A model to provide comprehensive testing for HIV, viral hepatitis, and sexually transmitted infections at a short-term drug treatment center.

Substance users are at high risk for blood-borne infections as well as those that are transmitted sexually. Substance abuse treatment centers present an opportunity to offer comprehensive counseling and testing (CCT) for HIV, viral hepatitis, and sexually transmitted infections (STIs) to this high-risk population. We examined the feasibility and acceptability of one model of CCT among substance users. CCT was offered to 145 consecutive inpatients; study participants completed a risk factor questionnaire and selected from a menu of testing options. Thirty-six percent of those approached agreed to participate and accepted at least one biologic test. Sixty-two percent of participants accepted all tests that were offered. While beneficial to those who accept testing, the described model of CCT is feasible in a drug treatment center, but acceptable to only a minority of inpatients.

Racial differences in serum lipids in HIV+ women treated with protease inhibitor regimens.

PURPOSE: To evaluate cardiovascular risk factors in Caucasian and African American HIV+ women undergoing treatment with HAART including a protease inhibitor (PI). METHOD: Anthropometric measures and fasting blood samples were obtained from 32 Caucasian and 10 African American women. Serum was analyzed for glucose, insulin, and lipid levels. RESULTS: The African American women were significantly older than the Caucasian women. Body mass index (BMI) was higher in the African American women, and 80% of the African American women and 47% of the Caucasian women were overweight. There were no significant differences in fasting insulin, fasting glucose, or HOMA-IR. However, African American women had significantly higher HDL levels, whereas Caucasian women had higher triglycerides and LDL. When age-matched women were compared, total as well as LDL cholesterol was significantly higher in the Caucasian women. The ratio of total cholesterol/HDL cholesterol was 3.4 +/- 1.1 in the African American women and 5.5 +/- 1.6 (p=.021) in the age-matched Caucasian women. CONCLUSION: The differences in lipid levels in HIV+ African American and Caucasian women were greater than those reported in the literature for normal women. Although the sample size is small, the data suggest that the effect of HIV infection and/or HAART on lipid levels may be different in Caucasian and African American women. Large-scale studies will be necessary to confirm these results and clarify the mechanisms involved.

Acceptability of sexually transmitted infection screening among women in short-term substance abuse treatment.

BACKGROUND: Substance abuse treatment centers provide an opportunity to offer sexually transmitted infection (STI) screening to a high-risk and hard-to-reach population. GOAL: The goal was to assess STI prevalence, risk factors, and acceptability of STI screening among females at substance abuse treatment centers with use of urine testing by ligase chain reaction and self-collected swab specimens. STUDY DESIGN: Adult, female inpatients were offered free testing and treatment for chlamydia infection, gonorrhea, and trichomonas infection. Interviews were conducted to collect risk behavior data. RESULTS: Eighty-six percent of inpatients (180/209) accepted testing. Twenty-three percent (41/177) had an STI. Of those with an STI, 90% (37/41) had trichomonas infection. All 41 infected patients received treatment. Drug use before sex, exchange of sex for money/drugs, and any gynecological complaint were significantly associated with infection. Most women were uninsured (76%). Only 45% had undergone a medical examination in the past year. CONCLUSION: STI screening is highly acceptable among women in substance abuse treatment centers. Substance users are at high risk for STIs and may not otherwise receive medical care.