Screening and analysis of HCV among drug users in Dehong Prefecture， Yunnan Province from 2014 to 2021 / 上海预防医学

ObjectiveTo analyze the prevalence of HCV antibody positive and associated factors among drug users in Dehong Prefecture， Yunnan， and to provide scientific evidence for HCV prevention. MethodsQuestionnaire surveys and serological testing were conducted among 400 drug users continuously selected from four national AIDS sentinel surveillance in Dehong Prefecture between January and July during 2014‒2021. Results11 683 drug users were included. The prevalence of HCV antibody positive was 20.2% overall， and 14.9%， 20.1%， 22.4%， 19.8%， 22.5%， 20.6%， 24.5%， 19.0% from 2014 to 2021， respectively （trend Z=-3.78， P<0.001）. Multivariable analysis indicated the following were independently associated with HCV antibody positive： that older age （OR=1.02， 95%CI： 1.02‒1.03）， male （OR=1.70， 95%CI： 1.19‒2.42）， unmarried （OR=1.64， 95%CI： 1.44‒1.87）， divorced or widowed （OR=1.73， 95%CI： 1.48‒2.02）， Jingpo ethnicity （OR=1.39， 95%CI： 1.19‒1.63）， injection drug use （OR=15.46， 95%CI： 13.13‒18.12）， and HIV infection（OR=4.96， 95%CI：4.12‒5.99）. ConclusionThe prevalence of HCV antibody positive among drug users in Dehong Prefecture is high and increases with some fluctuations during 2014 to 2021， which highlights the need to develop interventions targeting this population.

Injecting drug use & HIV prevalence among female sex workers: Evidence from the National Integrated Biological & Behavioural Surveillance, India

Background & objectives: Female sex workers (FSWs) who inject drugs (FSW-IDs) have a higher risk of HIV infection and transmission. Understanding the socio-demographic characteristics and other risk behaviours among FSW-IDs will help in strengthening targeted interventions for HIV prevention and management. In the present study, the HIV prevalence, associated socio-demographic characteristics and risk behaviours among FSWs who injected drugs (FSW-IDs) and those who did not ID (FSW-NIDs) was determined in India. Methods: The national cross-sectional, community-based, integrated biological and behavioural surveillance was conducted in 2014-2015 at 73 randomly selected FSW domains across 28 States and Union Territories in India. The sample size was fixed at 400 for each domain, and a probability-based sampling method was followed. The data were analyzed by logistic regression methods. Results: Data from 27,007 FSWs were included in the analysis, of which 802 (3%) were FSW-IDs. HIV prevalence among FSW-IDs was significantly higher than that in FSW-NIDs (4.5 vs. 1.9%). Univariate analysis showed that factors significantly associated with higher HIV prevalence among FSW-IDs were older age, sex work as the only source of income, dissolved marriage, living with a sex worker, urban locality of sex work and consumption of alcohol or oral drugs. In multivariable analysis, factors such as older age of FSW-IDs (35 yr and above), having a dissolved marriage and sex work being the only source of income were observed to be independently and significantly associated with higher HIV prevalence. Interpretation & conclusions: Scaling up the HIV preventive interventions for FSW-IDs, such as facilitating awareness and improved access to needle and syringe exchange programme (NSEP) and opioid substitution therapy (OST), encouraging safe sex and injecting practices, educating on the harmful effects of alcohol and drugs and providing alternative vocation options to secure their financial needs are several strategies that may reduce HIV transmission among FSWs.

Prevalence of hepatitis C virus and risk factors among drug users in Taizhou City of Zhejiang Province， 2009‒2020 / 上海预防医学

ObjectiveTo determine the prevalence of hepatitis C virus （HCV） infection and identify the underlying risk factors among drug users in Taizhou City of Zhejiang Province during 2009‒2020. MethodsA consecutive cross-sectional survey was conducted. A total of 400 drug users in correctional settings were randomly selected from April to August. The drug users were interviewed with a questionnaire to collect demographic characteristics， AIDS-related knowledge， detoxification service， drug use， and sexual behavior. Blood samples were then collected for anti-HCV antibody testing. Chi-square test and multivariate conditional logistic regression were used. ResultsA total of 5 042 drug users were included in this study. Seroprevalence of HCV was determined to be 22.7%. From 2009 to 2019， the seroprevalence showed a significant downward trend， from 34.9% to 8.8% （χ2=221.025， P<0.001）. However， in 2020， the seroprevalence was 12.7%. The multivariate logistic regression analysis showed that senior age （≥25 years old）， cohabitation， taking traditional or mixed drugs， injection drug use， and needle sharing were risk factors associated with HCV seroprevalence. ConclusionSince 2009， HCV seroprevalence among drug users in Taizhou City has shown a downward trend， however， it has increased slightly in 2020. It warrants strengthening prevention and treatment measures in response to risk factors related to HCV infection among drug users.

Motivações dos trabalhadores no atendimento à pessoa em crise no CAPS AD III: um estudo fenomenológico / Motivations of workers in caring for people in crisis at CAPS AD III: a phenomenological study

