitative studies to inform safer practices.
How hidden are unobserved networks among people who inject drugs?
Publisher: American Public Health Association
Date: 06-2015
Hepatitis C Virus Phylogenetic Clustering Is Associated with the Social-Injecting Network in a Cohort of People Who Inject Drugs
Publisher: Public Library of Science (PLoS)
Date: 26-10-2012
Field engagement further facilitates hepatitis B vaccination completion: Letter in response to: Day et al. (in press)
Publisher: Elsevier BV
Date: 09-2016
Concordance between self-reported and actual hepatitis C virus infection status in a cohort of people who inject drugs.
Publisher: Wiley
Date: 03-09-2012
DOI: 10.1111/J.1465-3362.2012.00502.X
Abstract: Accurate knowledge of in idual hepatitis C virus (HCV) status is an important component of comprehensive health services for people who inject drugs (PWID). In this paper we compare the perceived HCV status of PWID in a longitudinal cohort study with their actual status, as verified by HCV-RNA testing. Participants who consented to blood testing at first follow up (352/688) were included. Self-reported HCV status (positive/negative/don't know), was compared with serology test results for participants. In comparing self-report with HCV-RNA results, 274 of 352 participants had valid serology and self-report results of these, 220 (80%) accurately reported their HCV status. The findings of this study suggest that large proportions of PWID know their true HCV infection status, but the discordant participants represent potential HCV infection risks. Despite the majority of participants displaying concordance, this study reinforces the need for regular blood testing and the giving of accurate, practical and comprehensive HCV result information.
Factors Influencing Access to Sexual Health Care Among Behaviorally Bisexual Men in Vientiane, Laos
Publisher: SAGE Publications
Date: 11-2015
Abstract: In Laos, men who have sex with men (MSM) are disproportionately affected by HIV, and bisexual behavior among men is common. We conducted a qualitative study to explore access and influences on sexual health care seeking among bisexual men in Vientiane. In 2013, behaviorally bisexual men were recruited from bars, clubs and dormitories for 5 focus group discussions and 11 in-depth interviews. Participants (aged 18-35 years) commonly reported high-risk sexual behaviors, yet most had never been tested for HIV, and none reported testing for sexually transmitted infections. Common barriers to testing were low perception of risk, expectation of symptoms, fear of HIV, shyness, perceived stigma, confidentiality concerns, and waiting times. Many men were unaware of available services. Most clinics cannot provide comprehensive HIV and sexually transmitted infection services. Strategies are needed to generate demand for testing, improve the capacity of sexual health care providers, and promote available services among behaviorally bisexual men in Vientiane.
Prevalence of latent tuberculosis infection and HIV among people who inject drugs in Iran
Publisher: Wiley
Date: 20-12-2021
DOI: 10.1111/DAR.13233
Field research contextualizes local risk behaviors in Northern Vietnam
Publisher: Mary Ann Liebert Inc
Date: 02-2015
The impact of khat use on East African communities in Melbourne: a preliminary investigation.
Publisher: Wiley
Date: 05-04-2011
DOI: 10.1111/J.1465-3362.2011.00312.X
Abstract: Catha Edulis Forsk (khat) is a plant-reported to have a stimulant effect similar to that of hetamines-grown and used by eastern African communities worldwide. Khat can be legally consumed in many parts of the world, including Victoria, Australia. Recent concerns have been raised about the social and economic impacts of khat consumption among Victoria's East African community members. This study explores khat use and the social impact it has on East African families and communities in Melbourne, Australia. Focus groups and in idual interviews were conducted in 2009 with 29 members of Melbourne's East African community recruited via community leaders and snowball s ling. Fifty-five per cent of the s le reported khat use and the remainder reported only having experience of other people's use of the drug. Participants who did not report chewing khat were mainly concerned with the negative social impacts of its use, such as the extended time men spent away from their families while consuming the drug. These participants (mainly women) expressed their hope that khat would be prohibited in Victoria. Participants who reported the use of khat (mainly men) reported that any social problems existed independently of khat consumption. This study found only limited evidence that khat use has been impacting directly on people's health and well-being. Any moves to prohibit khat use may further marginalise already vulnerable groups of people.
