Crack cocaine use has physical, social, and biological effects that may explain why it remained an independent risk factor for HCV in our study. Physically, when crack cocaine is smoked, individuals can suffer mucosal burns and ulcerations, which could enhance the likelihood of HCV viral transmission. Crack has neurochemical effects that make it uniquely addictive and, with chronic use, causes strong cocaine craving and a desire for frequent use. In addition to a desire to use crack frequently, crack’s neurochemical effects can result in increased sexual risk behaviors. Our multivariate analyses, however, showed that the analyzed sex-risk behaviors did not contribute independently to HCV infection. Thus, the social and contextual factors that underlie the enhanced use of crack cocaine among African Americans are complex, and the biological effects of this drug may also underlie other high-risk behaviors, including sex-risk behaviors.
This is the first study to assess racial differences in HBV and HCV infection rates and self-reported behavioral risks among veterans with SMI, a very high-risk subpopulation. Overall, the prevalence of both these infections was high. Over half of these infections were newly diagnosed; thus, most veterans were unaware of the infection. African Americans had higher rates of both HBV and HCV than did Caucasians. This difference was statistically significant for HBV, and a similar trend was observed for HCV There was no significant racial difference observed in this sample for lifetime IDU. However, several drug- and sex-risk behaviors were reported significantly more often in African Americans than in Caucasians, specifically, smoking crack, sniffing or snorting drugs over their lifetime, unprotected sex for drugs in their lifetime, and multiple sex partners in the past six months. These observations are consistent with findings on high-risk sexual behavior reported for the general population. The rates of hepatitis infections in veterans with SMI are much higher than those reported in the general population for both races and across similar age groupings.
The final sample was 376 persons with SMI: 155 Caucasian and 221 African-American military veterans, of whom over 90% were men (see Table 1). Compared with Caucasians, African Americans were younger, a smaller proportion were currently married, and a greater proportion were institutionalized or homeless. There were no racial differ ences in educational status or having at least one child. A greater proportion of African Americans had a diagnosis of schizophrenia spectrum disorders and drug use disorders, fewer were diagnosed with PTSD or bipolar disorder, and a smaller proportion had experienced combat exposure. Over 40% of the study cohort had an alcohol use disorder, with no racial difference observed.
This is a cross-sectional study of risk behaviors and the prevalence of HBV and HCV infection among veterans with SMI. We recruited 399 consecutive patients admitted to the Durham VA inpatient psychiatric unit between March 1998 and June 2000. The study setting was a VA psychiatric ward with 26 inpatient beds and an average length of stay of eight days.
Vulnerable subpopulations with high rates or risks of hepatitis-B virus (HBV) and hepatitis-C virus (HCV) infection may warrant focal points for public health efforts to reduce or eliminate the transmission of these diseases. Although four million persons in the United States—or 1.8% of the population—are thought to be infected with HCV, the estimated U.S. rates for non-Hispanic African Americans are as high as Э.2%. For HBV, the estimated rates for the United States are approximately 5%, whereas the rates for non-Hispanic African Americans are as high as 12%. Recently, persons with severe mental illness (SMI), including veter ans, were specifically defined as another high-risk subpopulation for both HBV and HCV infection, with rates of 20% and 23%, respectively. SMI criteria include the presence of a major mental illness, chronicity, and pervasive impairment of function. SMI diagnoses include schizophrenia, bipolar disorder, depression, and, for veterans, PTSD because of its severe and disabling effect in this population.
What is Hepatitis A – Hepatitis B – Hepatitis C:
Hepatitis A – An inflammatory viral disease of the liver with a short incubation period. Hepatitis A may be transmitted by eating contaminated food, by fecal-oral contact, and/or through household contact. Hepatitis A may be mild to severe; symptoms include fever, nausea, and jaundice.
Hepatitis B – Formerly called serum hepatitis, it is caused by the hepatitis B virus. About 12% of cases progress to chronic hepatitis. It is spread through shared needles, through sexual contact with infected individuals, through exposure to infected body fluids, and from mother to child. Common symptoms include abdominal pain, fatigue, fever, jaundice, and elevated liver enzymes.
Hepatitis C – is a life-threatening, disease of the liver, which is transmitted by exposure to blood. A particularly dangerous form of viral hepatitis, it is caused by an RNA virus. Hepatitis C can lead to serious, permanent liver damage, and in many cases, death. More than 82 percent of those who are infected will progress to chronic liver disease. It is suspected that there are, at present, more than 4.5 million people in the United States that are infected with hepatitis C, and more than 200 million around the world. You deserve the finest quality treatment there is, which is why this advantageous canadian health&care mall inc is the kind of thing you will appreciate, being offered best quality medications costing a fair amount of money.