Introdução: A atenção à crise psíquica no contexto de pessoas que fazem uso de álcool e outras drogas sofreu mudanças paradigmáticas importantes com o advento da Reforma Psiquiátrica. O modelo manicomial de exclusão social, violações de direitos humanos e de controle de corpos dá lugar ao modelo psicossocial de cuidado aos sujeitos, baseado no cuidado com respeito às subjetividades, no âmbito comunitário e em redes de serviços de saúde. Todavia, sobram cicatrizes sociais profundas do modo manicomial na atuação de trabalhadores frente à crise psíquica. Objetivo: Este estudo tem o objetivo de compreender o significado das ações dos trabalhadores no atendimento à pessoa em crise no CAPS AD III. Metodologia: Trata-se de um estudo qualitativo, sob a luz do referencial teórico-fenomenológico da fenomenologia social de Alfred Schütz. Esta pesquisa foi realizada em um Centro de Atenção Psicossocial Álcool e Outras Drogas, localizado no município de Porto Alegre, no estado do Rio Grande do Sul. Os participantes do estudo foram selecionados através do método bola de neve e constituíram-se em um total de 14 trabalhadores. A coleta das informações foi realizada por meio de entrevista fenomenológica de forma on-line através da plataforma Google Meet e de forma presencial nas dependências do CAPS AD, nos meses de fevereiro e março de 2022. Os preceitos éticos foram respeitados e o estudo foi aprovado no dia 09 de dezembro de 2021 pelo Comitê de Ética em Pesquisa sob o parecer n.o 5.155.975/CAE 52618321.0.0000.5347. Resultados: A partir da análise das informações emergiram quatro categorias concretas: a compreensão do fenômeno crise; ações dos trabalhadores frente ao fenômeno crise; sentimentos dos trabalhadores no atendimento à crise e intenções dos trabalhadores no atendimento à crise. A partir dos resultados, percebeu-se que a crise é compreendida pelos trabalhadores como um momento de sofrimento agudo, mas que carrega em si um potencial de transformação. As relações sociais existentes referentes a família, questões socioeconômicas e pandemia da COVID-19 influenciam no processo de crise dos sujeitos. As ações dos trabalhadores são focadas no manejo verbal e no vínculo, sendo a contenção mecânica realizada somente como última alternativa para evitar riscos maiores ao usuário como autoagressão e heteroagressão. Sentimentos de angústia e tristeza são evidenciados pelos trabalhadores, durante a contenção mecânica, e frustrações são evidências referentes à ausência do familiar como corresponsável do cuidado. Os trabalhadores têm como expectativa realizar um manejo em que não haja contenção mecânica, em que ocorra a diminuição do sofrimento e, ainda, esperam encontrar significados para a crise. Considerações finais: Percebe-se que fatores ligados ao modelo biologicista, periculosidade, criminalização e estigmatização do usuário são dificultadores do atendimento nos CAPS AD. Avalia-se a educação permanente e a discussão de casos entre os trabalhadores como potência para uma abordagem ampliada referente ao atendimento de crise. Portanto, este estudo auxilia na compreensão por parte dos trabalhadores no que diz respeito à pessoa em crise e contribui para efetivação do cuidado em liberdade e em redes de atenção psicossocial.

Introduction: The attention to the psychic crisis in the context of people who use alcohol and other drugs underwent important paradigmatic changes with the advent of the Psychiatric Reform. The insane asylum model of social exclusion, human rights violations and body control gives way to the psychosocial model of care for subjects, based on care with respect to subjectivities, in the community and in health service networks. However, there are deep social scars of the insane asylum mode in the work of workers in the face of the psychic crisis. Objective: This study aims to understand the meaning of workers' actions in caring for people in crisis at CAPS (psychosocial care center) AD III. Methodology: This is a qualitative study, in the light of Alfred Schütz's theoretical-phenomenological framework of social phenomenology. This research was conducted in a Psychosocial Care Center for Alcohol and Other Drugs, located in the city of Porto Alegre, in the state of Rio Grande do Sul. Study participants were selected using the snowball method and constituted a total of 14 workers. The collection of information was conducted through a phenomenological interview online through the Google Meet platform and in person at CAPS AD premises, in February and March 2022. Ethical precepts were respected, and the study was approved on December 9, 2021 by the Research Ethics Committee under opinion No. 5.155.975/CAE 52618321.0.0000.5347. Results: From the analysis of the information, four concrete categories emerged: the understanding of the crisis phenomenon; workers' actions in the face of the crisis phenomenon; workers' feelings in responding to the crisis and workers' intentions in responding to the crisis. From the results, it was noticed that the crisis is understood by the workers as a moment of acute suffering, but that it carries a potential for transformation. Existing social relationships related to family, socioeconomic issues and the COVID-19 pandemic influence the crisis process of the subjects. The workers' actions are focused on verbal management and bonding, with mechanical restraint being performed only as a last alternative to avoid greater risks to the user, such as self-harm and hetero-aggression. Feelings of anguish and sadness are evidenced by workers during mechanical restraint, and frustrations are evidence regarding the absence of the family member as co-responsible for the care. The workers expect to conduct a management in which there is no mechanical restraint, in which suffering is reduced, and they also hope to find meanings for the crisis. Final considerations: It is noticed that factors linked to the biological model, dangerousness, criminalization and stigmatization of the user are obstacles to care in CAPS AD. Continuing education and the discussion of cases among workers are evaluated as a potential for an expanded approach regarding crisis care. Therefore, this study helps workers understand the person in crisis and contributes to the effectiveness of care in freedom and in psychosocial care networks.

"Vinte mil pedras no caminho": a representação gráfica de uma carreira de usuário de drogas baseada em sua autobiografia / "Veinte mil piedras en el camino": la representación gráfica de una carrera de usuario de drogas basada en su autobiografía / "Twenty thousand stones along the way": a graphic representation of a drug user career based on his autobiography

O objetivo deste artigo é, com base em uma narrativa autobiográfica que descreve a carreira de usuário de drogas, construir um diagrama que permita visualizar o desenvolvimento da carreira e dividi-la em fases sucessivas quanto ao incremento ou à diminuição do autocontrole sobre o uso de drogas. A construção de um diagrama nos permitiu visualizar os períodos de maior e menor autocontrole sobre o consumo de substâncias e os principais fatores intervenientes. Tal procedimento mostrou-se uma ferramenta capaz de fornecer uma representação sintética e, ao mesmo tempo, diacrônica da carreira de usuário, dividida em fases sucessivas quanto ao incremento ou à diminuição do autocontrole, que constatamos depender da droga consumida e do contexto pessoal e social do usuário. (AU)

El objetivo de este artículo es, a partir de una narrativa autobiográfica que describe la carrera de usuario de drogas, construir un diagrama que permita visualizar el desarrollo de la carrera y dividirla en fases sucesivas en lo que se refiere al aumento o disminución del autocontrol sobre el uso de drogas. La construcción de un diagrama nos permitió visualizar los períodos de mayor y menor autocontrol sobre el consumo de substancias y los principales factores intervinientes. Tal procedimiento se mostró una herramienta capaz de suministrar una representación sintética y, al mismo tiempo, diacrónica de la carrera de usuario, dividida en fases sucesivas con relación al aumento o la disminución del autocontrol, que conforme constatamos depende de la droga consumida y del contexto personal y social del usuario. (AU)

