Shelly Iskandar

High risk behavior for HIV transmission among former injecting drug users: a survey from Indonesia.

BackgroundInjecting drug use is an increasingly important cause of HIV transmission in most countries worldwide, especially in eastern Europe, South America, and east and southeast Asia. Among people actively injecting drugs, provision of clean needles and opioid substitution reduce HIV-transmission. However, former injecting drug users (fIDUs) are often overlooked as a high risk group for HIV transmission. We compared HIV risk behavior among current and former injecting drug users (IDUs) in Indonesia, which has a rapidly growing HIV-epidemic largely driven by injecting drug use.MethodsCurrent and former IDUs were recruited by respondent driven sampling in an urban setting in Java, and interviewed regarding drug use and HIV risk behavior using the European Addiction Severity Index and the Blood Borne Virus Transmission Questionnaire. Drug use and HIV transmission risk behavior were compared between current IDUs and former IDUs, using the Mann-Whitney and Pearson Chi-square test.ResultsNinety-two out of 210 participants (44%) were self reported former IDUs. Risk behavior related to sex, tattooing or piercing was common among current as well as former IDUs, 13% of former IDUs were still exposed to contaminated injecting equipment. HIV-infection was high among former (66%) and current (60%) IDUs.ConclusionFormer IDUs may contribute significantly to the HIV-epidemic in Indonesia, and HIV-prevention should therefore also target this group, addressing sexual and other risk behavior.

Injecting drug use is associated with a more rapid CD4 cell decline among treatment naive HIV-positive patients in Indonesia

It remains unclear whether the natural course of human immunodeficiency virus (HIV) differs in subjects infected through injecting drug use (IDU) and no data have been published from low‐ or middle‐income countries. We addressed this question in an urban cohort in Indonesia, which is experiencing a rapidly growing HIV epidemic strongly driven by IDU.

Successful testing and treating of HIV/AIDS in Indonesia depends on the addiction treatment modality

Background In many settings, people who inject drugs (PWID) have limited access to human immunodeficiency virus (HIV) care which is provided in several hospitals and primary health centers in big cities. Substance abuse treatment (SAT) can be used as the entry-point to HIV programs. The aim of this study is to describe the characteristics of the PWID who had accessed SAT and determine which SAT modality associates significantly with HIV programs. Methods PWID were recruited by respondent-driven sampling in an urban setting in Java, Indonesia and interviewed with the Addiction Severity Index (ASI), Blood-Borne Virus Transmission Risk Assessment Questionnaires, and Knowledge Questionnaire on HIV/AIDS. The information regarding the use of substance abuse treatment and HIV program were based on questions in ASI. Results Seventy-seven percent of 210 PWID had accessed SAT at least once. PWID who had accessed a SAT modality reported more severe drug problems. The most widely used SAT were opioid substitution (57%) and traditional/faith-based treatment (56%). Accessing substitution treatment (adjusted odds ratio [OR] = 5.8; 95% confidence interval [CI]: 2.5–13.9) or residential drug-free treatment (adjusted OR = 3.7; 95% CI: 1.4–9.7) was significantly associated with HIV testing, whereas accessing substitution treatment (adjusted OR = 3.8; 95% CI: 1.9–7.5) or other medical services (adjusted OR = 3.1; 95% CI: 1.1–8.7) was significantly associated with HIV treatment. There was no significant association between accessing traditional/faith-based treatment and HIV testing and treatment. Conclusion Efforts should be made to link HIV services with traditional/faith-based treatment to increase the coverage of HIV programs.

Detection of Drug Effects on Brain Activity using EEG-P300 with Similar Stimuli

Drug addiction poses a serious problem to our species. The worry that our significant family might be involved in drug use and are concerned to know how to detect drug use. Examinations of thirty taped EEG recordings were performed. The subjects consist of three group: addictive, methadone treatment (rehabilitation), and control (normal) which 10 subjects for each group. Statistical analysis was performed for the relative frequency of wave bands. The higher average amplitude is obtained from the addiction subjects. In the comparison with the signals source, channels P3 provide slightly higher average amplitude than other channels for all of subjects.

Addiction training for health professionals as an antidote to the addiction health burden in Indonesia.

Keywords: Addiction; addiction curriculum; addiction medicine training; education; Indonesia; substance use

Experience in care, burden, and hope of the family members of HIV patients with and without a history of injecting drug use in Indonesia: An exploratory case

Addiction and human immunodeficiency virus (HIV) patients suffer from many medical problems. Family can be a source of stress or relief for the patients. Therefore, we explored and compared the perception of family members of HIV patients with and without a history of injecting drug use (IDU) in Indonesia in the context of: (i) care provided for HIV patients, (ii) harmful impact of the disease for their relatives, and (iii) the hopes of family members concerning the future of their sick relatives. An exploratory case study was conducted with 79 family members: 36 family members of HIV patients with a history of IDU and 43 family members of HIV patients without a history of IDU. They were recruited through consecutive sampling in a HIV clinic in an urban setting in West Java. The Family Contact Information Support scale, the Family Member Impact scale, and the Hopefulness-hopelessness questionnaire were used to interview the family members. Most family members were spouses/partners (30%) or parents (28%). ...