Danielle C Ompad
Danielle C. Ompad
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Professor of Epidemiology
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Professional overview
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Dr. Danielle Ompad is an epidemiologist whose work is focused in the areas of urban health, HIV, illicit drug use, and adult access to vaccines. With respect to illicit drug use, her work has spanned the entire natural history of addiction – from initiation to cessation, with particular attention paid to risk for infectious diseases such as HIV, hepatitis B and C, and STIs. She has primarily worked with people who use heroin, crack, cocaine, and/or club drugs.
In New York City, she has been examining heroin cessation among current, former, and relapsed heroin users. Working with Alliance for Public Health and the Ukrainian Institute on Public Health Policy, she analyzes harm reduction service utilization among people who inject drugs, in order to optimize service delivery in Ukraine. Since 2013, she has served as faculty for the Fogarty-funded New York State International Training and Research Program with the goal of building research capacity in Ukraine.
Dr. Ompad’s National Institute of Allergy and Infectious Diseases-funded study aims to determine if herpes simplex 1 and 2 infections explain racial disparities in HIV incidence among a cohort of young gay, bisexual, and other men who have sex with men (YMSM). In addition, Dr. Ompad and colleagues are assessing HPV infection prevalence, persistence, and clearance among this same cohort.
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Education
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BS, Biology, Bowie State University, Bowie, MDMHS, Epidemiology, Johns Hopkins University, Baltimore, MDPhD, Epidemiology, Johns Hopkins University, Baltimore, MD
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Honors and awards
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Excellence in Public Health Teaching Award, New York University (2014)Excellence in Public Health Teaching Award, New York University (2013)National Hispanic Science Network on Drug Abuse Scientific Development Travel Fellowship (2010)Delta Omega Honorary Society, Alpha Chapter (2002)
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Areas of research and study
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EpidemiologyHIV/AIDSInfectious DiseasesSocial Determinants of HealthSTIsSubstance AbuseVaccines
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Publications
Publications
Determinants of influenza vaccination in hard-to-reach urban populations
AbstractBryant, W. K., Ompad, D. C., Sisco, S., Blaney, S., Glidden, K., Phillips, E., Vlahov, D., & Galea, S. (n.d.).Publication year
2006Journal title
Preventive MedicineVolume
43Issue
1Page(s)
60-70AbstractObjective.: Influenza vaccination rates among disadvantaged minority and hard-to-reach populations are lower than in other groups. We assessed the barriers to influenza vaccination in disadvantaged urban areas. Methods.: We conducted a cross-sectional study, using venue-based sampling, collecting data on residents of eight neighborhoods throughout East Harlem and the Bronx, New York City. Results.: Of 760 total respondents, 461 (61.6%) had received influenza vaccination at some point in their life. In multivariable models, having access to routine medical care, receipt of health or social services, having tested positive for HIV, and current interest in receiving influenza vaccination were significantly associated with having received influenza vaccination in the previous year. Of participants surveyed, 79.6% were interested in receiving an influenza vaccination at the time of survey. Among participants who had never previously received influenza vaccination in the past, 73.4% were interested in being vaccinated; factors significantly associated with an interest in being vaccinated were minority race, lower annual income, history of being homeless, being uninsured/underinsured, and not having access to routine medical care. Conclusions.: Participants who are unconnected to health or social services or government health insurance are less likely to have been vaccinated in the past although these persons are willing to receive vaccine if it were available.Distribution of influenza vaccine to high-risk groups
AbstractOmpad, D. C., Galea, S., & Vlahov, D. (n.d.).Publication year
2006Journal title
Epidemiologic ReviewsVolume
28Issue
1Page(s)
