Mark W Tyndall

..116) or assaults/robbery (174 vs. 180), although a decline in vehicle break-ins/vehicle theft was observed (302 vs. 227). The SIF was not associated with increased drug trafficking or crimes commonly linked to drug use...

..Our study suggests that the SIF provides an opportunity to coordinate policing and public health efforts and thereby resolve some of the existing tensions between public order and health initiatives...

..The objective of this study was to develop a scale to measure the unique experience of STI-related stigma among women...

..The programmes initiated in Vancouver demonstrate the positive impact that a comprehensive DOT programme can have on ARV adherence, as well as highlight the challenges that remain...

..This analysis was conducted to describe the attendance, demographic characteristics, drug use patterns, and referrals made during the first 18 months of operation...

..However, risk factors for CIRI have not been well described in the literature. We sought to characterize the risk factors for current CIRI among individuals who use North America's first supervised injection facility (SIF)...

..We sought to examine whether there were differential rates of HIV incidence among Aboriginal and non-Aboriginal injection drug users in a Canadian setting...

..Spontaneous clearance of hepatitis C virus (HCV) occurs in approximately 25% of individuals...

..We examined the association of methadone maintenance therapy (MMT) with highly active antiretroviral therapy (HAART) adherence and HIV treatment outcomes among a cohort of HIV/HCV co-infected injection drug users (IDUs)...

..We evaluated virological responses to HAART among HIV-1 infected patients who were injection drug users (IDUs) in a population-based setting where HIV/AIDS care is delivered free of charge...

..We investigated the relationship between environmental-structural factors and condom-use negotiation with clients among female sex workers...

..5%) received antiretroviral medication >or=75% of the time during their first year receiving therapy. The data demonstrate the need for novel interventions to expand HIV care to specific populations...

..We examined the time to antiretroviral therapy (ART) use among antiretroviral naïve HIV infected injection drug users participating in a prospective cohort study in Vancouver, Canada...

..We assessed the rate of methadone use in a cohort of opioid injection drug users in Vancouver and investigated whether methadone use was associated with Aboriginal ethnic background...

..To examine whether there were differential rates of hepatitis C virus (HCV) incidence in injecting drug-using youths who did and did not report involvement in survival sex work...

..A large-scale police "crackdown" to control illicit drug use in Vancouver's Downtown Eastside provided us with an opportunity to evaluate the effect...

..79, 95% CI: 1.23-2.62) remained independent predictors of HIV seroconversion. CONCLUSIONS: These data demonstrate the need for interventions to reduce the risk of HIV infection among IDUs who require help injecting...

..This analysis aimed to determine HIV prevalence among women engaged in survival sex work, and explore sexual and drug-related vulnerabilities associated with baseline infection...

..Opposition to needle exchange programs has been fueled by a Vancouver study showing an association between frequent program use and elevated rates of human immunodeficiency virus (HIV) infection among injection drug users...

..This risk factor remains poorly understood. The present study investigates this risk factor among Vancouver IDUs...

..Syringe buyers were more likely to need help injecting, have difficulty finding new syringes, have binged on drugs, and have visited the SEP at least once weekly. Syringe buying most frequently occurred when the SEP was closed...

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..We examined whether North America's first SIF was attracting IDUs who were at greatest risk of overdose and blood-borne disease infection...

..We sought to characterize the state of nursing SIE practice in Vancouver and prospectively examine SIE among SIF users...

..Members of the injection drug community, particularly those who are not taking HAART, experience elevated mortality in comparison with those without a history of drug use...

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..We evaluated factors associated with public drug injection among a cohort of injection drug users (SEOSI) originally recruited from within Vancouver's supervised injecting facility (SIF)...

..Ongoing evaluation will be required to assess its impact on overdose rates and HIV infection levels, as well as its ability to improve IDU contact with medical care and addiction treatment...

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..70, 95% CI: 1.10-2.81). These findings highlight the need for evidence-based prevention and harm reduction initiatives that directly targeting crack cocaine smokers, with particular attention given to female dual users of injection drugs...

..Closer scrutiny of enforcement efforts is warranted to ensure that resources are delivered to the most efficient and cost-effective public health programs...

..These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use...

..Also relevant to this topic are interventions to prevent transition into injection drug use, and SSFs may also be evaluated as a potential strategy to address this concern...

..To examine the effect of incarceration within 12 months of initiating highly active antiretroviral therapy (HAART) on non-adherence and HIV-1 RNA suppression...

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..22, 2003. Although similar facilities exist in a number of European cities and in Sydney, Australia, no standardized evaluations of their impact have been presented in the scientific literature...

..The findings also suggest that other forms of syringe-exchange programs should consider the benefits of offering fixed site nighttime service...

..The SIS provided a sterile environment for injection drug use without measured negative consequences and demonstrated the feasibility of a peer-driven low-threshold SIS...

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..To evaluate the factors associated with receiving cutaneous injection-related infection (CIRI) care among a representative cohort of supervised injecting facility (SIF) users...

..Injection cocaine users remain particularly vulnerable to HIV infection and treatment options for cocaine dependency remain woefully inadequate...

..This study investigated the structural-environmental and individual-level social factors associated with the numbers of commercial sex clients of female sex workers (FSWs) per month (CPM)...

..23; 95% CI, 0.10-0.51, P < .001). In conclusion, individuals with clearance of HCV infection may have a lower risk of acquiring HCV than individuals who have never been infected, despite ongoing exposure to HCV...

