Fatal and non-fatal overdose after narcology hospital discharge among Russians living with HIV/AIDS who inject drugs

详细信息    查看全文

• 作者：Alexander Y. Walley^a ; ^{awalley@bu.edu} ; ; Debbie M. Cheng^b ; Emily K. Quinn^c ; Elena Blokhina^d ; Natalia Gnatienko^a ; Christine E. Chaisson^b ; ^c ; Evgeny Krupitsky^d ; ^e ; Philip O. Coffin^f ; ^g ; Jeffrey H. Samet^a ; ^h
• 关键词：Overdose ; HIV ; Injection drug use ; Mortality ; Russia
• 刊名：International Journal of Drug Policy
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：39
• 期：Complete
• 页码：114-120
• 全文大小：522 K
• 卷排序：39

文摘

Among Russians living with HIV/AIDS who inject drugs, we examined the incidence of fatal and non-fatal overdoses following discharge from a narcology hospital and the associations with more advanced HIV infection.DesignProspective cohort study of data collected at baseline, 3 and 6 months from HIV-infected patients with a history of injection drug use who were not treated with anti-retroviral therapy. Participants were recruited between 2012&ndash;2014 from a narcology (addiction) hospital in St. Petersburg, Russia.MethodsFatal overdose was determined based on contact reports to study staff in the year after discharge. Non-fatal overdose was self-reported at the 3- and 6-month assessments. The main independent variable for HIV severity was CD4 cell count at the baseline interview (<200 cells/mm3 ≥ 200 cells/mm3). Secondary analyses assessed time since HIV diagnosis and treated with anti-retroviral treatment (ART) prior to enrolment as independent variables. We fit Cox proportional hazards models to assess whether HIV severity is associated with either fatal or non-fatal overdose.ResultsAmong 349 narcology patients, 18 participants died from overdose within one year after discharge (8.7%, 95% CI 3.4&ndash;14.2 by Kaplan&ndash;Meier); an estimated 51% [95% CI 34&ndash;68%] reported at least one non-fatal overdose within 6 months of discharge. HIV severity, time since HIV diagnosis and ever ART were not significantly associated with either fatal or non-fatal overdose events.ConclusionFatal and non-fatal overdose are common among Russians living with HIV/AIDS who inject drugs after narcology hospital discharge. Overdose prevention interventions are urgently warranted among Russian narcology patients with HIV infection.