54-70AbstractVaccine distribution programs have historically targeted individuals at high risk of complications due to influenza. Despite recommendations from the Advisory Committee on Immunization Practices, vaccination coverage among high-risk populations has been generally low. This review systematically summarizes the recent literature evaluating programs in different settings, from within medical settings to venue-based and community-based approaches, in an effort to identify successful program components. The published literature was identified by using the MEDLINE database from 1990 to 2006 covering studies that reported on interventions or programs aimed at vaccinating high-risk populations. The authors reviewed 56 studies. In the United States, the Healthy People 2010 goals included 90% vaccination coverage for adults aged ≥65 years and 60% for high-risk adults aged 18-64 years. Only a handful of the studies reviewed managed to meet those goals. Interventions that increased vaccination coverage to Healthy People 2010 goals included advertising, provider and patient mailings, registry-based telephone calls, patient and staff education, standing orders coupled with standardized forms, targeting of syringe exchange customers, and visiting nurses. Few studies evaluated the impact of vaccination programs by race/ethnicity and socioeconomic status. Few studies targeted individuals outside of the health-care and social services sectors. Given the growing disparities in health and health-care access, understanding the way in which interventions can remedy disparities is crucial.Gender differences in sexual behaviors, sexual partnerships, and HIV among drug users in New York City
AbstractAbsalon, J., Fuller, C. M., Ompad, D. C., Blaney, S., Koblin, B., Galea, S., & Vlahov, D. (n.d.).Publication year
2006Journal title
AIDS and BehaviorVolume
10Issue
6Page(s)
707-715AbstractWe compared sexual behaviors/partnerships and determined sexual risk correlates associated with HIV by gender among street-recruited drug users using chi-square tests and logistic regression. Men reported higher risk sexual behaviors, yet fewer high-risk sexual partners than women. After adjustment, HIV seropositive men were more likely than seronegatives to be older, MSM, use condoms, and have an HIV-infected partner. HIV seropositive women were more likely to be older, have an HIV-infected partner, and not use non-injected heroin. IDU was not associated with HIV. Prospective studies are needed to determine how gender-specific sexual behaviors/partnerships among drug users affect HIV acquisition.Heroin and cocaine dependence and the risk of accidental non-fatal drug overdose
AbstractGalea, S., Nandi, A., Coffin, P. O., Tracy, M., Piper, T. M., Ompad, D., & Vlahov, D. (n.d.).Publication year
2006Journal title
Journal of Addictive DiseasesVolume
25Issue
3Page(s)
79-87AbstractThe relation between illicit drug dependence and the likelihood of drug overdose is unclear. We recruited 1,066 habitual drug users for this analysis through street-based outreach in New York City. In this sample, 99.3% of respondents used heroin in the past year and 87.1% of respondents used cocaine; 819 (77.5%) heroin users and 735 (79.2%) cocaine users were severely dependent on either drug respectively. In multivariable models, among heroin users, persons who were severely heroin dependent were less likely (OR = 0.6; 95% CI = 0.4-0.9) to have overdosed on any drug in the past year; among cocaine users, those who were severely cocaine dependent were more likely (OR = 1.6; 95% CI = 1.0-2.6) to have overdosed in the past year. The relation between illicit drug dependence and risk of overdose may vary for different patterns of drug dependence. These observations suggest that overdose prevention interventions, perhaps even those specifically targeting opiate overdose, may be more efficiently directed at individuals exhibiting cocaine dependence.Period and birth-cohort effects on age of first phencyclidine (PCP) use among drug users in New York City, 1960 to 2000
AbstractBryant, W. K., Ompad, D. C., Ahern, J., Wu, Y., Vlahov, D., & Galea, S. (n.d.).Publication year
2006Journal title
Annals of EpidemiologyVolume
16Issue
4Page(s)