..This rationale involves limitations in conventionally applied drug-control efforts, and gaps in current public-health policies in controlling the spread of infectious diseases, and the incidence of overdose among IDUs...

..Vancouver, Canada recently opened a medically supervised injecting facility (SIF) where injection drug users (IDU) can inject pre-obtained illicit drugs. Critics suggest that the facility does not help IDU to reduce their drug use...

..Degree of adherence has also been shown to be associated with AIDS-related morbidity, mortality, and hospitalizations...

..Illicit drug users account for the majority of cases of HCV infection in the developed world, but few have received treatment...

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..Although this would not predict long-term treatment success, the PDI approach to HIV treatment support is a promising program for women who might otherwise be excluded from treatment altogether...

..Incarceration has been associated with a number of health-related harms among injection drug users (IDU). However, little is known about the prevalence and correlates of incarceration among community-based samples of IDU...

..Our findings indicate that a sub-population of IDU might benefit from overdose prevention interventions. Our findings refute the suggestion that the SIF may increase the likelihood of overdose...

..To determine whether "high-risk" clients occupied important sociometric positions in sexual networks of commercial sex workers and to estimate whether they were more likely to be HIV and STI infected...

..Our findings highlight the need for the monitoring of therapeutic guidelines to ensure equitable access, as treatment strategies are updated...

..Similarities between transient and full virologic responders also appear to be time limited and are often associated with greater cumulative use of antiretroviral therapy by transient virologic responders...

..Although rates of sexually transmitted infection (STI) tend to be higher in urban Canada, the province of British Columbia has recently seen above-average rates in the northern health regions...

..07, 95% CI: 0.87-1.33). Current injection drug users were less likely to achieve HIV-1 RNA suppression compared with non-drug users. Adherence as measured by pharmacy refill compliance was not a reliable measure in this subpopulation...

..The objective of this study was to investigate determinants of hospitalization for a CIRI or related infectious complication among a cohort of supervised injection facility (SIF) users...

..The objective in this study was to perform an economic evaluation of the incremental net benefit associated with an intervention to expand treatment with HAART in British Columbia, Canada...

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..Nevertheless, women and men are affected differently by sexual violence at different ages, and this has significant implications for health promotion programs, and specifically HIV prevention...

..Use of distribution beyond fixed sites will improve such outreach, thereby increasing program effectiveness and further preventing the transmission of blood-borne infections...

..The practice of SND appears to be an important mechanism for needle acquisition, especially for those at highest risk for HIV and hepatitis C transmission...

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..Although comprising up to 80% of the commercial sex industry in Canada, indoor female sex workers (FSW) are generally not represented in research because they are a hidden population and difficult to access...

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..These findings indicate that the safer injecting facility's benefits have not been offset by a rise in initiation into injection drug use...

..To examine the independent association of discordant virologic and immunologic responses to highly active antiretroviral therapy (HAART) with mortality...

..30, 0.11-0.82, p=0.02) after adjustment for relevant sociodemographic and drug-use characteristics. These findings could help inform discussions about the merits of such facilities...

..We sought to examine the prevalence and correlates of being unable to access addiction treatment in a representative sample of injection drug users randomly recruited from a supervised injection facility...

..Supervised injecting facilities have been proposed as a potential solution, but fears have been raised that they might encourage drug use...

..To determine if immunological response is associated with disease progression in patients with virological suppression after initiating HAART...

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..Non-fatal overdose is a major determinant of morbidity among injection drug users (IDU). We sought to evaluate factors associated with non-fatal overdose among IDU in Vancouver...

..05, 95% CI: 0.88-1.27). These findings suggest that the SIF is not having an adverse impact on efforts to seek employment...

..The findings highlight the crucial need to move beyond the individual to gender-focused safer environment interventions that mediate the physical and social risk environment of crystal methamphetamine use among FSWs...

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..This study emphasizes that the facility enables contact with the healthcare system and thereby helps to facilitate the management of injection-related infections...

..These results suggest that HIV infection is having a relatively large impact in Vancouver and that evidence-based prevention and harm reduction strategies should be expanded...

..We sought to estimate the number of deaths potentially averted by the implementation of a medically supervised safer injection facility (SIF) in Vancouver, Canada...

..Different risk factors for seroconversion for women as opposed to men suggest that sex-specific prevention initiatives are urgently required...

..This study was undertaken to explore injection drug users' experiences and opinions regarding North America's first SIF in Vancouver, Canada...

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..To examine the use of social and health services by illicit opioid users outside of treatment in five Canadian cities ('OPICAN' cohort)...

..Drug use patterns and serious bloodborne infections commonly have dermatologic manifestations among illicit injection-drug users (IDUs)...

..These findings indicate that different individuals display different patterns of opioids and cocaine co-use...

..Scale-up of evidence-based HIV treatment and prevention to injection drug users, however, will require increasing political will among both national policy-makers and international public health agencies...

..Although the impact of SSFs in North America can only be quantified by scientific evaluation, these data indicate a potential for public health and community benefits if SSFs were to become available...

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..As well, increased outreach to HIV-infected drug users recently released from prison to ensure continuity of care needs to be further developed...

..Although the impact of SIFs in North America can only be quantified by scientific evaluation, these data indicate a high potential for immediate community and public health benefits if SIFs were presently available...