A Retrospective Cohort Study of Women and Men Living with HIV, Attending an HIV Clinic in Australia
Publisher: Mary Ann Liebert Inc
Date: 11-2022
Vietnamese-Australian heroin users' perspectives on the role of the family in treatment
Publisher: Informa UK Limited
Date: 2009
Rapid testing for hepatitis C does not infer current infection
Publisher: Informa UK Limited
Date: 26-08-2017
Review article: Rapid review of the emergency department‐initiated buprenorphine for opioid use disorder
Publisher: Wiley
Date: 21-10-2020
Internal funding required to improve HIV care
Publisher: Wiley
Date: 08-12-2018
DOI: 10.1111/JVH.12824
Patient‐reported outcomes of the Treatment and Prevention Study: A real‐world community‐based trial of direct‐acting antivirals for hepatitis C among people who inject drugs
Publisher: Wiley
Date: 03-05-2021
DOI: 10.1111/JVH.13516
Abstract: The impact of hepatitis C cure with direct‐acting antivirals (DAAs) on patient‐reported outcomes (PROs) in community settings remains unclear. We aimed to assess changes in PROs over time and whether treatment was associated with sustained improved PROs in a cohort of people who inject drugs. This study is a sub‐analysis of the Treatment and Prevention Study, a nurse‐led trial where people who inject drugs and their injecting partners were recruited in a community setting, in Melbourne, Australia. Three participant groups were characterized: treatment, untreated and non‐viremic (hepatitis C RNA negative at screening). PROs included assessment of health‐related quality of life using the Short Form‐8 (SF‐8) Survey and life satisfaction using Personal Wellbeing Index (PWI). PROs were measured at baseline and every 12 weeks until week 84. Generalized estimating equations were used to measure whether treatment was associated with longitudinal PRO change. A total of 215 participants were included in this analysis. PWI scores were significantly higher at week 12 for both treatment group ( p = 0.0309) and non‐viremic group ( p = 0.0437) compared to baseline. However, treatment was not associated with longitudinal change in PRO scores. In conclusion, we found DAA treatment did not significantly improve PRO scores compared to those not receiving treatment and without hepatitis C. The measures used in this study may not be sensitive enough to capture the hepatitis C specific improvements in quality of life that treatment affords or factors other than treatment may be influencing quality of life scores in this cohort.
Differences in the social networks of ethnic Vietnamese and non-Vietnamese injecting drug users and their implications for blood-borne virus transmission
Publisher: Cambridge University Press (CUP)
Date: 17-05-2008
DOI: 10.1017/S0950268807008679
Abstract: The social networks of 49 ethnic Vietnamese injecting drug users (IDUs) and 150 IDUs of other ethnicities recruited in Melbourne, Australia, were examined for ethnic differences in distribution of hepatitis C virus infection risk using social network analysis and molecular epidemiology. Vietnamese IDUs were more highly connected than non-Vietnamese IDUs, and more likely to be members of dense injecting sub-networks. More related infections were detected in IDUs with discordant ethnicities than were captured in the social network data nonetheless, most dyads and most IDU pairs with related infections had matching ethnicity, confirming that mixing was assortative on that criterion. Mixing was not obviously dissortative by risk low-risk Vietnamese IDUs injected more frequently than did correspondingly low-risk non-Vietnamese IDUs, but results for other measures were reversed or equivocal. Network measurements suggest that ethnic Vietnamese IDUs are at elevated risk of blood-borne infection, a conclusion supported by their relatively high HIV prevalence.
Change in hepatitis C virus genotype in injecting drug users
Publisher: Wiley
Date: 13-10-2004
DOI: 10.1002/JMV.20212
Abstract: Six major genotypes of the hepatitis C virus (HCV) have been described it is assumed to be uncommon for genotypes to change in chronically infected in iduals. Venous blood s les obtained from Vietnamese-Australian injecting drug users who participated in successive studies conducted in Melbourne, Australia, were genotyped using the Bayer line probe assay and genotype confirmed by sequencing whenever possible. Three changes of HCV genotype were observed, and one infection in an in idual not exposed previously. The rate of change of genotype was 3 in 11.4 person-years (py), or 26.4 per 100 py (95% CI: 8.5, 81.6). Traditionally-calculated HCV incidence was 1 in 4.3 py, or 23.3 per 100 py (95% CI: 3.3, 165.1). These data imply that HCV genotype change in injecting drug users occurs at least as frequently as infections in naive in iduals, and that traditionally-calculated HCV incidence rates represent a minority of actual HCV transmission among practicing injecting drug users.