The objective of this article is to construct a diagram based on the autobiographical narrative that describes the trajectory of a drug user, to allow visualizing the development of his career and dividing it into successive phases regarding the increase or decrease of self-control over drug use. The construction of a diagram allowed us to visualize the periods of increased and decreased self-control over substance use and the main factors involved. This procedure proved to be an able tool to provide a synthetic and, at the same time, diachronic representation of the user's career, divided into successive phases regarding the increase or decrease of self-control, which we found to be dependent on the drug consumed and the personal and social context of the user. (AU)

Prevalence of hepatitis-C viral infection among opioid dependent injectable drug users: a study conducted at regional hospital drug de-addiction and treatment centre, Solan, Himachal Pradesh, India

Background: There are a limited number of studies regarding the prevalence of hepatitis B, hepatitis C and HIV infections among the drug addicts in Himachal Pradesh; C virus (HCV) infection in north India especially Himachal with very high rates of substance abuse. The present study was attempted to study the prevalence of hepatitis C among the injectable drug users, which is more important in a country like India where viral hepatitis is estimated to be among the top ten causes of deaths.Methods: A study was conducted in 2019-2020 (July-April). HBsAg, anti-HBs, anti-HCV and anti-HIV tests in 235 drug addicts were studied. Urine samples obtained from drug addicts were analyzed for cannabis, opiate and cocaine metabolites.Results: The subjects included were 235 IDUs who were opioid dependent. All the 235 drug users were males, and their mean age was 30.69±9.494 years; 112 (47.7%) of them were in the age group ranging 20 - 29 years (p <0.05). Of 235 drug addicts, 113 (48.1%) and 115 (48.9%) were only cannabis and opiate users, respectively. The frequencies of HBsAg, anti-HBs and anti-HCV among drug addicts were 2.6%, 38.3%, and 9.4%, respectively.Conclusions: The obtained results showed that HCV infection was an alarming problem among opiate users in this part of Himachal. It is suggested to rapidly diagnose the infected persons; thus preventive measures and appropriate control may limit further transmission of these infections.

Deep venous thrombosis induced by intravenous thrombogenic drugs

Background: Deep vein thrombosis (DVT) is a major preventable cause of morbidity and mortality worldwide with the potential to cause a dreaded pulmonary embolism (PE). Disease and patient-specific considerations are preferably incorporated into therapeutic options for effective management. Materials and methods: Sixty-eight cases of acute deep vein thrombosis were treated within a period of 3 years from January 2016. All the cases were subjected to routine investigations with the Doppler study of the affected limb. Low molecular weight heparin (dalteparin) was administered in all the cases for a period of 15 days and the Doppler study was repeated at the end of the drug therapy. After the course of low molecular weight heparin, the patients were given acenocoumarol 2mg daily. Estimation of partial thromboplastin time and prothrombin time were performed before starting and during the treatment of the low molecular weight heparin and acenocoumarol regularly. A venogram was done only when the repeated Doppler study revealed unsatisfactory response to low molecular weight heparin therapy. Eight cases underwent thrombectomy and the postoperative period was uneventful. Results: Age group of 21-30 years was most affected (80.8%) with right lower limb being the commonest affected site of injection and associated lesions. Conclusion: DVT in the young population remains a challenge to the evaluating clinician. A variety of disease states can alter the anticoagulant factors. Urgent diagnosis and appropriate intervention carry paramount importance.

Representações sociais das drogas e de seus usuários para grupos religiosos: contribuições para o cuidado de saúde e enfermagem / Social representations of drugs and their users: contributions to health care and nursing

Para se realizar o estudo das representações sociais das drogas e de seus usuários para grupos religiosos, adotou-se como objetivo: analisar as representações sociais das drogas psicoativas e dos seus usuários para grupos religiosos católicos, evangélicos, espíritas e para religiões de matriz africana no contexto dos templos religiosos. Objetivos específicos: descrever os conteúdos e a estrutura representacional dos grupos religiosos acerca das drogas psicoativas e dos seus usuários; discutir as representações sociais acerca das drogas psicoativas e de seus usuários para os diferentes grupos religiosos; discutir a influência dessas representações na inclusão da espiritualidade e da religiosidade nas práticas de cuidar. Trata-se de um estudo descritivo e exploratório, de abordagem de métodos mistos, sob a ótica das representações sociais, realizado entre 2017 e 2020 em templos religiosos católicos, evangélicos históricos, evangélicos pentecostais, evangélicos neopentecostais, umbandistas, candomblecistas e espíritas. Na primeira etapa do estudo, participaram 1.400 sujeitos, sendo 200 de cada religião, sendo 100 para cada termo indutor, que responderam à caracterização, à coleta de evocação livre e à escala de religiosidade para os termos "drogas" e "usuários de álcool e de drogas". No segundo momento, foram realizados os testes de centralidade: testes mise-em-cause, choix-par-bloc e esquemas cognitivos de base. Nessa etapa, participaram 100 sujeitos de cada grupo religioso, com exceção para os esquemas cognitivos de base - nestes participaram 10 sujeitos de cada grupo social, totalizando 70 sujeitos. Os resultados demonstraram no termo indutor "drogas" que: o núcleo central para os católicos é a dependência; para os evangélicos históricos, é o vício e a dependência; para os evangélicos pentecostais, é a destruição e a dependência; para os evangélicos neopentecostais, é a ajuda; para os umbandistas, é a tristeza e a morte; para os candomblecistas, é a destruição e a doença; para os espíritas, é a doença. No termo indutor "usuário de álcool e de drogas", foram encontrados os seguintes núcleos centrais para católicos: católico é ajuda, evangélico histórico é ajuda, evangélico pentecostal é vício e dependência, para evangélicos neopentecostais é ajuda, para umbandistas é ajuda, para candomblecistas é cuidado e doença e para espíritas é dependência. Na análise processual, os resultados demonstram as diferentes facetas das drogas e dos usuários de drogas para cada grupo religioso. Ao final do estudo, podemos constatar que enquanto a representação das drogas baseia-se na consequência da utilização, a representação do usuário baseia-se no cuidado. Desse modo, pode-se entender que os indivíduos dos grupos religiosos, no momento em que representam a droga e seus usuários, nos permitem pensar em um cuidado que privilegie as áreas religiosa e espiritual para além da doença.