266-272AbstractPURPOSE: The aim of the study is to determine period and birth-cohort effects in the early initiation of phencyclidine (PCP) use in drug users in New York City (NYC). METHODS: We analyzed data collected from two surveys of street-recruited drug users in NYC. We used survival analysis and proportional hazards modeling to assess period and birth-cohort effects on risk for early initiation of PCP use. RESULTS: Of 787 participants, 292 (37.1%) had used PCP by the age of 23 years. Before 1987, there was a greater risk for initiation of PCP use through the age of 23 years (hazard ratio [HR] = 34.77; 95% confidence interval [CI], 21.45-56.36). Proportional hazards modeling showed that those born in the 1971 to 1975 birth cohort compared with those born in 1976 to 1980 had a lower risk for initiation of PCP use through age 23 years (HR = 0.58; 95% CI, 0.37-0.91). Other significant predictors of PCP use by age 23 included white race and having been in a juvenile detention center. CONCLUSIONS: There are period and birth-cohort differences in the likelihood of early initiation of PCP use. Changes in drug culture and social norms may influence the likelihood of initiation of PCP use. This may have implications for interventions aimed at slowing the nationwide increase in use of PCP.Predictors of early initiation of vaginal and oral sex among urban young adults in Baltimore, Maryland
AbstractOmpad, D. C., Strathdee, S. A., Celentano, D. D., Latkin, C., Poduska, J. M., Kellam, S. G., & Ialongo, N. S. (n.d.).Publication year
2006Journal title
Archives of Sexual BehaviorVolume
35Issue
1Page(s)
53-65AbstractOver the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18-24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age thanWhites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger andWhites.We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.Sexual and drug risk behaviors among women who have sex with women
AbstractBell, A. V., Ompad, D., & Sherman, S. G. (n.d.).Publication year
2006Journal title
American journal of public healthVolume
96Issue
6Page(s)
1066-1072AbstractObjectives. We examined risk behaviors of female drug users, comparing those who reported recently having had sex with women (recent WSW), those who reported previously having had sex with women (former WSW), and those who reported never having had sex with women (never WSW). Methods. We used data from the Risk Evaluation and Assessment of Community Health III Study. Adjusted odds for predictors of WSW status were determined via multinomial logistic regression analyses. Results. Of the participants, 75% were never WSW, 12% were former WSW, and 13% were recent WSW. In comparison with never WSW status, significant predictors of recent WSW status were living away from one's parents as a child (adjusted odds ratio [OR] = 3.05; 95% confidence interval [CI] = 1.07,8.67) and recently having been paid for sex by men (adjusted OR = 4.02; 95% CI = 1.67, 9.68). Also, recently having been paid for sex by men was a significant predictor of former WSW status as opposed to never WSW status (adjusted OR = 3.97; 95% CI = 1.65, 9.59). Conclusions. The recency with which they had sex with women is one of the facets influencing the risk profile of WSW. The diverse characteristics of the WSW population need to be incorporated into future studies and risk interventions targeting this group.A comparison of HIV seropositive and seronegative young adult heroin- and cocaine-using men who have sex with men in New York City, 2000-2003
AbstractFuller, C. M., Absalon, J., Ompad, D. C., Nash, D., Koblin, B., Blaney, S., Galea, S., & Vlahov, D. (n.d.).Publication year
2005Journal title
Journal of Urban HealthVolume
82Page(s)
i51-i61AbstractThe purpose of this analysis was to determine the prevalence and correlates of HIV infection among a street-recruited sample of heroin- and cocaine-using men who have sex with men (MSM). Injection (injecting ≤3 years) and non-injection drug users (heroin, crack, and/or cocaine use <10 years) between 18 and 40 years of age were simultaneously street-recruited into two cohort studies in New York City, 2000-2003, by using identical recruitment techniques. Baseline data collected among young adult men who either identified as gay/bisexual or reported ever having sex with a man were used for this analysis. Nonparametric statistics guided interpretation. Of 95 heroin/ cocaine-using MSM, 25.3% tested HIV seropositive with 75% reporting a previous HIV diagnosis. The majority was black (46%) or Hispanic (44%), and the median age was 28 years (range 18-40). HIV-seropositive MSM were more likely than seronegatives to be older and to have an HIV-seropositive partner but less likely to report current homelessness, illegal income, heterosexual identity, multiple sex partners, female partners, and sex for money/drug partners than seronegatives. These data indicate high HIV prevalence among street-recruited, drug-using MSM compared with other injection drug use (IDU) subgroups and drug-using MSM; however, lower risk behaviors were found among HIV seropositives compared with seronegatives. Large-scale studies among illicit drug-using MSM from more marginalized neighborhoods are warranted.Association of sex, hygiene and drug equipment sharing with hepatitis C virus infection among non-injecting drug users in New York City
