Infectious Diseases News Brief - February 22, 2013

HIV-Infected Russians Show Increased Sex And Drug Risk Behaviors Following Recent Marijuana Use

Researchers from Boston Medical Center (BMC) and Boston University's School of Medicine (BUSM) and School of Public Health (BUSPH) have found that in Russian HIV-infected risky drinkers, marijuana use is associated with other increased risky behaviors involving drug use and sex. These findings, published online in the journal Drug and Alcohol Dependence, may aid clinicians and public health experts in detecting individuals at a higher risk of transmitting HIV.
Marijuana, otherwise known as cannabis, is the most frequently used illicit drug worldwide. Previous research has shown that in certain non-HIV infected populations, marijuana use is associated with the use of other drugs such as cocaine and heroin, as well as an increase in unprotected sex and a larger number of sexual partners. In Russia, the HIV epidemic has been largely propelled by injection drug use (IDU), although HIV transmission through unprotected sex is increasing. Still, not much is known about marijuana use and its impact on those behaviors in individuals already infected with HIV. To investigate this, Jeffrey Samet, MD, MPH, from the Clinical Addiction Research and Education (CARE) Unit at BUSM and colleagues examined data collected in St. Petersburg, Russia, in a cohort of 700 HIV-infected individuals with risky drinking practices. Risky drinkers were defined as men who drink more than four drinks a day or 14 drinks a week and women who consume more than three drinks a day or seven drinks a week. In this population, the frequency of marijuana use within the previous year was determined and those who used were compared to the non-users with regard to risky drug and sex practices, including needle sharing, IDU, the number of sex partners and frequency of condom use.

Working with colleagues from Russia, the researchers found that baseline marijuana use was relatively common, with 20 percent having used within the previous month and 46 percent within the previous year. Forty-two percent of the respondents admitted to IDU and 23 percent to sharing needles within the previous 30 days, and 27 percent reported multiple sexual partners in the previous three months. The data also showed a significant association among individuals who reported using marijuana within the previous 30 days and an increase in sharing needles, IDU and increase in the number of injections. In addition, while marijuana use was not associated with decreased condom use, it was associated with an increased number of sexual partners. The study results indicate that asking HIV-infected patients about marijuana use may identify those who are at a higher risk for transmitting HIV.

Source: Medical News Today, February 17, 2013

Measles Elimination Efforts and 2008–2011 Outbreak, France

Although few measles cases were reported in France during 2006 and 2007, suggesting the country might have been close to eliminating the disease, a dramatic outbreak of >20,000 cases occurred during 2008–2011. Adolescents and young adults accounted for more than half of cases; median patient age increased from 12 to 16 years during the outbreak. The highest incidence rate was observed in children <1 year of age, reaching 135 cases/100,000 infants during the last epidemic wave. Almost 5,000 patients were hospitalized, including 1,023 for severe pneumonia and 27 for encephalitis/myelitis; 10 patients died. More than 80% of the cases during this period occurred in unvaccinated persons, reflecting heterogeneous vaccination coverage, where pockets of susceptible persons still remain. Although vaccine coverage among children improved, convincing susceptible young adults to get vaccinated remains a critical issue if the target to eliminate the disease by 2015 is to be met.

Source: Emerging Infectious Diseases Journal, March 2013, Volume 19, Number 3