Kamyar Arasteh

• PhD
• Nemours Children’s Health

Background The Standards for the Psychosocial Care of Children with Cancer and their Families (the Standards) support the provision of evidence‐based psychosocial care across the pediatric cancer trajectory by specialized multidisciplinary staff. This paper presents data from the Implementing the Standards Together: Engaging Parents and Providers i...

Objective Social-ecological factors are highly congruent with social determinants of health (SDOH): Economic Stability; Educational Access/Quality; Healthcare Access/Quality; Neighborhood/Built Environment; and Social/Community Context. In this topical review, the correspondence of social-ecological theory with SDOH and assessment approaches is rev...

We conducted a retrospective chart review of patients with neuromuscular scoliosis following spinal fusion surgery who were cared for post-operatively by either a hospitalist/orthopedics co-management team or a complex care clinic (CCC). Assignment to either treatment group was not random. To account for baseline differences between groups, we calc...

In resource-limited settings, alternatives to HIV viral load testing may be necessary to monitor the health of people living with HIV. We assessed the utility of self-report antiretroviral therapy (ART) to screen for HIV viral load among persons who inject drugs in Hai Phong Vietnam, and consider differences by recent methamphetamine use. From 2016...

Objective Prospectively examine racial and ethnic disparities in exposure to COVID-19-related stressors and their impact on families. Methods A racially, ethnically, and socioeconomically diverse cohort of caregivers of youth (n = 1,581) representative of the population served by a pediatric healthcare system completed the COVID-19 Exposure and Fa...

Background Pediatric cancer disrupts the lives of siblings in many ways, including physical separations from family and friends that increase risk for distress. Research suggests that siblings use technology and social media to connect with friends and family and seek social support and interaction. However, this may expose siblings to negative onl...

Objective: Identify and describe trajectories of cancer-related posttraumatic stress symptoms (PTSS) among siblings of children with cancer within two years of diagnosis. Method: Siblings (aged 8-18; M = 11.2 years) across the United States, and for each, one caregiver, were recruited for a cohort sequential longitudinal study with three data co...

Background: The psychosocial needs and risks of children with cancer and their families are well-documented including increased risk of parental distress, posttraumatic stress, and anxiety. There is a critical need to provide evidence-based psychosocial care to parents and caregivers of children with cancer. Digital health interventions are import...

Objective: The COVID-19 pandemic has disrupted traditional health care, including pediatric health care. We described the impact of the pandemic on disparities in pediatric health care engagement. Methods: Using a population-based cross-sectional time-series design, we compared monthly ambulatory care visit volume and completion rates (completed...

BACKGROUND The psychosocial needs and risks of children with cancer and their families are well-documented including increased risk of parental distress, posttraumatic stress, and anxiety. There is a critical need to provide evidence-based psychosocial care to parents and caregivers of children with cancer. Digital health interventions are importan...

Background There has been a significant increase in methamphetamine use among persons who use drugs in Vietnam in the last 5–10 years. We examined the degree to which adherence to antiretroviral therapy (ART) mediates the relationship between recent methamphetamine use and unsuppressed HIV viral load among people who inject drugs (PWID) in Hai Phon...

The more than one million COVID-19 deaths in the United States include parents, grandparents, and other caregivers for children. These losses can disrupt the social, emotional, and economic well-being of children, their families, and their communities, and understanding the number and characteristics of affected children is a critical step in respo...

Background Providing high-quality psychosocial care to parents and other primary caregivers of children with cancer (henceforth referred to as caregivers) is important, given the numerous challenges associated with a pediatric cancer diagnosis and the increased risk for negative psychosocial sequelae among caregivers. The Electronic Surviving Cance...

Objective: To understand the impact of the coronavirus disease 2019 (COVID-19) pandemic on adolescents and young adults (AYAs), we adapted the COVID-19 Exposure and Family Impact Scales (CEFIS; Kazak et al., 2021) for AYAs. Here, we report on the development, structure, and psychometric properties of the CEFIS-AYA. Methods: The CEFIS-AYA was dev...