AbstractHowe, C. J., Fuller, C. M., Ompad, D. C., Galea, S., Koblin, B., Thomas, D., & Vlahov, D. (n.d.).Publication year
2005Journal title
Drug and alcohol dependenceVolume
79Issue
3Page(s)
389-395AbstractBackground: Hepatitis C virus (HCV) rates are higher in non-injecting drug users (NIDUs) than general population estimates. Whether this elevated HCV rate is due to drug use or other putative risk behaviors remains unclear. Methods: Recent non-injection drug users of heroin, crack and/or cocaine were street-recruited from 2000 to 2003 and underwent an interview and venipuncture for HCV antibody assays. Multiple logistic regression analyses were used to assess correlates for HCV infection. Results: Of 740 enrollees, 3.9% were HCV positive. The median age (intraquartile range) was 30 (35-24) years, 70% were male and 90% were Black or Hispanic. After adjustment, HCV seropositives were significantly more likely than seronegatives to be older than 30 [adjusted odds ratio (AOR) = 5.71], tattooed by a friend/relative/acquaintance [AOR = 3.61] and know someone with HCV [AOR = 4.29], but were less likely to have shared nail or hair clippers, razors or a toothbrush [AOR = 0.32]. Conclusions: Non-commercial tattooing may be a mode of HCV transmission among NIDUs and education on the potential risk in using non-sterile tattooing equipment should be targeted toward this population. While no evidence was found for HCV transmission through NIDU equipment sharing or sexual risk behavior, further research is still warranted.Childhood sexual abuse and age at initiation of injection drug use
AbstractOmpad, D. C., Ikeda, R. M., Shah, N., Fuller, C. M., Bailey, S., Morse, E., Kerndt, P., Maslow, C., Wu, Y., Vlahov, D., Garfein, R., & Strathdee, S. A. (n.d.).Publication year
2005Journal title
American journal of public healthVolume
95Issue
4Page(s)
703-709AbstractObjectives. We examined the relation between childhood sexual abuse and injection drug use initiation among young adult injection drug users. Methods. We used mixed effect linear models to compare age at first injection among 2143 young injection drug users by first sexual abuse age categories. Results. The participants were predominantly male (63.3%) and White (52.8%). Mean age and age at first injection were 23.7 and 19.6 years, respectively; 307 participants (14.3%) reported childhood sexual abuse. After adjustment for gender, race/ethnicity, noninjection drug use before first injection drug use, and recruitment site, childhood sexual abuse was independently associated with younger age at first injection. Conclusions. Childhood sexual abuse was associated with earlier initiation of injection drug use. These data emphasize the need to integrate substance abuse prevention with postvictimization services for children and adolescents.Circumstances of witnessed drug overdose in New York City: Implications for intervention
AbstractTracy, M., Piper, T. M., Ompad, D., Bucciarelli, A., Coffin, P. O., Vlahov, D., & Galea, S. (n.d.).Publication year
2005Journal title
Drug and alcohol dependenceVolume
79Issue
2Page(s)
181-190AbstractDrug users frequently witness the nonfatal and fatal drug overdoses of their peers, but often fail to intervene effectively to reduce morbidity and mortality. We assessed the circumstances of witnessed heroin-related overdoses in New York City (NYC) among a predominantly minority population of drug users. Among 1184 heroin, crack, and cocaine users interviewed between November 2001 and February 2004, 672 (56.8%) had witnessed at least one nonfatal or fatal heroin-related overdose. Of those, 444 (67.7%) reported that they or someone else present called for medical help for the overdose victim at the last witnessed overdose. In multivariable models, the respondent never having had an overdose her/himself and the witnessed overdose occurring in a public place were associated with the likelihood of calling for medical help. Fear of police response was the most commonly cited reason for not calling or delaying before calling for help (52.2%). Attempts to revive the overdose victim through physical stimulation (e.g., applying ice, causing pain) were reported by 59.7% of respondents, while first aid measures were attempted in only 11.9% of events. Efforts to equip drug users to manage overdoses effectively, including training in first aid and the provision of naloxone, and the reduction of police involvement at overdose events may have a substantial impact on overdose-related morbidity and mortality.Correlates of initiation of injection drug use among young drug users in baltimore, Maryland: The need for early intervention