In order to study the social representations of drugs and their users for religious groups, the objective was to: analyze the social representations of psychoactive drugs and their users for Catholic, Evangelical, African religions and Spiritist in the context of religious temples. And as specific objectives: describe the content and representational structure of religious groups about psychoactive drugs and their users; discuss social representations about psychoactive drugs and their users for different religious groups; discuss the influence of these representations on the inclusion of spirituality and religiosity in care practices. This is a study, descriptive and exploratory with a multimethod approach, from the perspective of social representations, carried out between 2017 and 2020 in Catholic religious temples, historical evangelicals, Pentecostal evangelicals, neo-Pentecostal evangelicals, Umbandists [umbandistas], candomblecists [candomblécistas] and spiritists. In the first stage of the study, 1400 subjects participated, 200 for each religion, distributed 100 for each inductive term, who responded to the characterization, the collection of free evocation and the religiosity scale for the terms drugs and alcohol and drug users. In the second moment, the centrality tests were performed: mise-in-cause [put-in-cause], choix-par-bloc [choice-by-block] and schémas cognitifs de base [basic cognitive patterns]. In this stage, 100 subjects participated for each religious group, with the exception of the basic cognitive schemes in which 10 subjects participated for each social group, totaling 70 subjects. The results showed in the term drug inducer the central core for Catholics is dependence, for historical evangelicals it is addiction and dependence, for Pentecostal evangelicals it is destruction and dependence, for neo-Pentecostal evangelicals it is help, for Umbandists it is sadness and death, for Candomblecists are destruction and disease and for Spiritists it is disease. In the term inducer user of alcohol and drugs, the following central nuclei were found for Catholics: Catholic is help, historical evangelical is help, Pentecostal evangelical is addiction and dependence, for neo-Pentecostal evangelicals it is help, for Umbandistas it is help, for Candomblecists it is care and illness, for spiritists it is dependence. In the procedural analysis, the results demonstrate the different facets of drugs and drug users for each religious group. At the end of the study, one can see that while the representation of drugs is based on the consequence of use, the user's representation is based on care. In this way, we can understand that individuals from religious groups, at the moment they represent the drug and its users, allow us to think about care that privileges the religious and spiritual area beyond the disease.

Eu caminho, tu caminhas, nós caminhamos: (re)conhecendo as trajetórias de cuidado de familiares de usuários de drogas / I walk, you walk, we walk: (re)knowing the care trajectories of family members of drug users

As intervenções no grupo familiar ou na rede social de usuários de drogas trazem um impacto positivo nas famílias e na vida dos usuários. Apesar da efetividade bem documentada de diversas abordagens terapêuticas voltadas às famílias de usuários de drogas, apenas 10% das famílias recebem este apoio. Tais dados sugerem a existência de barreiras na implementação dessas abordagens terapêuticas e ilustram a dificuldade das equipes de saúde em assistir tais famílias. A trajetória de cuidado percorrida por esses familiares engloba uma série de ações terapêuticas que se dão em três setores de assistência à saúde: o informal, o popular (folk) e o profissional. As escolhas por essas alternativas de cuidado são realizadas conforme a necessidade, a disponibilidade, a condição socioeconômica e cultural da família. Assim se estabelece o fluxo de assistência à saúde, compreendido como a trajetória percorrida pelo usuário em busca de atendimento para resolver o seu problema. Considerando esta complexidade, o presente estudo teve como objetivo compreender as trajetórias de cuidado percorridas por familiares de usuários de drogas, apoiando-se no referencial teórico dos Setores de Assistência à Saúde de Helman e no conceito de fluxo proposto por Ramos. Este projeto utilizou os dados coletados em uma pesquisa maior intitulada "Familiares de usuários de drogas: um olhar compreensivo de suas vivências e trajetórias assistenciais". Tal pesquisa trata-se um estudo de abordagem qualitativa, descritiva, exploratória que se deu por meio de entrevistas semiestruturadas a partir de um roteiro com questões que contemplam a temática pesquisada. Os participantes da pesquisa foram 15 familiares de usuários de drogas acompanhados na internação e no ambulatório de um serviço em pertencente a uma instituição hospitalar do sul do Brasil. Para a análise e interpretação dos dados foi utilizado o método de análise de conteúdo de Bardin, que ocorreu em três etapas: 1) pré análise, 2) exploração do material e 3) tratamento dos dados obtidos e interpretação. Este projeto respeitou a todos aspectos éticos previstos na Resolução nº 466/12 do Conselho Nacional de Saúde, que trata sobre os aspectos éticos com pesquisa envolvendo seres humanos. Os familiares pesquisados percorrem pelos três setores de cuidado em saúde, sendo o informal o mais prevalente entre as 15 trajetórias de cuidado. A família foi o destaque neste setor, por ter sido a fonte de ajuda mais citada. No entanto, foi no setor profissional que os familiares encontraram os apoios mais efetivos para o tratamento do usuário. Porém, revelou se a escassez na oferta de espaços que oferecem assistência ao familiar do usuário de drogas no setor público de saúde. É urgente que as equipes se apropriem de atitudes e técnicas de intervenção no cuidado a essas famílias, tomando para si a responsabilidade em catalisar o processo de inseri-las no tratamento, trazendo-as de uma posição periférica e coadjuvante para o interior da cena, para que junto ao usuário possam atuar como protagonistas no tratamento.

