Social intervention against AIDS among injecting drug users

Many drug injectors continue to engage in behaviors that lead them to become infected with HIV in spite of a wide variety of public health programs. In addition, many persons have begun to inject drugs in spite of knowing the risks of AIDS. The inadequacy of current efforts to prevent these behaviors suggests that additional forms of intervention should be attempted. We suggest that social interventions be tried to complement current programs (almost all of which have an individual focus). Evidence that social factors such as peer pressure and the social relations of race affect risk behavior is presented. Social interventions that are discussed include organizing drug injectors against AIDS in ways analogous to those in which gays organized against the epidemic, and finding ways to change large-scale social relationships that predispose people to inject drugs.     

Process and predictors of drug treatment referral and referral uptake at the Sydney Medically Supervised Injecting Centre

Introduction and Aims . Low‐threshold drug services such as drug consumption rooms (DCRs) have been posited as referral gateways to drug treatment for injecting drug users (IDUs). We examined the process and predictors of drug treatment referral and referral uptake at an Australian DCR. Design and Methods . We undertook behavioural surveillance of the Sydney Medically Supervised Injecting Centre (MSIC) client cohort between May 2001 and October 2002. Data were collected for 3715 IDUs on demographics, injecting and drug use behaviours at registration and all subsequent MSIC service utilisation, including referrals. Referral uptake (defined as presentation for assessment at the relevant agency) was traced via reply‐paid postcards included with written referrals. Results . Sixteen per cent of clients who received written referrals to drug treatment had confirmed drug treatment referral uptake. Factors associated with drug treatment referral were frequent MSIC attendance [adjusted odds ratios (AOR = 9.4], receipt of written health (AOR = 4.8) or psychosocial (AOR = 4.3) referrals, heroin as main drug injected (AOR = 1.9) and completion of high school education (AOR = 1.6). Factors associated positively with drug treatment referral uptake were recent sex work (AOR = 2.6) and at least daily injection (AOR 2.3). Previous psychiatric illness or self‐harm was associated negatively with drug treatment referral uptake (AOR = 0.2). Discussion and Conclusions . MSIC engaged IDUs successfully in drug treatment referral and this was associated with presentation for drug treatment assessment and other health and psychosocial services. To improve rates of drug treatment referral and uptake, those with a history of mental health issues may require more intensive referral and case management.     

The Amino Acid Composition of Hemoglobin. V. The Preparation of Purified Hemoglobin Fractions by Chromatography on Cellulose Exchangers and Their Identification by Starch Gel Electrophoresis Using Tris-Borate-EDTA Buffer

The chromatographic separation of hemoglobin on two cellulose exchangers,CMC and DEAE, is discussed. Problems related to the use of these technicsare described. In addition, our experience with the use of Tris-Borate-EDTAbuffer (Smithies) for hemoglobin electrophoresis in starch gel is presented.

Submitted on May 4, 1964 Accepted on July 14, 1964     

Intrauterine Fetal Surgery A Nursing Challenge

Surgical treatment of the fetus In utero offers new options for selected families with fetal anomalies. Nurses caring for these families must be prepared to meet their unique needs. The diagnosis, treatment, support, and follow-up care of the family is discussed.