AbstractSherman, S. G., Fuller, C. M., Shah, N., Ompad, D. V., Vlahov, D., & Strathdee, S. A. (n.d.).Publication year
2005Journal title
Journal of Psychoactive DrugsVolume
37Issue
4Page(s)
437-443AbstractThis article examines individual and social factors associated with initiation of illicit drug injection, with a focus on racial differences. Data were derived from a cross-sectional survey of young injection and noninjection drug users in Baltimore, Maryland. Participants were aged 15 to 30 and had initiated use of heroin, cocaine, and/or crack within the prior five years. Bivariate and multivariate logistic regression models were used to identify correlates of injection initiation. Of 579 drug users, 73% were injectors, 56% were male, and 41% were African American. In a multivariate model controlling for age, correlates of injection initiation were: being an African American male [Adjusted Odds Ratio (AOR): 0.08; 95% Confidence Interval (CI): 0.04, 0. 17] or female (AOR = 0.12; 95%CI: 0.06, 027) compared to being a White male; younger age of first use of alcohol, marijuana, or inhalants (AOR=0.73; 95%CI: 0.65, 0.82); shorter time between first use of alcohol, marijuana, or inhalants and first use of heroin, crack, or cocaine (per year decrease, AOR=0.63, 95%CI: 0.40, 0.87); parental drug use (AOR=0.54, 95%CI: 0.32, 0.92); seeing someone inject prior to injection, AOR=1.96, 95%CI: 1.0 1, 3.50); and crack smoking (AOR=1.77, 95%CI: 1.07, 2.99). Early drug use panems and drug expos we factors are associated with initiation injection. Interventions are needed that target noninjection drug users to prevent transition to injection drug use.Drug use and the urban environment
Galea, S., Vlahov, D., Ompad, D., & Fuller, C. (n.d.). In Handbook of urban health (1–).Publication year
2005Page(s)
127-154Ecstasy use among hispanic and black substance users in New York City
AbstractOmpad, D. C., Galea, S., Fuller, C. M., Edwards, V., & Vlahov, D. (n.d.).Publication year
2005Journal title
Substance Use and MisuseVolume
40Issue
9Page(s)
1399-1407AbstractSurveillance data suggests that use of ecstasy in the U.S. is predominantly among white adolescent and young adults. To investigate ecstasy use among substance users in New York City we added questions to ongoing efforts to recruit heroin and cocaine users. Of 715 participants recruited, 58.3% were injection dug users (IDUs). The median age was 32 (range 17-64), 76.4% were male, 49.0% were currently homeless, 62.4% were Hispanic, 27.3% were black, and 34.5% were born outside the United States. Overall, 23.4% used ecstasy in their lifetime and 11.9% had used in the last-6 months. In multivariate logistic regression, correlates of lifetime ecstasy use included younger age, being born in the U.S., and current homelessness. We observed a significant interaction between injection drug use and race where, compared to black non-IDUs, Hispanic non-IDUs, and white IDUs were significantly more likely to have a history of lifetime ecstasy use while black IDUs were significantly less likely. These findings are limited to persons who use other drugs, but suggest that further investigation of ecstasy use in minority populations is warranted.Ecstasy use and its association with sexual behaviors among drug users in New York City
AbstractNovoa, R. A., Ompad, D. C., Wu, Y., Vlahov, D., & Galea, S. (n.d.).Publication year
2005Journal title
Journal of Community HealthVolume
30Issue
5Page(s)
331-343AbstractIn the past two decades, recreational use of ecstasy has become a growing concern in the United States, although most studies assessing ecstasy use have focused on white, middle-class adolescents who use ecstasy during raves and in clubs. We assessed the prevalence of recent ecstasy use among predominantly minority heroin, cocaine, and crack users in New York City and the association between ecstasy and sexual risk above and beyond that of the other drugs. Between 2002 and 2004, injection and non-injection heroin, crack and cocaine users (N = 534) completed a risk behavior questionnaire that included items on ecstasy use. Logistic regression was used to investigate the relation between current ecstasy use and sexual behaviors. Of 534 illicit drug users, 69.7% were aged 25 years or older, 65.2% were Hispanic, 27.9% Black and 77.4% male; 36.7% were injectors. 