The COVID-19 pandemic has been the single deadliest acute public health crisis in American history, and these deaths are a salient threat to the functioning of family and social networks. We assess counts and rates of parental and other in-home caregiver loss using death data published by the CDC and household composition data available through the...

Aims To describe the use of large-scale respondent driven sampling (RDS) surveys to demonstrate the “end of an HIV epidemic” (HIV incidence < 0.5/100 person-years) among persons who inject drugs (PWID) in a middle-income country. Large sample sizes are needed to convincingly demonstrate very low incidence rates. Methods 4 large surveys (Ns approxi...

Purpose The coronavirus disease (COVID-19) pandemic has affected Latinx immigrant neighborhoods in New York City (NYC) disproportionately. Poverty, hypertension and diabetes have been associated with adverse COIVD-19 outcomes. This study aims to assess the prevalence of these COVID-19 vulnerabilities among Latinx immigrants in NYC. Design/methodol...

Aims To describe the current methamphetamine (MA) use epidemic among persons who inject heroin (PWID) in Hai Phong, Vietnam, and consider possibilities for mitigating adverse effects of methamphetamine use. Methods This study conducted surveys of PWID in 2016, 2017, and 2018 (N = 1383, 1451, and 1445, respectively). Trained interviewers administer...

Injecting drugs for the first time almost always requires assistance from an experienced person who injects drugs (PWID). While there has been moderate amount of research on PWID who assist with first injections, most of this research has focused on identifying characteristics of PWID who assist with first injections. We do not have a formal model...

Objective: To determine whether it is possible to 'end an HIV epidemic' among persons who inject drugs (PWID) in a low/middle income country. Design: Serial cross-sectional surveys with a cohort of HIV seronegative participants with 6-month follow-up visits recruited from surveys. Methods: Surveys of PWID using respondent driven and snowball s...

Objective: We assessed the association between methamphetamine use and lack of viral suppression among a cohort of HIV seropositive persons who inject drugs (PWID) in Hai Phong, Vietnam. Design: Cohort study with random effects logit modeling and mediation analysis for ART adherence. Methods: PWID were recruited from October 2016-October 2017;...

Background The coronavirus disease (COVID-19) pandemic has affected Blacks and Hispanics in New York City (NYC) disproportionately. This study aims to assess the relationship of race/ethnicity with COVID-19 associated factors such as hypertension, diabetes, neighborhood poverty, and frontline work, in NYC.Methods The 2018 New York City Community He...

Compared to the US-born population, Hispanic immigrants are reported to have lower age-adjusted prevalence of hypertension. However, country of origin, race/ethnicity, and risk behaviors associated with acculturation, including hazardous drinking, can affect the prevalence of hypertension. Additionally, health disparities across immigration/nativit...

Background: Hepatitis C virus (HCV) infection is associated with substantial morbidity and mortality among people who use drugs (PWUD). Health disparities related to race/ethnicity and immigration status also increase the risk of HCV infection and decrease the probability of linkage to care. Effective, curative treatment is now available for HCV in...

In Vietnam, harm reduction programs to control HIV among people who inject drugs (PWID) were implemented approximately 10 years ago. Since then, the HIV prevalence has declined in this population, however, the impact of these programs on the rate of new HIV and Hepatitis C (HCV) infections remains unknown as high mortality can exceed the rate of ne...

Objectives. To report on the expansion of syringe service programs (SSPs) in the United States from 2015 to 2018. Methods. We obtained data from records of the Buyers’ Club of the Dave Purchase Project/North American Syringe Exchange Network (NASEN), including the number of US SSPs and the numbers of sterile syringes purchased by programs. We condu...

Background Achievement of HIV control among key populations through universal access to antiretroviral treatment (ART) requires a precise evaluation of the cascade of care. One of the main difficulties in obtaining an accurate community-based cascade of care is misreporting, which could represent one of the most important bias for people suffering...

