Drug Users Who "Think Positive" More Apt to Reduce Risk Behaviors

NEW YORK CITY, May 31 - When it comes to reducing risky drug-use behavior, belief in oneself increases the chance of success, according to a study of 792 injection drug users in Baltimore. The study appears in the June issue of the Journal of Urban Health, published by The New York Academy of Medicine.

Researchers from the Academy's Center for Urban Epidemiologic Studies, and from the Johns Hopkins University Bloomberg School of Public Health, found that injection drug users (IDUs) who believed they'd reduce drug use and related risk behaviors six months down the road were more likely to do so. Declines in drug use, injection frequency, and needle sharing -- strong risk factors for HIV infection -- were found among those with high self-expectancy, researchers found in six-month follow-up surveys.

"The results suggest that working with drug users to build a sense that they can make positive changes may be important for achieving better health outcomes," said Dr. David Vlahov, Director of the Center for Urban Epidemiologic Studies, a co-author of the paper with David Celentano, Sylvia Cohn and Richard Davis of Johns Hopkins.

Other important new studies in the June issue reveal trends in prenatal health, urban access to care, and syringe exchange. Findings include:

• A statewide policy requiring that partners of HIV-positive New Yorkers be notified of the infection, appears to have inhibited some pregnant women from undergoing HIV testing and prenatal care, according to a study of 5,007 patients from Central New York. The study found that the percentage of patients who did not undergo prenatal HIV testing or receive prenatal care increased significantly after named reporting and mandatory partner notification was instituted.

• Injection-drug users (IDUs) who obtain clean syringes through needle-exchange programs based in mobile vans, are at higher risk for infection from blood-borne disease than those who acquire needles in pharmacies or other fixed sites, according to an analysis of the Vancouver Injection Drug Users Study. The new study involving 1,020 IDUs found that syringe customers at mobile vans are more likely to inject cocaine daily and to have been incarcerated within the past six months, among other risk-raising factors. The results suggest that drug-users seeking syringes from each site have different characteristics, and that mobile vans achieve the greatest access to higher risk drug injectors, who are more desperately in need of these services. A more comprehensive HIV prevention program should include multiple approaches to reach all segments of the population in need, the study suggests. A larger portion of high-risk drug users would be reached if van-based needle distribution were increased, the authors say.

• Those who get routine medical care in a hospital rather than a doctor's office or health clinic do not receive fewer preventive services, according to a study of 695 low-income, predominantly African-American adults in Central Harlem, New York. Researchers from Columbia University's Mailman School of Public Health examined findings of the Harlem Household Survey, which studied risk factors linked to the community's high mortality rates. More Harlem residents reported relying on hospitals for medical care (24%) than U.S. residents as a whole (10%) and U.S. blacks (16%). But those who used hospitals for health care were no less likely to receive preventive and illness-related services such as cholesterol screenings, blood pressure checks, and breast exams in the past year, researchers found. The study did not address the quality of care received.

The New York Academy of Medicine is a non-profit organization founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on disadvantaged urban populations. The Academy publishes the Journal of Urban Health quarterly. View it online at http://www.jurban.oupjournals.org/current.shtml

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Posted on May 31, 2002

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