Interventions in the family group or social network of drug users have a positive impact on families and the lives of users. Despite the well documented effectiveness of several therapeutic approaches aimed at drug users' families, only 10% of families receive this support. These data suggest the existence of barriers in the implementation of these therapeutic approaches and illustrate the difficulty of health teams in assisting such families. The trajectory of care taken by these families encompasses a series of therapeutic actions that take place in three sectors of health care: the informal, the popular (folk) and the professional. The choices for these care alternatives are made according to the need, availability, socioeconomic and cultural condition of the family. This is how the flow of health care is established, understood as the trajectory travelled by the user seeking care to solve his problem. Considering this complexity, this study aimed to understand the trajectories of care taken by family members of drug users, based on the theoretical framework of Helman's Health Care Sectors and the flow concept proposed by Ramos. This project used the data collected in a larger survey entitled "Families of drug users: a comprehensive look at their experiences and care trajectories. This research is a qualitative, descriptive, exploratory approach that was carried out through semistructured interviews based on a script with questions that contemplate the researched theme. The participants in the research were 15 family members of drug users accompanied in the hospitalization and outpatient clinic of a service belonging to a hospital institution in southern Brazil. For the analysis and interpretation of the data, the Bardin content analysis method was used, which occurred in three stages: 1) pre analysis, 2) exploration of the material, and 3) treatment of the data obtained and interpretation. This project respected all the ethical aspects foreseen in Resolution 466/12 of the National Health Council, which deals with ethical aspects with research involving human beings. The family members researched travel through the three health care sectors, the informal one being the most prevalent among the 15 care trajectories. The family was the highlight in this sector, as it was the most cited source of help. However, it was in the professional sector that family members found the most effective support for the user's treatment. However, there was a scarcity of space in the public health sector that offered assistance to the drug user's family member. It is urgent that the teams take ownership of attitudes and techniques of intervention in the care to these families, taking for themselves the responsibility of catalyzing the process of inserting them in the treatment, bringing them from a peripheral and supporting position into the scene, so that together w ith the user they can act as protagonists in the treatment.

Prevalence of antiretroviral drug resistance in treatment-naive injecting drug users infected with HIV-1 in Guangzhou, 2008-2015 / 中华流行病学杂志

Objective To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou.Methods HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou,being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015.Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced.After that,data were submitted to the HIV resistance database of Stanford University for drug resistance analysis.Results Among the 518 HIV-1 infected IDUs,H1V-1 pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57％) aged 18-64 (37.44 ± 8.14) years.Among them,males accounted for 89.68％ (365/407),those of Han ethnic group accounted for 89.93％ (366/407),the unmarried accounted for 55.28％ (225/407),and those with education level of junior high school or below accounted for 83.78％ (341/407).The distribution of subtypes was predominated by CRF07_BC (47.18％,192/407),followed by CRF01_AE (23.83％,97/407),CRF08_BC (22.85％,93/407),and other subtypes (6.14％,25/407).The overall prevalence of drug resistance was 3.44％ (14/407).The prevalence of drug resistance to protease inhibitors,nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47％(6/407),0.25％ (1/407) and 1.72％ (7/407) respectively.The mutation rate was 12.29％ (50/407).No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions.Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC.Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes.The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23％).Two cases were resistant to all four drugs of NNRTIs.Conclusions The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015,in Guangzhou.Most infections were sensitive to existing antiviral drugs.However,drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.

Prevalence of antiretroviral drug resistance in treatment-naive injecting drug users infected with HIV-1 in Guangzhou, 2008-2015 / 中华流行病学杂志

Objective To understand the prevalence of drug resistance in treatment-naive injecting drug users (IDUs) infected with HIV-1 in Guangzhou.Methods HIV-1 RNA were extracted from the serum specimens of the newly confirmed HIV-1 positive IDUs living in Guangzhou,being infected through injecting drug use and receiving no antiretroviral therapy at the time of confirmation during 2008-2015.Full sequence of pol protease (PR) gene and partial sequence of reverse transcriptase (RT) gene were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced.After that,data were submitted to the HIV resistance database of Stanford University for drug resistance analysis.Results Among the 518 HIV-1 infected IDUs,H1V-1 pol gene segments were successfully obtained from the serum samples of 407 HIV-1 infected IDUs (78.57％) aged 18-64 (37.44 ± 8.14) years.Among them,males accounted for 89.68％ (365/407),those of Han ethnic group accounted for 89.93％ (366/407),the unmarried accounted for 55.28％ (225/407),and those with education level of junior high school or below accounted for 83.78％ (341/407).The distribution of subtypes was predominated by CRF07_BC (47.18％,192/407),followed by CRF01_AE (23.83％,97/407),CRF08_BC (22.85％,93/407),and other subtypes (6.14％,25/407).The overall prevalence of drug resistance was 3.44％ (14/407).The prevalence of drug resistance to protease inhibitors,nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.47％(6/407),0.25％ (1/407) and 1.72％ (7/407) respectively.The mutation rate was 12.29％ (50/407).No major drug resistance mutation was detected in protease and nucleoside reverse transcriptase regions.Higher rate of V179E mutation in the non-nucleoside reverse transcriptase region was detected in other subtypes and subtype CRF07_BC.Mutation seemed to have occurred in all 8 cases of subtype CRF55_01B in other subtypes.The highest mutation rate of E138A was detected in subtype CRF08_BC (3.23％).Two cases were resistant to all four drugs of NNRTIs.Conclusions The prevalence of drug resistance in treatment-naive HIV-1 positive IDUs remained at a relatively low level during 2008-2015,in Guangzhou.Most infections were sensitive to existing antiviral drugs.However,drug resistance surveillance in IDUs infected with HIV should be strengthened to prevent the prevalence of multi-drug resistance and cross drug resistance.