Non-gay identifying men who have sex with men and women (MSMW) are an important subgroup of men who have sex with men (MSM) and have been underrepresented in studies of MSM that only use gay venues to draw their samples. We assessed heterosexual and drug use risks of MSMW who use drugs in a sample of male entrants to the Mount Sinai Beth Israel dru...

Aims: To identify geographic "hotspots" for potential transmission of HIV and HCV and for drug overdose among persons who use heroin and cocaine in New York City and to examine historical continuities in problem drug use hotspots in the city. Methods: A total of 2714 study participants were recruited among persons entering Beth Israel substance...

We tested the hypothesis that an updated “Break the Cycle” (BtC) intervention, based in social cognitive theory and motivational interviewing, would reduce the likelihood that current persons who inject drugs (PWID) would assist persons who do not inject drugs (non-PWID) with first injections in Tallinn, Estonia and Staten Island, New York City. 40...

Objectives: Assess relationships among non-medical use of prescription opioid analgesics (POAs), heroin use, and HIV and hepatitis C (HCV) infection among persons who inject drugs (PWID) in New York City, 2016-2018. Methods: PWID (N = 134) were recruited from Mount Sinai Beth Israel drug treatment programs. HIV seropositive persons were oversamp...

Methamphetamine use has increased significantly in Southeast Asia in the last 5–10 years, but there is little research on risk behaviors associated with the increase in this region. We evaluate injection and sexual risk behaviors associated with current methamphetamine use among heterosexual persons who inject drugs (PWID) in Hai Phong, Vietnam. We...

Objective: Assess hepatitis C virus (HCV) prevalence and incidence among person who began injecting drugs during the opioid epidemic in New York City (NYC) and identify possible new directions for reducing HCV infection among persons who inject drugs. Methods: 846 persons who began injecting drugs between 2000 and 2017 were recruited from person...

We examined the potential for HIV and hepatitis C (HCV) transmission across persons who inject drugs (PWID), men-who-have-sex-with-men (MSM) and female commercial sex workers (CSW) PWID and the potential for sexual transmission of HIV from PWID to the general population in Hai Phong, Viet Nam. Using respondent driven and convenience sampling we rec...

Objective We identified potential geographic “hotspots” for drug-injecting transmission of HIV and hepatitis C virus (HCV) among persons who inject drugs (PWID) in New York City. The HIV epidemic among PWID is currently in an “end of the epidemic” stage, while HCV is in a continuing, high prevalence (> 50%) stage. Methods We recruited 910 PWID ent...

List of Zip codes by neighborhood, New York City five boroughs (Bronx, Brooklyn, Manhattan, Queens, and Staten Island. (PDF)

Zip codes by borough Maps. (PDF)

Background: Good estimates of key population sizes are critical for appropriating resources to prevent HIV infection. We conducted two capture/recapture studies to estimate the number of PWID currently in Hai Phong, Vietnam. Methods: A 2014 respondent-driven sampling (RDS) survey served as one capture, and distribution of cigarette lighters at d...

Background: We examined whether sex disparities (heterosexual male:female) in HIV infection continue to persist at the "end of the HIV epidemic" among persons who inject drugs (PWID) in New York City (NYC). An "end of the epidemic" was operationally defined as 1) prevalence of untreated HIV infection <5%, and 2) estimated HIV incidence <0.5/100 pe...

Objectives: To examine whether racial/ethnic disparities persist at the "end of the HIV epidemic" (prevalence of untreated HIV infection < 5%; HIV incidence < 0.5 per 100 person-years) among persons who inject drugs (PWID) in New York City. Methods: We recruited 2404 PWID entering New York City substance use treatment in 2001 to 2005 and 2011 to...

Background: Herpes simplex virus type 2 (HSV-2) infection increases both susceptibility to and transmissibility of human immunodeficiency virus (HIV), and HSV-2 and HIV are often strongly associated in HIV epidemics. We assessed trends in HSV-2 prevalence among non-injecting drug users (NIDUs) when HIV prevalence declined from 16% to 8% among NIDU...