17.2% of respondents reported recent (last six months) ecstasy use. In a multivariable logistic regression model, current ecstasy use was associated both with initiating sex before age 14 (adjusted odds ratio (AOR) = 1.51) and having two or more partners in the past two months (AOR = 1.86) after adjusting for age at study entry, current cocaine and marijuana use and being an injection drug user. This study suggests that ecstasy use may be more prevalent among urban drug users. Ecstasy use in urban settings, beyond clubs and raves, should continue to be monitored.Effects of race, neighborhood, and social network on age at initiation of injection drug use
AbstractFuller, C. M., Borrell, L. N., Latkin, C. A., Galea, S., Ompad, D. C., Strathdee, S. A., & Vlahov, D. (n.d.).Publication year
2005Journal title
American journal of public healthVolume
95Issue
4Page(s)
689-695AbstractObjectives. We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use. Methods. Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses. Results. Adolescent-initiating IDUs were less likely than adult-initiating IDUs to report high-risk sex and injection behaviors and more likely to report high-risk networks. African American IDUs from neighborhoods with large percentages of minority residents and low adult educational levels were more likely to initiate injection during adolescence than White IDUs from neighborhoods with low percentages of minority residents and high adult education levels. Conclusions. Racial segregation and neighborhood-level educational attainment must be considered when drawing inferences about age at initiation of injection drug use and related high-risk behaviors.Prevalence and correlates of crack-cocaine injection among young injection drug users in the United States, 1997-1999
AbstractSantibanez, S. S., Garfein, R. S., Swartzendruber, A., Kerndt, P. R., Morse, E., Ompad, D., Strathdee, S., Williams, I. T., Friedman, S. R., & Ouellet, L. J. (n.d.).Publication year
2005Journal title
Drug and alcohol dependenceVolume
77Issue
3Page(s)
227-233AbstractObjectives: We estimated prevalence and identified correlates of crack-cocaine injection among young injection drug users in the United States. Methods: We analyzed data from the second Collaborative Injection Drug Users Study (CIDUS II), a 1997-1999 cohort study of 18-30-year-old, street-recruited injection drug users from six US cities. Results: Crack-cocaine injection was reported by 329 (15%) of 2198 participants. Prevalence varied considerably by site (range, 1.5-28.0%). No participants injected only crack-cocaine. At four sites where crack-cocaine injection prevalence was greater than 10%, recent (past 6 months) crack-cocaine injection was correlated with recent daily injection and sharing of syringes, equipment, and drug solution. Lifetime crack-cocaine injection was correlated with using shooting galleries, initiating others into drug injection, and having serologic evidence of hepatitis B virus and hepatitis C virus infection. Conclusions: Crack-cocaine injection may be a marker for high-risk behaviors that can be used to direct efforts to prevent HIV and other blood-borne viral infections.Prospective evaluation of community-acquired acute-phase hepatitis C virus infection
AbstractCox, A. L., Netski, D. M., Mosbruger, T., Sherman, S. G., Strathdee, S., Ompad, D., Vlahov, D., Chien, D., Shyamala, V., Ray, S. C., & Thomas, D. L. (n.d.).Publication year
2005Journal title
Clinical Infectious DiseasesVolume
40Issue
7Page(s)
951-958AbstractBackground. More than two-thirds of hepatitis C virus (HCV) infections in Western countries are caused by injection drug use, but prospective clinical data regarding the most common mode of HCV acquisition are rare, in part because acute-phase HCV infection is usually asymptomatic. Methods. To characterize acute-phase HCV infection, 179 HCV antibody-negative injection drug users were prospectively evaluated; 62 (34%) of these patients had seroconverted. Twenty of the participants who seroconverted had long-term follow-up with consistent monthly sampling before and after seroconversion, allowing detailed study. Results. The first indication of HCV infection was the presence of HCV RNA in serum, which preceded elevation of alanine transaminase levels and total bilirubin levels to ≥2 times baseline in 45% and 77% of patients, respectively. No subjects had jaundice. The median