Follow-up of community injecting drug user cohort, 2014-2017 / 中华流行病学杂志

Objective@#To explore the methods of establishing and maintaining community injecting drug user (IDU) cohort.@*Methods@#From June 2014 to June 2017, a community survey was conducted on basis of local needle and syringe exchange site to recruit 200 HIV sero-negative IDU for a prospective cohort study in Longyang district of Baoshan city, Yunan province. Follow-up was carried out every six month to investigate high risk drug use behavior and sexual behavior, and blood samples were collected from them for the tests of HIV and HCV serum antibodies. The cohort would be opened every 12 months to replenish the cohort to 200 subjects.@*Results@#The follow up was conducted for 3 years in 229 IDUs. Cohort follow-up rate was 93.0% (213/229) for 6 months, 92.1% (211/229) for 12 months, 91.7% (200/218) for 18 months, 87.2% (190/218) for 24 months, 86.0% (172/200) for 30 months and 86.0% (172/200) for 36 months.@*Conclusion@#The community IDU cohort has a high follow-up rate.

Avaliação de empoderamento da rede de atenção psicossocial no cuidado ao usuário de drogas / Assessment of empowerment of the psychosocial care network in the care of drug users

Este estudo tem por objetivo avaliar a Rede de Atenção Psicossocial (RAPS) ao usuário de drogas no município de São Lourenço do Sul, Rio Grande do Sul. O estudo utilizou como referencial teórico-metodológico a Avaliação de Empoderamento, uma abordagem com foco na tomada de decisão democrática e participação dos grupos de interesse no processo, gestores, coordenadores e trabalhadores dos serviços da RAPS e da rede intersetorial. A produção de dados ocorreu em 2017, com o uso de técnicas de observação participante, entrevista semiestruturada, análise documental e fórum aberto. No fórum aberto, os grupos de interesse puderam manifestar suas discordâncias e concordâncias com o material empírico, elencando estratégias e interesses a serem pensados para o futuro da rede. A Avaliação de Empoderamento envolveu a necessidade de identificar a missão da rede, avaliar as práticas no contexto atual e discutir/problematizar propostas de planejamento para o futuro. A missão construída pelos grupos de interesse representou a busca por um cuidado integral, visando mudanças de práticas focadas no uso da substância e na doença para práticas de cuidado ampliadas, ancoradas em projetos biopsicossociais. Entre as estratégias que contribuem para o alcance da missão foram destacadas potencialidades e necessidades da rede. Destacaram-se, como potencialidades, a organização da rede como espaço de formação, a disponibilidade de diferentes serviços de cuidado, o apoio da gestão a propostas de atenção psicossocial e as facilidades de acesso aos serviços do município. Das necessidades do cuidado em rede, foram problematizadas as práticas de preconceito, estigma, as dificuldades de articulação do cuidado em saúde mental na atenção básica, as fragilidades do cuidado em saúde mental na zona rural. No planejamento para o futuro, priorizaram-se ações com foco na melhoria do cuidado em saúde mental na zona rural, identificado como ponto frágil da RAPS. Os grupos de interesse propuseram um cronograma de matriciamento e avaliaram a necessidade de qualificar a informatização da rede de saúde mental, investindo no uso de recursos tecnológicos ­ telefone e internet ­ para aproximar o campo da cidade. A condução do processo participativo proporcionou movimentos na rede, incentivando momentos de reflexão, educação permanente, compreensão das potencialidades e dificuldades do trabalho e, principalmente, a apropriação do contexto assistencial para subsidiar melhorias centradas no cuidado integral na atenção psicossocial.

This study aims to evaluate the Network of Psychosocial Attention (RAPS) to the drug user in the municipality of São Lourenço do Sul, Rio Grande do Sul. The study used as a theoretical-methodological reference the Empowerment Evaluation, an approach focused on democratic decision-making and participation of stakeholders in the process, managers, coordinators and workers of RAPS services and the intersectoral network. The data production occurred in 2017, using participant observation techniques, semi-structured interview, documentary analysis and open forum. In the open forum, stakeholders could express their disagreements and agreements with the empirical material, listing strategies and interests to be considered in the future of the network. The Empowerment Evaluation envolved the need to identify the network's mission, assess practices in the current context, and discuss/problematize future planning proposals. The mission built by the interest groups represented the search for integral care, aiming to changes in practice focused on the use of the substance and disease for extended care practices, anchored in biopsychosocial projects. Among the strategies that contribute to the achievement of the mission were highlighted potentialities and needs of the network. It was highlighted as potentialities the organization of the network as training space, the availability of different care services, management support to proposals for psychosocial care and access facilities between the services of the municipality. From the needs of networked care, were problematized the practices of preconception and stigma, the difficulties of articulating mental health care in basic care, the fragilities of mental health care in rural areas. In the planning for the future, priority was given to actions focused on improving mental health care in rural areas, identified as a fragile RAPS point. Interest groups proposed a matriciamento schedule and evaluated the need to qualify the computerization of the mental health network by investing in the use of technological resources - telephone and internet - to bring the countryside closer to the city. The conduction of the participatory process has provided movements in the network, encouraging moments of reflection, permanent education, understanding of the potentialities and difficulties of work and, mainly, appropriation of the assistance context to subsidize improvements focused on comprehensive care in psychosocial care.

O tratamento da dependência na perspectiva das pessoas que fazem uso de crack / El tratamiento de la dependencia desde la perspectiva de las personas que usan crack / Treatment for dependency from the perspective of people who use crack

O artigo pretende compreender, a partir da fala dos usuários, quais os aspectos fundamentais para o sucesso no tratamento da dependência do crack. Trata-se de um estudo descritivo, com abordagem qualitativa, onde foram entrevistadas 39 pessoas que fazem uso de crack, atendidas num programa de proteção social para usuários de drogas. Para a compreensão das narrativas, foi utilizada a técnica de análise de conteúdo, com referencial teórico baseado em Bardin. Foram mencionados, como importantes aspectos, realizar tratamento voluntário e espiritualidade, categorias que podemos agrupar como aspectos individuais; como, também, ampliação do cardápio de atividades, oferta de espaço protegido da droga e qualificação profissional com inclusão socioprodutiva, como aspectos institucionais. Essas demandas precisam ser consideradas para um melhor entendimento das necessidades para o sucesso no tratamento, assim como serem contempladas pelas políticas públicas voltadas para o problema.(AU)