Background and aims: HIV has reached high prevalence in many non-injecting drug user (NIDU) populations. Aims of this study were to 1) examine the trend in HIV prevalence among non-injecting cocaine and heroin NIDUs in New York City, 2) identify factors potentially associated with the trend, 3) estimate HIV incidence among NIDUs. Design: Serial-...

Objectives: Transitioning from injecting to non-injecting routes of drug administration can provide important individual and community health benefits. We assessed characteristics of persons who had ceased injecting while continuing to use heroin and/or cocaine in New York City. Methods: We recruited subjects entering Mount Sinai Beth Israel det...

Combined prevention for HIV among persons who inject drugs (PWID) has led to greatly reduced HIV transmission among PWID in many high-income settings, but these successes have not yet been replicated in resource-limited settings. Haiphong, Vietnam experienced a large HIV epidemic among PWID, with 68% prevalence in 2006. Haiphong has implemented nee...

AIDS among persons who inject drugs, first identified in December 1981, has become a global epidemic. Injecting drug use has been reported in 148 countries and HIV infection has been seen among persons who inject drugs in 61 countries. Many locations have experienced outbreaks of HIV infection among persons who inject drugs, under specific conditio...

Background: To examine the prospects for "ending the HIV epidemic" among persons who inject drugs (PWID) in Haiphong, Vietnam. Reaching an incidence of <0.5/100 person-years at risk (PY) was used as an operational definition for "ending the epidemic." Methods: A respondent driven sampling study of 603 PWID was conducted from September to October...

Objectives: To compare methods for estimating low HIV incidence among persons who inject drugs. Methods: We examined 4 methods in New York City, 2005 to 2014: (1) HIV seroconversions among repeat participants, (2) increase of HIV prevalence by additional years of injection among new injectors, (3) the New York State and Centers for Disease Contr...

It has not been determined whether implementation of combined prevention programming for persons who inject drugs reduce racial/ethnic disparities in HIV infection. We examine racial/ethnic disparities in New York City among persons who inject drugs after implementation of the New York City Condom Social Marketing Program in 2007. Quantitative inte...

Hepatitis C virus infection is a source of significant preventable morbidity and mortality among persons who inject drugs (PWID). We sought to assess trends in hepatitis C virus (HCV) infection among PWID from 2006 to 2013 in New York City (NYC). Annual cross-sectional surveys of PWID entering a large drug abuse treatment program were performed. Ri...

New York City has experienced the largest HIV epidemic among persons who use psychoactive drugs. We examined progress in placing HIV seropositive persons who inject drugs (PWID) and HIV seropositive non-injecting drug users (NIDU) onto antiretroviral treatment (ART) in New York City over the last 15 years. We recruited 3511 PWID and 3543 NIDU from...

In 1981, when acquired immune deficiency syndrome (AIDS) was first observed among persons who inject drugs, almost all US states had laws criminalizing the possession and distribution of needles and syringes for injecting illicit drugs. We reviewed changes to these laws to permit 'syringe exchanges' and the provision of public funding for such prog...

Objective: Significant racial/ethnic and sex disparities in HIV infection among persons who inject drugs (PWID) have been observed in many countries, with ethnic minority group members and females usually having higher HIV prevalence. There are evidence-based interventions to reduce HIV transmission among PWID, but whether implementation of these p...

Background: Adherence to antiretroviral (ARV) medication is vital to reducing overall morbidity and mortality among HIV infected persons. People who inject drugs (PWID) represent a population at an elevated risk for HIV. In this review, we assess adherence levels to ARVs among HIV positive PWID in TLMIC. Methods: Systematic review was conducted to...

Prevalence of human immunodeficiency virus (HIV) infection has reached 16% among non-injecting drug users (NIDU) in New York City, an unusually high prevalence for a predominantly heterosexual population that does not inject drugs. Using a long-term study (1983-2011, >7,000 subjects) among persons entering the Beth Israel drug-treatment programs in...