time from initial viremia to seroconversion was 36 days (range, 32-46 days). In one instance, viremia was detected 434 days before seroconversion. However, in no other case was HCV RNA detected >63 days before seroconversion. In subjects with viral persistence, a stable level of HCV RNA in the blood was noted in some subjects within 60 days after the initial detection of viremia, but in others, it was not apparent until >1 year later. In subjects with long-term viral clearance, HCV became persistently undetectable as early as 94 and as late as 620 days after initial viremia. Conclusions. These data underscore the importance of nucleic acid screening of blood donations to prevent HCV transmission and of long-term follow-up to ascertain whether there is viral persistence, at least among injection drug users.Suicidal ideation among African-American non-injection drug users
AbstractHavens, J. R., Ompad, D. C., Latkin, C. A., Fuller, C. M., Arria, A. M., Vlahov, D., & Strathdee, S. A. (n.d.).Publication year
2005Journal title
Ethnicity and DiseaseVolume
15Issue
1Page(s)
110-115AbstractThe objective of the study was to explore correlates of suicidal ideation among African Americans in a community-based cohort in Baltimore, Md. Participants had initiated use of heroin, crack, or cocaine by means other than injection in the prior 10 years. An interview-administered questionnaire collected information regarding drug use history, depressive symptoms, drug dependence, and suicidal thoughts and attempts within the past six months. Multiple logistic regression was used to identify factors independently associated with suicidal ideation. Of 148 persons, median age was 27 years, and 60.8% were female. Suicidal ideation was reported by 21.6% of participants. Those reporting suicidal ideation were significantly more likely to be dependent on two or more drugs (adjusted odds ratio =2.93, 95% confidence interval=1.25, 6.88). Our findings underscore the need to integrate treatment for psychiatric comorbidity and drug dependence and target these services toward young, African-American drug users.Vaccine disparities can be overcome
Ompad, D., & Vlahov, D. (n.d.). In Baltimore Sun (1–).Publication year
2005Acceptance and completion of hepatitis B vaccination among drug users in New York City.
AbstractOmpad, D. C., Galea, S., Wu, Y., Fuller, C. M., Latka, M., Koblin, B., & Vlahov, D. (n.d.).Publication year
2004Journal title
Communicable disease and public health / PHLSVolume
7Issue
4Page(s)
294-300AbstractHepatitis B (HBV) vaccination rates remain low among drug users. We examined correlates of vaccine acceptance and completion in two ongoing prospective studies of young injecting and non-injecting drug users in New York City. Street recruited drug users were enrolled at one of two neighbourhood locations (Harlem and the Bronx) between 2000 and 2004 and completed risk behaviour questionnaires and HBV testing. Free HBV vaccination was offered. Among 1117 participants, 26.1% (275) had a previous HBV infection, 57.9% (610) were susceptible to HBV, and 16.0% (169) had serological evidence of previous vaccination. Of the 610 participants susceptible to HBV, 466 (76.4%) returned for their results and were offered vaccination; 53.9% (251) received at least one dose of the vaccine (acceptors). Correlates of vaccine acceptance included older age, public assistance as main income source, and being recruited in the Bronx. Daily crack users were significantly less likely to initiate the vaccine series. Among 240 vaccine acceptors, 98 (40.8%) completed all three doses. Daily injectors, Hispanics, and those recruited in Harlem were less likely to complete the vaccination series. HBV vaccination acceptance among drug users seems likely in programmes that are convenient and offer remuneration; however, extended efforts are needed to improve series completion.Club drug use among minority substance users in New York City
AbstractOmpad, D. C., Galea, S., Fuller, C. M., Phelan, D., & Vlahov, D. (n.d.).Publication year
2004Journal title
Journal of Psychoactive DrugsVolume
36Issue
3Page(s)
397-399AbstractSurveillance data suggests that club drug use (Ecstasy, GHB, ketamine, LSD, methamphetamine, PCP and flunitrazepam) has been a predominantly White adolescent and young adult phenomenon in the United States. The authors investigated the use of club drugs among 323 streetrecruited minority substance users in northern New York City (66.3% were Hispanic, 23.8% were Black, and 9.9% were White/other race; median age = 32 years old). While Whites were more likely than others to have used club drugs, club drug use among Hispanics and Blacks was not uncommon; 45.3% Hispanics and 56.4% of Blacks reported a lifetime history of club drug use. PCP was the most commonly reported club drug used among all racial/ethnic groups. Further investigation of club drug use in minority populations is warranted.Explaining the relationship between race/ethnicity and pharmacy purchased syringes among injection drug users in New York City
