Mark A. Quinones

Psychological distress, drug and alcohol use as correlates of condom use in HIV-serodiscordant heterosexual couples.

ObjectiveTo investigate the relationship between psychological distress, alcohol, drug and condom use in HIV-serodiscordant heterosexual couples. MethodsStructured interviews were conducted to collect demographic information, detailed data on psychological distress, drug and alcohol use and sexual behavior. ResultsAnalyses were based on 106 pairs of sexually active discordant couples. Significant differences among heterosexual condom users and non-users varied according to gender and HIV serostatus. Affect domains of interpersonal sensitivity and hostility were significant, as were the variables of regular drug or alcohol use and combining sex with drugs or alcohol. Employment was strongly associated with condom use in HIV-negative women whose regular sexual partners were HIV-positive men. ConclusionThe risk of vaginal sex without condoms in HIV-serodiscordant heterosexual couples may be reduced by specific psychological counseling and attention to drug and alcohol use as risk factors. Further research on the effect of employment of HIV-negative women is required.

Behavioral and Demographic Risk Factors for Transmission of Human Immunodeficiency Virus Type 1 in Heterosexual Couples: Report from the Heterosexual HIV Transmission Study

We compared 224 heterosexual couples who were discordant for human immunodeficiency virus (HIV) type 1 infection (one partner HIV infected) with 78 HIV-concordant couples (both partners HIV infected) to identify demographic and behavioral risk factors for HIV transmission. Among the 229 couples whose male partner was first infected, HIV-concordant couples had engaged in anal sex more frequently before and after knowing that the male was infected than had HIV-discordant couples. Pap smears of grade 2 or higher (inflammation) were more prevalent among the second-infected female partners in HIV-concordant couples than among uninfected women in discordant couples (58% vs. 23%; P < .001). Anal sex and unprotected vaginal sex after knowledge of a male partners infection were significant correlates of concordance in a multivariate logistic model, as were ethnicity, marital status, and antiviral therapy. Ethnicity strongly predicted concordance, even after controlling for sexual risk behaviors and stage of disease.

An evaluation of detoxification as an initial step in the treatment of heroin addiction.

Of 802 voluntary patients admitted to the detoxification unit of a comprehensive treatment system, 69% completed detoxification but only 9.6% of thest patients sought long-term treatment. The demographic profile of detoxification patients differed somewhat from that of patients in long-term treatment. The authors suggest that new approaches, including legal pressure, are needed to induce detoxification patients to accept prolonged therapy.

Assessment of Treatment Outcomes in a Drug Abuse Rehabilitation Network: Newark, New Jersey

A comparative evaluation outcome model designed to aid in referral of clients to appropriate drug abuse treatment centers was developed for a multimodality drug abuse rehabilitation network in Newark, New Jersey. The model analyzes retention rates and treatment dropout outcome to assess impact, and graduate outcome to assess the effectiveness of the various drug abuse treatment centers. Study of 3,943 addicts found a number of demographic and psychosocial variables that correlated with retention in specific programs; retention of some subgroups in specific treatments was substantially longer than overall retention rates. One year retention rates of 65% in methadone maintenance; 22, 16, and 8.5% in the three therapeutic communities; and less than 5% in two outpatient drug-free programs suggested a study of treatment dropouts outcome. Significant reduction in criminality and drug use were found for all treatment dropouts including a “no-treatment” comparison group; however, significantly larger improvements...

Depressed cholinesterase activities among farm workers in New Jersey

The widespread use of organophosphate pesticides creates the possibility of excessive exposure of migrant farm workers to these compounds. Blood cholinesterase determinations were used to compare the organophosphate pesticide exposure of 57 migrant farm workers with that of 35 controls. Frequently reported symptoms of the farm workers which might be related to pesticide exposure were also studied, including headaches, dizziness, loss of weight, nausea, and a general feeling of weakness or loss of energy. Significantly depressed cholinesterase activities were found in the farm workers, with 10.5% of the farm workers having values below the lower limit of normal. There was no significant relationship between frequently reported symptoms of the farm workers and depressed cholinesterase levels.

A coupon program--drug treatment and AIDS education.

The New Jersey State Department of Health developed a program to test the following hypotheses: (1) numerous heroin addicts will respond to free detoxification treatment offered through a coupon program, (2) a substantial number of these patients will continue in treatment beyond the free detoxification attempt, and (3) participation in an AIDS education session can increase the knowledge level of intravenous drug abusers regarding this disease. Eighty-four percent of the 970 distributed coupons were redeemed for detoxification treatment. Twenty-eight percent of the program participants continued in treatment after the free detoxification period, and the AIDS information session significantly increased the knowledge of participating addicts.

A vitamin profile of heroin addiction.

Circulating thiamine, riboflavin, nicotinates, folates, vitamin B12, B6, A, and carotenes of 149 heroin addicts aged 17-60 years were compared to 204 healthy subjects not using drugs or vitamins. Only 24 per cent of the addicts had no evidence of hypovitaminemia; 45 per cent and 37 per cent had vitamin B6 and folate deficit respectively, whereas deficits of thiamine, vitamin B12, riboflavin, and nicotinate were recorded for 13-19 per cent of the addict population; impaired liver function in addicts did not influence these results.

Pesticide exposure among migrant workers in southern New Jersey.

ConclusionsMigrant workers represent a substantial percentage of farm workers in South New Jersey. Although the general health level for the migrants examined appears to be good, this finding must be interpreted with caution because of the relatively young age of the population studied. There is evidence that some of the health problems which were found (frequent headaches, blurred vision, dizziness, a general feeling of weakness, and depressed plasma cholinesterase activity) could be related to excessive exposure to pesticides. Further testing is needed to establish more precisely the extent of this problem in New Jersey.Clearly, this “captive” group stands at risk from the chronic effects of pesticide exposure because of their general lack of awareness of dangers and symptoms, and the lack of availability of treatment. In particular, there may be little opportunity for the improvement of the health of the individual migrant worker because the mobility inherent in his occupation prevents him from receiving continuing medical care from the same sources.To date there has been little effort towards remedying the specific health problems of our migrant population. In effect, they have been given the lowest priority in terms of health and social services. Obviously, programs to improve this situation are needed in New Jersey.

The Training of Teachers for Drug Abuse Education Programs: Preliminary Considerations

Recognizing that a variety of responses to the drug abuse problem has resulted, the authors turn their attention to the development of the wide range of educational programs for various population groups. A detailed description of drug programs implemented in the State of New Jersey is presented. The general outline includes the course content, format of workshops, treatment programs sociological considerations and the epidemiology of student drug use. Careful research data relative to the program are presented, analyzed and interpreted. Such factors as knowledge of personal risk associated with drug abuse, and of drug laws, changes in attitude and emphasis on drug topics by the participants in the workshop setting are discussed. Additionally, techniques for evaluating the effectiveness of the program are considered. The authors conclude that an intensive institute using the formats of lectures, discussion groups, and various assignments can result in important changes in the participants level of knowledge, self-confidence and attitudes in changing his role in the schools drug abuse programs.

Drug Abuse During the Civil War (1861–1865)

The Civil War (1861-1865) has long been blamed as the catalyst for the spread of drug addiction in America. This paper attempts to examine this hypothesis through an extensive review of pertinent literature, and to clarify misconceptions concerning addiction problems associated with the war.