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People who smoke crack cocaine are at increased risk of becoming HIV-infected, report researchers in a new CMAJ (Canadian Medical Association Journal) study. The study also found that smoking crack cocaine has dramatically increased over the last several years.

These findings point to the urgent need for innovative public-health programs targeted at crack cocaine smokers.

The study looked at 1048 injection drug users participating in the Vancouver Injection Drug Users Study in Vancouver, British Columbia. Almost 36% of participants were female, 26% self-identified as Aboriginal and the median age at the start of the study was 34 years. The participants were HIV negative at enrolment but by the end of the 9 year study, 137 people contracted HIV.

In addition, the proportion of people who smoked crack cocaine daily jumped from 11.6% in the first 3 ½ year period to 39.7% in the last period.

“We have observed that use of crack cocaine has become one of the strongest risk factors for HIV seroconversion in Vancouver,” stated Dr. Evan Wood of the BC Centre for Excellence in HIV/AIDS. Study authors suggest this could be because of mouth wounds caused from crack pipes which make people more vulnerable to infection, or association with more HIV-positive individuals, which could increase likelihood of HIV infection through sex and needle sharing. However, they were unable to assess these possible risk factors in the study.

The authors urge adoption and rigorous evaluation of innovative - but controversial - harm reduction programs to help crack cocaine smokers, such as distribution of safer crack kits and provision of safe inhalation rooms. These interventions would provide opportunities for health workers to engage with crack smokers and help address their other health care needs.

In a related commentary, Dr. David Celentano and Dr. Susan Sherman of Johns Hopkins Bloomberg School of Public Health write that “with the increasing proportion of injection drug users who are smoking crack cocaine, harm reduction programs need to address the unique needs of these people as part of a comprehensive HIV prevention strategy. Although controversial, the distribution of “crack kits” (glass stem with mouth piece, metal screen, lip balm and hand wipes) to this population has the potential to reduce HIV transmission.”

Link to paper

Link to commentary

Source
Canadian Medical Association Journal

HIV and sexual health charity Terrence Higgins Trust is launching a new information pack today aimed at gay men recently diagnosed with HIV. The pack which is called ‘What Next?’ is a handy pocket sized guide and contains information on a selection of the support services that THT and other organisations provide.

In 2008, around 2,800 gay men were diagnosed with HIV in the UK but when diagnosed, many people feel quite alone. To address this, the pack contains information on issues such as finding out you have HIV, ways of telling people that you are HIV positive, health, dealing with medical staff and information on HIV, treatment and transmission.

Men can pick up a pack for free by contacting 020 7812 1783 or by emailing stephen.adair@tht.org.uk “What Next?’ is also available for sexual health clinics to order free in bulk either with or without the inserts. The aim is to give GUM clinics the option to include information about their own services as well as others in their region - giving men an information pack that’s specific to their needs and their location.

THT is calling for GUMs and other sexual health clinics to stock the information packs so that as many men as possible can find out about the support that’s available for them, whether it’s counselling, advice about treatment, or simply being able to talk to someone for confidential advice and support.

Alan Wardle, Head of Health Promotion at Terrence Higgins Trust said “Being diagnosed with HIV can make people feel like they’re on an emotional roller coaster. Many people are left feeling quite alone or feel like they have hundreds of questions to ask. This pack aims to give some practical information that gay men might want after they’ve been diagnosed. Crucially it gives contact details of organisations that can offer support and information at a time when it might be most needed.”

Dr Christian Jessen presenter of Channel 4’s Embarrassing Illnesses said: “The ‘What Next?’ information pack is an essential tool kit for any gay man who has recently been diagnosed with HIV. There are so many things to take on board when you’ve been diagnosed and sometimes you may not be able to take it all in initially. Having a pack that you can take away and read when you’re ready is a great idea.”

The information pack follows the successful launch of the interactive website ‘What next?’ which provides information and support specifically for newly diagnosed gay men.

Source
Terrence Higgins Trust