Tuning the Loading and Release Properties of MicroRNA-Silencing Porous Silicon Nanoparticles by Using Chemically Diverse Peptide Nucleic Acid Payloads
Publisher: American Chemical Society (ACS)
Date: 09-2021
Factors affecting hepatitis C treatment intentions among Aboriginal people in Western Australia: a mixed-methods study
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/AH19194
Abstract: ObjectiveThe aim of this study was to identify the hepatitis C treatment intentions of Aboriginal people living with hepatitis C virus (HCV) in Western Australia. MethodsThis study used a mixed-methods design. In the cross-sectional survey, 123 Aboriginal people who inject drugs and self-report as living with hepatitis C completed a purpose-designed questionnaire. In the qualitative phase, 10 participants were interviewed about the factors influencing their future intentions to undertake hepatitis C treatment. ResultsAnalysis of the survey data revealed significant associations between an intention to undertake hepatitis C treatment and support, community attachment, stable housing and stigma. In addition, there was a high overall level of expressed intention to undertake HCV treatment, with 54% of participants responding positively. Analysis of the qualitative data supported quantitative findings, revealing concerns about stigma, lack of social support and unstable housing as factors affecting the intention to undertake hepatitis C treatment. ConclusionThis mixed methods study with Aboriginal people living with self-reported HCV indicates interventions focused on reducing stigma and unstable housing could positively affect hepatitis C treatment intentions. These findings have implications for developing holistic programs to promote and support people on hepatitis C treatment. What is known about the topic?Substantial knowledge gaps need to be resolved if HCV elimination among Aboriginal Australians is to be achieved. Current research has prioritised non-Aboriginal communities. What does this paper add?This study found that stigma and unstable housing require attention if Aboriginal Australians are to obtain the full benefits of direct acting antiviral (DAA) hepatitis C treatment. What are the implications for practitioners?Reducing stigma (in the primary healthcare setting) and providing access to stable housing are vital components of supportive, non-judgemental and culturally appropriate care for Aboriginal people. This study highlights the importance of education for nurses and other primary care providers to increase engagement in the hepatitis cascade of care. To achieve this, scaling-up of HCV treatment engagement, trained Aboriginal community healthcare workers and HCV treatment advocates must mobilise and support Aboriginal people to avoid the negative effects of stigma, build positive and enabling relationships and reinforce positive attitudes towards DAA hepatitis C treatment.
The prevalence and risk behaviours associated with the transmission of blood‐borne viruses among ethnic‐Vietnamese injecting drug users
Publisher: Elsevier BV
Date: 12-2006
DOI: 10.1111/J.1467-842X.2006.TB00779.X
Abstract: To measure the prevalence and determinants of blood-borne virus (BBV) transmission in ethnic Vietnamese injecting drug users (IDUs). The study was conducted in Melbourne, Australia, in 2003. It was a cross-sectional design with participants recruited from street-based illicit drug markets predominately using a snowball technique. One hundred and twenty-seven participants completed a questionnaire that asked about illicit drug use and participants' blood s les were tested for HIV, HCV and HBV. One hundred and three (81.1%) ethnic Vietnamese IDU study participants were HCV positive and three (2.4%) were HIV positive. More than 60% had evidence of being infected with HBV (either in the past, acute infection or chronic infection). Almost 60% had injected daily over the past 12 months. Fifty-nine participants had recently travelled to Vietnam 24 (41%) had injected drugs in Vietnam and three (12.5%) reported sharing injecting equipment in Vietnam. The prevalence of BBVs was higher in this study's IDU population compared with IDUs in Australia generally, despite the fact that the injecting risk behaviours were similar to IDUs more generally. Culturally sensitive drug treatment and education programs need to be developed in Australia for both ethnic Vietnamese IDUs and their families to reduce this group's risk of contracting a BBV.
Directly observed hepatitis C treatment with opioid substitution therapy in community pharmacies: A qualitative study
Publisher: Elsevier BV
Date: 09-2019
DOI: 10.1016/J.SAPHARM.2019.04.004
Abstract: The hepatitis C virus (HCV) will only be eliminated through successful engagement with people who inject drugs (PWID), however some of this population experience socioeconomic and in idual issues that can lead to poor HCV treatment adherence. A key sub-group of (PWID) are those who receive opioid substitution therapy (OST). In Australia, OST is most often delivered under direct supervision by a community pharmacist every day or multiple times a week. This regular interaction could be an ideal opportunity to enhance direct-acting antiviral (DAA) treatment adherence under directly observed therapy (DOT) by the pharmacist. The aim of this study was to explore the perspectives of OST patients with a lived experience of HCV to understand whether or not dispensing DAAs in the same way as, or simultaneously with OST would benefit HCV treatment. Data collection occurred from June to August 2017. Semi-structured interviews were conducted with a s le of PWID living with HCV and on OST programs (n = 12) in Melbourne, Australia. Interviews were voice recorded and transcribed in verbatim. Interpretive phenomenology guided analysis of the data. Themes reported by participants that provide insight into the suitability of DOT of DAAs include: Adherence and non-adherence to DAA treatment Mixed views towards DOT of DAAs Experiences and perceptions of OST providers and Perceived stigma in the pharmacy. Community pharmacies offering OST may be an effective place for DOT of HCV treatment, but is likely only to benefit people who face significant challenges to adherence. We suggest that a positive pharmacist-patient relationship, high OST adherence, and commitment to reducing stigma in the pharmacy would be necessary for the intervention to be effective. Further research is needed to evaluate the expanded-role of community pharmacies in improving DAA adherence and eliminating HCV.