To examine herpes simplex virus 2 (HSV-2)/HIV co-infection as a contributing factor in the increase in HIV infection among non-injecting heroin and cocaine users in New York City. Subjects were recruited from the Beth Israel Medical Center drug detoxification and methadone maintenance programs in New York City in 1995-1999 and 2005-2011. All report...

We assessed awareness and use of the "NYC Condom" among persons who use heroin and cocaine in New York City. The NYC Condom distribution program is the largest free condom distribution program in the USA, with over 30 million condoms distributed per year. It includes a condom social marketing program for a specific brand, the NYC Condom with its ow...

Examine long term sexual risk behaviors among persons who inject drugs (PWID) in New York City following implementation of "combined" prevention programming, including condom social marketing. Quantitative interviews and human immunodeficiency virus (HIV) testing were conducted among PWID entering Beth Israel Medical Center drug treatment programs...

Background: Opiate Substitution Treatment (OST) can increase quality of life (WHO-QOLBREF) and reduce addiction severity (ASI) among participants. Program participants in several studies have noted that improvements in quality of life is one of the most important factors to their reduction in drug use and associated risky behavior. However, there i...

Opioid substitution treatment (OST) can increase quality of life (WHOQOL-BREF) and reduce addiction severity index (ASI) scores among participants over time. OST program participants have noted that improvement in quality of life is one of the most important variables to their reduction in drug use. However, there is little systematic understanding...

Transitions from injecting to non-injecting drug use have been reported from many different areas, particularly in areas with large human immunodeficiency virus (HIV) epidemics. The extent to which such transitions actually protect against HIV and HCV has not been determined. A cross-sectional survey with HIV and hepatitis C (HCV) testing was condu...

Disparities in HIV infection, with females having higher rates of HIV infection than males, have been noted among persons who inject drugs (PWID) in many countries. We examined male/female HIV disparities among PWID in Central Asia and compared these disparities with patterns worldwide. A systematic review and meta-analyses were conducted for studi...

Medication assisted treatment (MAT) is a key component in overdose prevention, reducing illicit opiate use and risk of blood borne virus infection. By retaining participants in MAT programs for longer periods of time, more noticeable and permanent changes in drug use, risk behavior, and quality of life can be achieved. Many studies have documented...

To examine the potential contribution of herpes simplex virus 2 (HSV-2) infection to female/male and racial/ethnic disparities in HIV among non-injecting heroin and cocaine drug users. HSV-2 infection increases susceptibility to HIV infection by a factor of two to three. Subjects were recruited from entrants to the Beth Israel drug detoxification p...

373 Background: Sunitinib is a small molecule which inhibits receptor tyrosine kinases involved in cell proliferation and angiogenesis. Though the incidence and risk of unique toxicities associated with sunitinib, such as hypertension and thromboembolic events, have been previously reported, the incidence and risk of hematologic toxicities have bee...

Noninjection drug use, although recognized as an emerging risk factor for acquisition of other blood-born pathogens, is still unconfirmed as a route of hepatitis C virus (HCV) transmission. Our goal was to measure HCV exposure and prevalence in noninjection drug users (NIDUs). Fifty-seven NIDUs were screened by extensive questionnaire to exclude pr...

Aims: The Ethnic Minority Meta-Analysis (EMMA) aims to assess racial/ethnic disparities in HIV infection among people who inject drugs (PWID) across various countries. This is the first report of the data. Methods: Standard systematic review/meta-analysis methods were utilized, including searching for, screening and coding published and unpublis...

Injecting drug use continues to be a primary driver of HIV epidemics in many parts of the world. Many people who inject drugs (PWID) are sexually active, so it is possible that high-seroprevalence HIV epidemics among PWID may initiate self-sustaining heterosexual transmission epidemics. Fourteen countries that had experienced high seroprevalence (<...

No Transition Countries. Locations that had not experienced a transition from IDU-concentrated to heterosexual sustained HIV/AIDS epidemics, and newly reported HIV/AIDS cases among PWID still surpass newly reported heterosexual HIV/AIDS cases. Each data point corresponds to the number of newly reported HIV/AIDS cases, by risk group, for each year d...