El artículo pretende comprender, a partir de las palabras de los usuarios, cuáles son los aspectos fundamentales para el éxito en el tratamiento de la dependencia del crack. Se trata de un estudio descriptivo, con abordaje cualitativo, en donde fueron entrevistadas 39 personas que utilizan crack, atendidas en un programa de protección social para usuarios de drogas. Para la comprensión de las narrativas se utilizó la técnica de análisis de contenido con referencial teórico basado en Bardin. Se mencionaron como aspectos importantes la realización de tratamiento voluntario y la espiritualidad, categorías que podemos agrupar como aspectos individuales, como también la ampliación del menú de actividad, oferta de espacio protegido de la droga y calificación profesional con inclusión socio-productiva, como aspectos institucionales. Esas demandas deben considerarse para un mejor entendimiento de las necesidades para el éxito en el tratamiento, así como su inclusión por las políticas públicas enfocadas en el problema.(AU)

The aim of this study is to understand the essential aspects for a successful treatment for crack dependency, based on the speech of users. This is a descriptive study, using a qualitative approach. Interviews were conducted with 39 crack users who were assisted in a social protection program for drug users. In order to understand the narratives, the content analysis technique was used and the theoretical framework was based on Bardin. Aspects that were mentioned as important were undergoing voluntary treatment and spirituality, categories that can be grouped as individual aspects, as well as increasing the list of activities, supply of settings protected from drugs and professional qualification with socio-productive inclusion, as institutional aspects. These demands must be considered for a better understanding of what is needed for a successful treatment, and contemplated by public policies targeted at this issue.(AU)

Survey of the depressive disorders prevalence and related risk factors among male new drug users in certain drug rehabilitation center of Changsha city / 中华预防医学杂志

Objective@#To understand the depressive disorders prevalence and related risk factors among new drug users in a male drug rehabilitation center.@*Methods@#The cross-sectional study was used. A total of 250 new drug users from a male drug rehabilitation center were recruited during March, 2017. The drug users who only use new type of drugs single or use traditional drugs at the same time were collected as the new drug users. Their general information and drug-related information were collected by self-made questionnaire, and depressive disorders and sleep quality information were collected by the self-reported Patient Health Questionnaire-9 (PHQ-9) and the self-reported Pittsburgh Sleep Quality Index Questionnaire respectively. Logistic regression test was used to establish associations between variables.@*Results@#Of all 250 drug users, the mean age (P25, P75) was 30 (26, 35) years old, and 32.8% (82) had the depressive disorders. The individuals taking drug dose over 0.4 g daily before entering drug rehabilitation center had significantly more risk of the depressive disorders for 3.18 (1.71-5.90) than those not over 0.4 g daily.The individuals who bad sleep quality had significantly more risk of the depressive disorders for 6.07 (95%CI:3.31-11.12) than those had good sleep quality.The individuals who were depressive patients before the first drug use for 2.39 (95%CI: 1.12-5.10) than those were not depressive patients before the first drug use.@*Conclusion@#There were a high rate of the depressive disorders among new drug users in the rehabilitation center; In addition, several risk factors including the individuals taking drug dose over 0.4 g daily and bad sleep quality, history of the depressive disorders were negatively associated with depressive disorders.

Efficacy and safety of a raltegravir containing antiretroviral regimen among human immunodeficiency virus infected patients on methadone maintenance therapy / 中华传染病杂志

Objective To explore the efficacy and safety of a raltegravir (RAL)-containing regimen among patients on methadone maintenance therapy.Methods From January 2010 to November 2010, 30 virus (HIV) treatment naive patients who were on methadone maintenance therapy were enrolled from a HIV clinic in Kunming, Yunnan Province and a HIV clinic in Hengyang, Hunan Province.All patients were given RAL, tenofovir (TDF) and lamivudine (3TC) as highly active antiretroviral therapy (HARRT).Patients were followed up for 48 weeks to evaluate the adjustment of methadone dose, opiate withdrawal reaction, antiretroviral efficacy and safety.Results From January 2010 to November 2010, 30 HIV patients were enrolled from the two appointed HIV clinics.The mean age was 39±6 years, with 73.3% male patients and 97% Han population.Before the treatment, their mean CD4+T lymphocyte counts was 210 /μL.Ninety percent of patients were co-infected with hepatitis C.Twenty-nine patients who completed study follow-up were included in final analysis.Five (17.8%) patients reported opiate withdrawal symptoms and increased methadone dose 4 weeks after HARRT.At 24 weeks and 48 weeks of HARRT, the average increase of CD4+T lymphocyte counts were (136±71) /μL and (185±88)/μL, respectively.Among patients who provided valid HIV-1 RNA testing results, 82.6% (19/23) and 95.8% (23/24) of patients had undetectable viral load at week 24 and week 48.Six grade 1-2 adverse events were reported in 4 patients.Conclusions In this pilot study, the new regimen containing RAL, TDF and 3TC appears to be an ideal option for patients on methadone maintenance therapy, because of its limited impact on methadone dose and good efficacy and safety profile.

A cross-sectional survey of receiving no methadone maintenance treatment in HIV infected injecting drug users in Dehong Dai and Jingpo autonomous prefecture, Yunnan province / 中华流行病学杂志

Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.

A cross-sectional survey of receiving no methadone maintenance treatment in HIV infected injecting drug users in Dehong Dai and Jingpo autonomous prefecture, Yunnan province / 中华流行病学杂志

Objective To understand the current status of receiving no methadone maintenance treatment (MMT) and influencing factors in HIV infected injecting drug users (IDUs) in Dehong Dai and Jingpo autonomous prefectures,Yunnan province.Methods Data of survival of IDUs with AIDS in Dehong were collected from "Chinese National Comprehensive HIV/AIDS and Care Information System" in December,2014.Results There were 987 IDUs who should receive MMT,the majority of them were males (94.6％,934/987),aged 35-44 years (53.0％,523/987) and farmers (77.2％,762/987).Among the 987 IDUs,60.2％ (592/987) received no MMT.Multivariate logistic regression analysis showed that being female (OR=2.66,95％CI:1.21-5.87),in Jingpo ethnic group (OR=3.05,95％CI:1.97-4.71) were the major risk factors for receiving no MMT;not being farmers (OR=0.46,95％CI:0.31-0.70),in Dai ethnic group (OR=0.53,95％CI:0.36-0.79),diagnosed HIV infection history ≥ 10 years (OR=0.60,95％CI:0.45-0.81) were the major protective factors for receiving no MMT.The reasons for receiving no MMT included long distance journey (289,48.8％),fear of exposure (124,20.9％),poor daily medication compliance (59,10.0％),fear of side effects (47,7.9％),others (73,12.3％).Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high.Being female and farmer,in Jingpo ethnic group,low educational level,short diagnosed HIV infection history were influencing factors for receiving no MMT.The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.

