To determine the seroprevalence of hepatitis B (HBV), hepatitis C (HCV) and HIV infections in problem drug users (PDU) in Luxembourg. To measure the validity of self-reported test results provided by study participants as well as obtained through the national drug-monitoring system (RELIS).
In a cross-sectional multisite study, data were collected by voluntary, anonymous and assisted questionnaires and serological detection of antibodies and antigens. Out of 1169 contacts, 397 participants were recruited within in and out-of-treatment settings (84.2% injecting drug users; IDU).
The prevalence of antibodies to HIV was 8/272 (2.9%; 95% CI 0.9% to 4.9%), to HCV 245/343 (71.4%; 66.6% to 76.2%), and 67/310 (21.6%; 17.1% to 26.2%) to total HBV antibodies and surface antigen (for IDU 5/202, 218/268 and 59/239, respectively). Specificity of study self-reports was very high for HBV and perfect for HCV and HIV. Sensitivity was 0.224, 0.798 and 0.800, respectively. Kappa scores provided degrees of agreement between serological tests and study self-reports of 0.89 for HIV, 0.65 for HCV and 0.25 for HBV. In contrast to simultaneous cross-sectional self-reports, secondary self-reported data (RELIS) showed high agreement for HIV and HBV infections and provided a good proxy for estimation of HCV seroprevalence.
HIV testing routines in PDU should be completed at least by HBV and HCV detection given the poor validity of cross-sectional self-reports on hepatitis infections. HIV and hepatitis prevalence estimations in PDU gain by relying on multisite/setting data collection. Research should further investigate the validity of HIV and hepatitis self-reports from routine drug-monitoring systems versus cross-sectional surveys.
- Date de parution: janvier 2012
- Alain ORIGER, Jean-Claude SCHMIT
- Editeur: BMJ
We analysed gender differences in national fatal overdose (FOD) cases related to opiates and cocaine use between 1985 and 2011 (n = 340).
Cross-examination of national data from law enforcement and drug use surveillance sources and of forensic evidence. Bivariate and logistic regression analysis of male/female differences according to sociodemographics, forensic evidence and drug use trajectories.
The burden of deaths caused by FOD on the general national mortality was higher for men (PMR/100=0.55) compared with women (PMR/100=0.34). Compared with their male peers, women were younger at the time of death (t=3.274; p=0.001) and showed shorter drug use careers (t=2.228; p=0.028). Heroin use was recorded more frequently in first drug offences of female victims (AOR=6.59; 95% CI 2.97-14.63) and according to forensic evidence, psychotropic prescription drugs were detected to a higher degree in females (AOR=2.019; 95% CI 1.065-3.827).
The time window between the onset of illicit drug use and its fatal outcome revealed to be shorter for women versus men included in our study. Early intervention in female drug users, routine involvement of first-line healthcare providers and increased attention to use of poly- and psychotropic prescription drugs might contribute to prevent premature drug-related death and reduce gender differences.
- Date de parution: février 2014
- Alain ORIGER A, Sofia LOPES DA COSTA S, Michèle BAUMANN
- Editeur: Karger