Pattern A transitions from IDU-concentrated to heterosexual HIV epidemics. Locations that experienced transitions from IDU-concentrated to heterosexual sustained HIV/AIDS epidemics at the peak newly reported HIV/AIDS cases among PWID. Each data point corresponds to the number of newly reported HIV/AIDS cases, by risk group, for each year data was a...

Pattern B transitions from IDU-concentrated to heterosexual epidemics. Locations that experienced transitions from IDU-concentrated to heterosexual sustained HIV/AIDS epidemics and low levels of newly reported HIV/AIDS cases among PWID. Each data point corresponds to the number of newly reported HIV/AIDS cases, by risk group, for each year that sur...

Mixed Transition from IDU-concentrated to heterosexual epidemics. Locations that had experienced a transition from IDU-concentrated to heterosexual sustained HIV/AIDS epidemics, and newly reported HIV/AIDS cases among PWID still surpass newly reported heterosexual HIV/AIDS cases. Each data point corresponds to the number of newly reported HIV/AIDS...

There are multiple reasons why females who inject drugs may be more likely to become infected with HIV than males who inject drugs. Where this is the case, special HIV prevention programs for females would be needed. International systematic review and meta-analysis of studies across 14 countries. Countries with high seroprevalence (>20%) HIV epide...

Objective: There are several reasons females who inject drugs may be at higher risk for HIV compared to male injectors: 1) females may have more difficulties obtaining sterile injection equipment, 2) females may be more likely to inject after males in group settings, and 3) females are more susceptible to sexual transmission. We conducted a systema...

Objectives: Examine relationships between herpes-simplex virus type 2 (HSV-2, a biomarker for sexual risk), and hepatitis C virus (HCV, a biomarker for injecting risk), with HIV among injecting drug users who began injecting after large-scale expansion of syringe exchange programs in New York City. Methods: 337 heroin and cocaine users who began in...

Objectives: Many injecting drug users (IDUs) also use drugs through means other than injecting (smoking, snorting, oral). If the non-injecting use substitutes for injecting use, then non-injecting use might protect against infection with blood-borne viruses (BBVs). Methods: In New York City (NYC), 726 IDUs were recruited at a short-term drug detoxi...

Preventing HCV infection among people who inject drugs is a difficult public health challenge. We examined the potential role of intranasal drug use in reducing HCV acquisition. Subjects were recruited from IDUs entering the Beth Israel drug detoxification program from 2005 to 2010. A structured interview was administered and serum samples were col...

We examined relationships between herpes simplex virus type 2 (HSV-2), a biomarker for sexual risk, and HCV, a biomarker for injecting risk, with HIV among injecting drug users (IDUs) who began injecting after large-scale expansion of syringe exchange programs in New York City. We recruited 337 heroin and cocaine users who began injecting in 1995 o...

New York City experienced the first and largest HIV epidemic among injecting drug users (IDUs). Using data collected from IDUs entering the Beth Israel drug detoxification program, we trace the history of this epidemic from the mid-1970s through the early 2000s. The epidemic can best be described in terms of successive stages: (1) introduction and...

Introduction It has now been 30 years since AIDS was first formally observed among injecting-drug users (IDUs) 1 and about 35 years since HIV was first intro-duced into the population of IDUs in New York City. 2 During this time, both injecting drug use and HIV among IDUs have spread to many different coun-tries, in particular, to low-and middle-in...

Background: High prevalence HIV infections among injection drug users (IDUs) may transition to self-sustaining heterosexual epidemics. Despite evidence of such epidemic transitions, little international comparative research exists on this topic. Methods: An international systematic review was conducted on transitions from IDU-concentrated to self...

Background: Syringe exchange programs began in the US in the late 1980s and there are presently approximately 180 active syringe exchange programs (SEPs). During this time period, HIV incidence among IDUs declined by 80%. The ban on federal funding for syringe exchange was recently removed, but programs may be facing severe budget cuts due to fisca...

