Adaptation of PhotoVoice methodology to promote policy dialog among street-based drug users in Santo Domingo, Dominican Republic.

BACKGROUND: Like other epidemics, the current heroin epidemic in Santo Domingo, Dominican Republic is a largely invisible and devastating social problem linked to numerous structural and social determinants of health. METHODS: In this article, we connect a community-based participatory research methodology - "PhotoVoice" - with the theoretical orientation of critical medical anthropology to identify local interpretations of complex social and structural factors that are most salient to the well-being of local Dominican populations affected by drug addiction. RESULTS: Specifically, we describe Proyecto Lentes (Lens Project), a PhotoVoice initiative launched in 2014, which brought together active drug users to visually unveil and critically analyze the micro- and macro-factors shaping the marginalized and stigmatized drug addiction epidemic in Santo Domingo. CONCLUSIONS: While the synthesis of PhotoVoice and critical medical anthropology provides a powerful political analysis tool, this fusion is particularly apt in its ability to capture the "invisible voices" of marginalized communities, potentially contributing to future policy reform and social empowerment.

Human pegivirus molecular epidemiology in Argentina: potential contribution of Latin American migration to genotype 3 circulation.

In order to determine the human pegivirus (HPgV) genotypic diversity in Argentina taking into account the potential contribution of human migration from neighboring countries, samples from 130 Argentine injecting drug users, 116 Argentine- and 50 immigrant-pregnant women were analyzed. HPgV RNA prevalence among human immunodeficiency virus (HIV)-positive injecting drug users was similar to HIV-positive pregnant women, as was the case when comparing HIV-negative injecting drug users and HIV-negative pregnant women (P > 0.05). HPgV genotype 2 (HPgV/2) was prevalent among both Argentine injecting drug users and pregnant women, in contrast to HPgV/3 observed among pregnant women from Latin American countries with predominant indigenous populations and who had experienced their initial sexual intercourses--and possibly their source of infection--in those countries (P < 0.01). In addition, HPgV vertical and horizontal transmission was proven by molecular analysis of E2 gene and construction of identity matrixes with epidemiologically non-related isolates. This study shows that human migration from neighboring Latin American countries with predominant indigenous populations might contribute to HPgV/3 circulation in Argentina.

Prevalence and genotypes of hepatitis C virus among injecting drug users from Salvador-BA, Brazil

Hepatitis C virus (HCV) is the major infectious disease agent among injecting drug users (IDUs), with seroprevalence ranging from 50-90 percent. In this paper, serological and virological parameters were investigated among 194 IDUs, 94 ex-IDUs and 95 non-IDUs that were sampled by the "snowball" technique in three localities renowned for both intense drug use and trafficking activities in Salvador, Brazil. The majority of the participants were male, but sex and mean age differed significantly between IDUs/ex-IDUs and non-IDUs (p < 0.05). Anti-HCV screening revealed that 35.6 percent, 29.8 percent and 5.3 percent of samples from IDUs, ex-IDUs and non-IDUs, respectively, were seropositive. HCV-RNA detection confirmed that the prevalence of infection was 29.4 percent, 21.3 percent and 5.3 percent for IDUs, ex-IDUs and non-IDUs, respectively. Genotyping analysis among IDUs/ex-IDUs determined that 76.9 percent were infected with genotype 1, 18.5 percent with genotype 3 and 4.6 percent with a mixed genotype; this result differed significantly from non-IDUs, where genotype 3 was the most frequent (60 percent), followed by genotype 1 (20 percent) and a mixed genotype (20 percent). We report a significantly higher prevalence of HCV infection in IDUs/ex-IDUs compared to the control group (p < 0.001). Although the sample size of our study was small, the differences in HCV genotype distribution reported herein for IDUs/ex-IDUs and non-IDUs warrant further investigation.