Situación de VIH en usuarios de drogas inyectables en Colombia / HIV among intravenous drug users in Colombia

Objetivo: Describir la seroprevalencia de VIH en la población usuaria de drogas inyectadas (UDI) de 6 ciudades de Colombia y analizar algunos comportamientos descritos de riesgo para la infección por VIH. Material y método: Es un estudio observacional transversal, de 1.464 UDI activos seleccionados desde el año 2011 a 2014 en 6 ciudades de Colombia utilizando la metodología de respondent driven-sampling. Se realizó prueba de laboratorio para la detección del VIH. Resultado: El 88,9% de los UDI eran hombres, con una edad promedio de 26,67 años. El microtráfico reportó una alta frecuencia en ciudades como Cali, Medellín y Armenia; el 9,8% eran hombres que tenían sexo con hombres; la mayor proporción de los UDI en las 6 ciudades luego de utilizar la jeringa la botan en una caneca; uno de cada 3 la guarda para ser usada nuevamente, y un 12% la botó en el piso sin utilizar normas de bioseguridad. Discusión: En Colombia la seroprevalencia de VIH no es tan alta en UDI como en otros países, aunque en Cúcuta, la proporción estimada de VIH en la población fue mayor del 5%, indicando una epidemia concentrada. Conclusiones: Se identificó la presencia de VIH en UDI en 6 ciudades de Colombia, confirmando así que el abuso de drogas es un fenómeno social complejo que alimenta la epidemia de VIH/sida.

Objective: Determine HIV prevalence in the intravenous drug user (IDU) population from 6 Colombian cities and analyse several reported risk behaviors for HIV infection. Material and method: Cross-sectional study. A total of 1,464 active IDU were recruited from 2011 to 2014 in 6 Colombian countries, using the methodology of respondent driven-sampling. Laboratory tests for HIV detection were performed. Result: A total of 88.9% of the IDUs were men. The mean age of the participants from the 6 cities was 26.67 years. A high frequency of micro-trafficking was reported in Cali, Medellin and Armenia; some 9.8% were men who had sex with men. Most IDUs from the 6 cities discarded the syringe in the trash after using it; one of every 3 saved it for a new use and 12% threw it on the floor without following biosafety standards. Discussion: HIV prevalence among IDUs in Colombia is not as high as in other countries. However, in Cucuta the estimated proportion of HIV infection in the population was 5% higher, which could indicate a concentrated epidemic. Conclusions: HIV presence was identified among IDUs in 6 Colombian cities, which reinforces that drug abuse is a complex social phenomena that contributes to the HIV/AIDS epidemic.

Representação Social do Usuário de Drogas na Perspectiva de Dependentes Químicos / Drug User’ Social Representation in the Perspective of the Chemical Dependent / Representación Social del Usuario de Drogas en la Perspectiva de Dependientes Químicos

Resumo Os usuários de drogas estão ligados a um imaginário que remete à irresponsabilidade e à delinquência; por isso, não há muita disponibilidade para ouvir sobre suas experiências e vivências. Diante disso, objetivou-se conhecer e analisar o conteúdo e a estrutura da representação social do usuário de drogas. A amostra compreendeu 30 dependentes químicos em tratamento numa instituição psiquiátrica em João Pessoa-PB. Foi utilizada uma entrevista, analisada por meio da Análise de Conteúdo Temática, e a Técnica de Associação Livre de Palavras, analisada a partir do EVOC. Os instrumentos foram administrados individualmente no ambiente institucional. Constatou-se que a representação social do usuário de drogas é negativa, pois ele é concebido como não confiável e mau-caráter, e como um doente, não tendo capacidade de lutar contra sua dependência. Conclui-se que essas representações podem ter repercussões negativas na vida desses usuários, pois adquirem status de verdade, guiando suas condutas e a forma como compreendem sua realidade....(AU)

Abstract Drug users are associated to irresponsibility and delinquency, which makes it difficult for them to be heard. This study sought to know and to analyze the content and structure of drug-user’s social representation. The sample included 30 under-treatment drug addicts in a psychiatric institution in João Pessoa-PB. An interview – analyzed by the Thematic Content Analysis –, and a Free Association of Words Technique – analyzed from EVOC – were used. The instruments were individually administrated inside the institutional environment. The drug user’s social representation was seen as negative, as he is considered as a bad character, and as a sick and an unreliable person without the capacity of fighting against his addiction. In conclusion, these representations might have negative outcomes on the users’ lives as they acquire status of truth, guiding their behaviors and the way they comprehend their realities....(AU)

Resumen Los usuarios de drogas están ligados a un imaginario que remite a la irresponsabilidad y a la delincuencia; por eso, no hay mucha disponibilidad para oír sobre sus experiencias y vivencias. Ante esto, se buscó conocer y analizar el contenido y la estructura de la representación social del usuario de drogas. La muestra comprendió 30 dependientes químicos en tratamiento en una institución mental en João Pessoa-PB. Fue utilizada una entrevista, analizada por medio del Análisis de Contenido Temático, así como una Técnica de Asociación Libre de Palabras, analizada a partir del EVOC. Los instrumentos fueron administrados individualmente en el ambiente institucional. Se constató que la representación social del usuario de drogas es negativa, pues es concebido como no confiable, de mal carácter, y como un enfermo, no teniendo capacidad de luchar contra su dependencia. Se concluye que esas representaciones pueden tener repercusiones negativas en la vida de esos usuarios, pues adquieren estatus de verdad....(AU)