Older injectors: An emerging and under-recognised public health issue
Publisher: Wiley
Date: 05-2010
The impact of a police crackdown on a street drug scene: evidence from the street
Publisher: Elsevier BV
Date: 09-2002
Narratives of Young Men With Injecting Drug Use Histories Leaving Adult Prison
Publisher: SAGE Publications
Date: 28-12-2017
Abstract: This research focuses on an under-examined aspect of the post-release prison trajectory for a seldom-researched cohort. Narratives of the immediate days/weeks surrounding release were gathered from young men with histories of injecting drug use (IDU). Twenty-eight participants (aged 19-24) released from adult prisons in Victoria, Australia, participated in face-to-face in-depth qualitative interviews after release. Analysis of findings through the lens of a “risk environment” framework reveals how their experiences were compromised by risk factors embedded in the physical spaces and social situations they inhabited, as well as the multi-sectoral policy environments under which they were governed. A complex interplay between these factors, young men’s drug use and broader issues of structural vulnerability, including institutionalization and social disadvantage, combined to limit young men’s chances of “success” 1 on the outside. Narratives provide evidence for interventions that transform risk environments into enabling environments, thereby promoting a more successful transition from prison to community for young men with IDU histories.
The decline and fate of an iron-induced subarctic phytoplankton bloom
Publisher: Springer Science and Business Media LLC
Date: 17-03-2004
DOI: 10.1038/NATURE02437
Abstract: Iron supply has a key role in stimulating phytoplankton blooms in high-nitrate low-chlorophyll oceanic waters. However, the fate of the carbon fixed by these blooms, and how efficiently it is exported into the ocean's interior, remains largely unknown. Here we report on the decline and fate of an iron-stimulated diatom bloom in the Gulf of Alaska. The bloom terminated on day 18, following the depletion of iron and then silicic acid, after which mixed-layer particulate organic carbon (POC) concentrations declined over six days. Increased particulate silica export via sinking diatoms was recorded in sediment traps at depths between 50 and 125 m from day 21, yet increased POC export was not evident until day 24. Only a small proportion of the mixed-layer POC was intercepted by the traps, with more than half of the mixed-layer POC deficit attributable to bacterial remineralization and mesozooplankton grazing. The depletion of silicic acid and the inefficient transfer of iron-increased POC below the permanent thermocline have major implications both for the biogeochemical interpretation of times of greater iron supply in the geological past, and also for proposed geo-engineering schemes to increase oceanic carbon sequestration.
The role of respect in interactions with police among substance-using African refugee young people in Melbourne, Australia
Publisher: Informa UK Limited
Date: 22-02-2017
Social and demographical determinants of quality of life in people who live with HIV/AIDS infection: evidence from a meta-analysis
Publisher: Informa UK Limited
Date: 18-03-2019
DOI: 10.1080/19485565.2019.1587287
Abstract: The aim of this meta-analysis is to summarize the available evidence on the social and demographic determinants of health-related quality of life (QoL) for HIV-infected populations in order to provide a direction to policy makers, planners, and program developers on how best to use their resources to improve the QoL of HIV-infected people.PubMed, Science Direct, Web of Science, and Cochrane electronic databases were searched (up to February 2017) to identify the relevant studies. A meta-analysis was conducted with procreate polled odds ratios (ORs and β) and the confidence intervals of 95% on determining factors of QoL in social and demographic terms. Random effect model was applied to calculate pooled estimation, due to varied s ling methods of researches.In total, 5607 papers were identified from 4 databases and additional search in reference lists. Of these, 2107 articles were selected for full-text review. We included 19 studies that met the eligibility criteria. The pooled effect size shows a relative positive impact of social support for QoL among HIV/AIDS patients and its lower boundary is about 0.61 and the higher about 1.49. The pooled effect size has a considerable negative impact stigma on people who live with HIV/AIDS (PWLHs') QoL ranges from -0.34 to -0.32. Low socioeconomic status (poverty situation) was found to have a degenerative impact with PWLHs' QoL. Our finding indicates an association between younger 35 and QoL is negative with a relatively wide range, the minimum level of education has a weak association with PWLHs' QoL (ES: 0.14-0.2).There are several sociodemographic determinants of QoL among PWLHs and in this study, we found that stigma, low level of socioeconomic status, and being younger than 35 years old have a negative association with QoL, while the social support showed a positive association and a minimum level of education did not show a rigorous negative or positive association.
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