Changes in locus-of-control attitudes about drug misuse in a self-help group in a methadone maintenance clinic.

Clients of a methadone-maintenance clinic in Brooklyn, New York participating in a clinically-guided self-help (CGSH) program plus standard treatment (methadone maintenance plus individual counseling) demonstrated statistically significant changes in locus-of-control beliefs, from external to internal causation, about personal responsibility for drug misuse. Members of two control groups--one participating in a didactic lecture program plus standard treatment and the other receiving only standard treatment--failed to demonstrate similar changes. This increase in internal locus of control in the CGSH group suggests the potential efficacy of CGSH as a relapse-prevention therapeutic technique.

Demographic, medical history and sexual correlates of HIV seropositive methadone maintained women.

Beginning in January 1989, consecutive female admissions to the ARTC MMTP Clinics in NYC were interviewed about their medical, drug, sexual and social experiences during 6 distinct historical years. Bloods were drawn and each sample tested for HIV via ELISA and Western Blot analysis. The data for 256 females was analyzed. The sample was predominantly Black (56%) and Hispanic (36%). Fifty-four percent (140) were between the ages of 31 and 40; 35% (91) were between the ages of 18 and 30; and 10% (27) were 41 or older. The majority, 179 (69%), had less than a high school education, while 79 (31%) had a high school education or greater. The seropositivity for this sample of females was 60.4%. Aside from the common types of illnesses often seen in gay men infected with the HIV virus (i.e., pneumonia, night sweats, sore throat and swollen glands) our sample of females presented with symptoms such as abnormal discharges from the vagina, infections or abscesses of the veins, kidney or bladder infections, bleeding from the bowels and hepatitis infections. The most commonly reported risk factors among our sample of HIV positive females were sharing injecting materials (38%); injecting drugs in the veins (37.2%); dividing an injection (24.3%); and blood transfusions (10.9%). Of our HIV positive females, 42 of 97 (43.3%) reported having sex with a man they shared needles with only one time so that having sex with a man who is potentially infected with the HIV virus only once may be enough for a female to seroconvert. One limitation of this data is that there is no knowledge of when the HIV positive women seroconverted. Some of the behaviors reported could be due to exposure to AIDS education, and not to the knowledge to their HIV serostatus.

Medical disorders in a cohort of New York city drug abusers: much more than HIV disease.

We evaluated the medical histories, drug abuse patterns, sexual behaviors, serological studies for syphilis and hepatitis B infection and other laboratory studies in 1780 patients enrolled in New York City drug treatment clinics in 1987. HIV serology was available for 168 patients. Nearly seventy-five percent had at least one medical disorder and 57% one abnormal laboratory parameter. A history of gonorrhea, hepatitis B infection, pneumonia, and anemia was reported in 28%, 23%, 21%, and 20.7% of the patients, respectively. Fifty-seven percent of 168 patients tested HIV seropositive and 16% of 1,780 patients were tuberculin reaction positive. Given the considerable prevalence of medical disorders, in which early identification and intervention is possible, serious consideration should be given to extend the scope of drug abuse services to include primary medical care services targeted at the medical sequelae of drug abuse, and medical disorders not directly associated with either HIV disease or drug abuse.

Sexual behaviors and HIV infection in intravenous drug users in New York City.

Heterosexual transmission of HIV infection is closely linked with intravenous drug use. This study investigated the sexual behaviors of intravenous drug users (IVDUs) in New York City. In 1986, 284 IVDUs were recruited from newly enrolled patients in methadone treatment clinics. A questionnaire asking for information on sexual behaviors was administered and sera were collected and tested by ELISA and Western Blot techniques. Associations between behavioral data and HIV serology were evaluated using univariate methods of analysis. HIV infection was significantly associated with age (p = 0.01). Subjects not claiming prostitution were also significantly more likely to be infected (p = 0.01). Subjects reporting condom use and oral sex had lower infectivity rates. Higher infection rates were observed in subjects reporting anal sex and homosexual or bisexual sexual behavior. The findings of this study suggest that greater efforts to isolate those sexual behaviors that are predictors or correlates of heterosexual transmission of HIV infection is much needed in order to design behavioral interventions that will effectively curtail the spread of this virus.

Human immunodeficiency virus infection in a cohort of intravenous drug users in New York City. Demographic, behavioral, and clinical features.

In 1985, 454 intravenous drug users were recruited from among patients scheduled for physical examination in methadone treatment clinics in New York City. A questionnaire was administered, and serum was collected for human immunodeficiency virus (HIV) serology. The HIV seroinfection rate was 60.6%, with antibody and antigen detected in 58.4% and 4.3%, respectively, of the population. Nineteen percent of 307 subjects were in Group III or Group IV of the Centers for Disease Control (CDC) classification system for HIV-associated infections. Only behavioral factors (p = 0.001) and clinical indicators (p = 0.003) were found to distinguish the HIV-infected from the non-infected subjects. Frequent use of intravenous drugs (p = 0.016), duration of drug use (p = 0.050), and duration of drug treatment enrollment (p = 0.038) were significantly associated with HIV seroinfection status and CDC stage of HIV disease. These findings strongly support aggressive efforts to reduce parenteral drug use and enroll intravenous drug users into effective drug treatment programs.