Background: Higher rates of HIV infection among racial/ethnic minority injecting drug users (IDUs) have been reported in North America, South America, Europe and Asia. Methods: Standard systematic review/meta-analysis methods are utilized, including searching for published and unpublished reports, standardized screening and coding, and meta-analy...

To examine prevalence of and associations between herpes simplex virus type 2 (HSV-2) infection and HIV infection among never-injecting heroin and cocaine drug users (NIDUs) in New York City. Subjects were recruited from patients entering the Beth Israel drug detoxification program. Informed consent was obtained, a structured questionnaire includin...

Studies in North America and Western Europe have reported an association between hazardous drinking and HIV sexual risk behaviors among injection drug users (IDUs). However, we lack such studies from developing and transitional countries, where different cultural norms and contexts of drinking may change this association. We used a multi-site study...

As no single HIV prevention program has eliminated HIV transmission, there is growing interest in the effectiveness of "combined" prevention programming. To compare HIV infection among persons injecting in the initial programs environment (IPE) in New York City (self-initiated risk reduction, methadone, education/outreach, and HIV testing) to HIV i...

Objective: We examined long-term outcomes of large-scale implementation of syringe exchange in terms of the goal of eliminating HIV infection among IDUs in New York City. Prior to large-scale implementation of syringe exchange in the mid-1990s, HIV prevalence was 57% among Black, 53% among Latino/a, and 27% among White IDUs. Methods: Subjects wer...

Objective: Among the various modes of drug administration, injection is the most cost-effective and provides the most intense drug effect. We examined characteristics of former injectors, drug users who transitioned from injecting to non-injecting use of heroin and cocaine, and avoided relapse back to injecting. Methods: Former injectors were def...

To assess trends in injecting and non-injecting drug use after implementation of large-scale syringe exchange in New York City. The belief that implementation of syringe exchange will lead to increased drug injecting has been a persistent argument against syringe exchange. Administrative data on route of administration for primary drug of abuse amo...

We examined racial/ethnic disparities in HIV infection among injection drug users (IDUs) before and after implementation of large-scale syringe exchange programs in New York City. Participants were recruited from IDUs entering the Beth Israel drug detoxification program in New York City. Participants (n = 1203) recruited from 1990 through 1994, pri...

To describe recent research done primarily during the past 12 months (i.e., primarily in 2008) on the epidemiology of HIV infection among injecting drug users (IDUs). Major research developments include a global assessment of HIV infection among IDUs and evidence of a transition from epidemics concentrated among IDUs to generalized, heterosexual ep...

We analyzed data from 1253 HIV-positive injection drug users (IDUs) entering detoxification or methadone maintenance treatment in New York City between 1990 and 2004 to assess HIV risk behaviors and their association with at-risk drinking (defined as more than 14 drinks per week for males or 7 drinks per week for females) and intoxication. Most (81...

To test the hypothesis that at-risk drinking is associated with a smaller probability of prior HIV testing and access to antiretroviral treatment (ART) among injection drug users (IDUs) entering treatment for drug abuse. HIV infected IDUs (N = 643) entering detoxification or methadone maintenance treatment in New York City between 1997 and 2002 com...

To explore the potential utility of hepatitis C virus (HCV) seroprevalence as a biomarker for injection risk, and herpes simplex virus-2 (HSV-2) as a biomarker for sexual risk among injecting drug users (IDUs). We examined the relationships between HCV and HIV and between HSV-2 and HIV among injecting drug users in New York City relative to the lar...

nsite, Vancouver's supervised injection facility for in- jection drug users, opened in 2003 under an exemption from Canadian federal drug laws. A substantial amount of research has since been conducted on the facility (www .vch.ca/sis/). Although randomized controlled trials have not been possible, the research has indicated substantial public heal...

Objective: Assess relationships between HIV, hepatitis C virus (HCV) and herpes simplex virus-2 (HSV-2) seroprevalence among injecting drug users in New York City. HCV is readily transmitted through unsafe drug injecting but only inefficiently through unsafe sexual behavior, and can serve as a biomarker for unsafe injections. HSV-2 is transmitted s...