Needling Policy Makers and Sharpening the Debate: Do Syringe Exchange Programs Improve Health at the Population Level?

Context: In the midst of the current opioid epidemic, states have selected differing legislative routes implementing pathways to ensure access to clean needles and syringes. Objective: To determine whether states that implemented laws supporting syringe exchange programs (SEPs) had reductions in transmission rates of hepatitis B, hepatitis C, and HIV infection compared with states without such laws. Design and Setting: Utilizing a longitudinal panel design, we determined the legal status of SEPs in each state for years 1983-2016. Disease transmission rates for this period were estimated via a simple Poisson regression, with transmitted cases as the dependent variable, law categories as the predictor variables, and the log of state population as the exposure. The mean number of incident cases per state-year was also calculated. Participants: US states were utilized as the unit of analysis. Results: Hepatitis B and hepatitis C mean transmission rate per 100 000 population declined in states with local ordinances/decriminalized statutes and legalized SEPs (hepatitis B: 71% and 81%, respectively, differences P
Source: Journal of Public Health Management and Practice - Category: Health Management Tags: Research Reports: Research Full Report Source Type: research

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ConclusionsClinical testing guidelines have not been effectively translated to practice. Additionally, compared to HIV and HBV, HCV infections during pregnancy are becoming more prevalent, yet current national HCV screening guidelines are the least comprehensive.
Source: Maternal and Child Health Journal - Category: Health Management Source Type: research
Authors: Tang Q, Zhang X, Lu H Abstract Acquired immune deficiency syndrome (AIDS), hepatitis B virus (HBV), hepatitis C virus (HCV), gonorrhea and syphilis are the major sexually transmitted diseases (STDs) in the world, which are the focus of epidemic prevention and control in China. The epidemiological trend analysis of STDs in Shanghai could reflect the epidemic situation of these diseases in high-income areas of China, providing a reference for how to control their epidemic. Although the overall incidence rate of infectious diseases levelled off after 2009, Shanghai still faces many new obstacles in the fight ...
Source: BioScience Trends - Category: Biomedical Science Tags: Biosci Trends Source Type: research
Abstract The US is in the midst of a major epidemic of opioid addiction and related co-morbidities. Persons with opioid use disorder (OUD) are at significant risk for transmission of several blood-borne pathogens including the human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV). Commonly abused opioids and their receptors promote viral replication and virus-mediated pathology. However, most studies demonstrating an adverse effect of drugs of abuse have been conducted in vitro, the specific effects of synthetic opioids on viral replication have been poorly characterized, and the...
Source: Current HIV Research - Category: Infectious Diseases Authors: Tags: Curr HIV Res Source Type: research
This study estimated the frequency of viral hepatitis by occupational and non-occupational infections and analyzed the factors associated with case notifications in Brazil from 2007 to 2014. MATERIAL AND METHODS: This was an exploratory epidemiological study using the Notifiable Diseases Information System database. Descriptive and multivariate analyses were performed. RESULTS: The frequency of viral hepatitis by occupational infections was 0.7%, of which 1.3% were due to hepatitis A virus (HAV), 45.1% hepatitis B virus (HBV), and 45.3% hepatitis C virus (HCV). There was a significant association of the disease wit...
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
AbstractPurpose of ReviewIn prior decades, liver cancer was viewed as a neoplasm that almost exclusively arose among high-risk populations in low- and middle-income countries. Incidence rates in some high-risk populations, however, have been declining, while rates in low-risk populations have been increasing, reflecting changes in underlying etiology. In this review, we highlight the evolving epidemiology of liver cancer, focusing on recent research and advances.Recent FindingsEfforts to reduce or eliminate the risk associated with major risk factors such as hepatitis B virus (HBV), hepatitis C virus (HCV), and aflatoxin B...
Source: Current Epidemiology Reports - Category: Epidemiology Source Type: research
This study has several limitations. Frist, HCV exists in a quasispecies form in human body (Martell et al., 1992). It will be better to obtain a single full-length genome sequence from a single virus. However, because of failure in amplification of near full-length HCV genome (>5000 bps), we amplified and sequenced 10 overlapping HCV genomic segments to obtain the whole genome sequence. Therefore, the genomic sequences obtained in this study contain some ambiguous (or degenerate) nucleotides (quasispecies population). Second, previous studies showed that vast majority of IDUs in Yunnan, especially in the China-Myanmar b...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
In this study, we investigated the immunological changes in the levels of monocytes and Tregs and the associations between these cell types in HIV-1-infected MSM with syphilis. Methods Study Participants We enrolled 81 participants in this study. These individuals were assigned to four groups on the basis of serologic testing and HIV-1 results, namely, the rapid plasma reagin (RPR+) group, the CHI group, the CHI&RPR+ group, and the healthy control group. HIV-1 infection status was determined with the HIV-1/2 antigen/antibody combo enzyme immunoassay (Beijing Wantai Biological Medical Company, Beijing, China). Positive ...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
The introduction of blood donor screening by virus nucleic acid amplification technology (NAT) in the mid to late 1990s was driven by the so-called AIDS and hepatitis C virus (HCV) epidemic, with thousands of recipients of infected blood products and components. Plasma fractionators were the first to introduce NAT testing besides pathogen reduction procedures, to reduce the virus transmission risk through their products. To achieve a similar safety standard, NAT was then also introduced for labile blood components. German transfusion centres were the first to start in-house NAT testing of their donations in pools of up to ...
Source: Transfusion Medicine and Hemotherapy - Category: Hematology Source Type: research
The number and proportion of increased risk donors have increased since 2010, likely because of the epidemic of opioid overdose deaths. Compared with standard risk donors, increased risk donors were significantly more likely to have hepatitis B virus and hepatitis C virus infection.
Source: CDC Morbidity and Mortality Weekly Report - Category: American Health Tags: Hepatitis B MMWR Morbidity & Mortality Weekly Report Organ Translplants Source Type: news
Conclusion: Our population-representative hepatitis seroprevalence estimates in Burkina Faso advocate for the inclusion of hepatitis serological tests and risk factor questionnaire items in future surveys, the results of which are crucial for the development of appropriate health policies and infection control programmes. PMID: 30455530 [PubMed - in process]
Source: Bulletin of the World Health Organization - Category: International Medicine & Public Health Authors: Tags: Bull World Health Organ Source Type: research
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