AbstractFuller, C. M., Galea, S., Blaney, S., Ompad, D. C., Deren, S., Des Jarlais, D., & Vlahor, D. (n.d.).Publication year
2004Journal title
Ethnicity and DiseaseVolume
14Issue
4Page(s)
589-596AbstractObjective: Pharmacy syringe sales without a prescription became legal in New York State on January 1, 2001 through the Expanded Syringe Access Demonstration Program (ESAP). At the same time, Pharmacy use among Black and Hispanic injection drug users was found to be significantly lower when compared to Whites. The purpose of this study was to assess the factors that could explain the relationship between race/ethnicity and pharmacy use. Design: Data were combined from 2 on-going injection drug user (IDU) studies in 2 New York City neighborhoods. Social and behavioral factors independently associated with ever purchasing a nonprescription syringe in the past 6 months and examined using cross-sectional logistic regression. Results: Of 337 IDUs, the majority were male (79%). Hispanic (73%) and had a mean age of 35 years. In bivariate analysis, IDUs who reported pharmacy use were less likely to be Black or Hispanic, older, and to have reported recent syringe exchange program (SEP) attendance compared to non-pharmacy users. Additionally, pharmacy users were more likely to have knowledge of ESAP, and report discrimination by police in the past year compared to non-users. After adjustment for recent SEP attendance (adjusted odds ratio [AOR]=0.27; 95% confidence interval [CI]=0.14-0.55), ESAP knowledge (AOR= 13.11; 95% CI=6.54-26.31), discrimination by police (AOR=3.56; 95% CI=1.73-7.35), and discrimination due to race (AOR=0.25, 95% CI=0.11-0.58), race/ethnicity was not a significant predictor of pharmacy use. Conclusions: Race/ethnicity may not be an important determinant of ESAP when more salient social circumstances, such as past discrimination, are considered. Educational efforts should be enhanced to reach those who continue to perceive barriers to ESAP.Hepatitis C Incidence - A Comparison between Injection and Noninjection Drug Users in New York City
AbstractFuller, C. M., Ompad, D. C., Galea, S., Wu, Y., Koblin, B., & Vlahov, D. (n.d.).Publication year
2004Journal title
Journal of Urban HealthVolume
81Issue
1Page(s)
20-24AbstractHepatitis C virus (HCV) burdens injection drug users (IDUs) with prevalence estimated from 60-100% compared to around 5% among noninjection drug users (non-IDUs). We present preliminary data comparing the risk for HCV among IDUs and non-IDUs to inform new avenues of HCV prevention and intervention planning. Two cohorts, new IDUs (injecting ≤3 years) and non-IDUs (smoke/sniff heroine, crack or cocaine ≤10 years), ages 15-40, were street-recruited in New York City. Participants underwent risk surveys and HCV serology at baseline and 6-month follow-up visits. Person-time analysis was used to estimate annual HCV incidence. Of 683 non-IDUs, 653 were HCV seronegative, 422 returned for at least 1 follow-up visit, and 1 became HCV seropositive. Non-IDUs contributed 246.3 person-years (PY) yielding an annual incident rate of 0.4/100 PY (95% Confidence Interval [CI]=0.0-1.2). Of 260 IDUs, 114 were HCV seronegative, 62 returned for at least 1 follow-up visit, and 13 became HCV seropositive. IDUs contributed 36.3 PY yielding an annual incidence rate of 35.9/100 PY (95%CI=19.1-61.2). Among IDUs, HCV seroconverters tended to be younger (median age 25 vs. 28, respectively), and inject more frequently (61.5% vs. 34.7%, respectively) than nonseroconverters. These interim data suggest that IDUs may have engaged in high-risk practices prior to being identified for prevention services. Preventing or at least delaying transition into injection could increase opportunity to intervene. Identifying risk factors for transition into injection could inform early prevention to reduce onset of injection and risk of HCV.Updating the Infection Risk Reduction Hierarchy: Preventing Transition into Injection
AbstractVlahov, D., Fuller, C. M., Ompad, D. C., Galea, S., & Des Jarlais, D. C. (n.d.).Publication year
2004Journal title
Journal of Urban HealthVolume
81Issue
1Page(s)
14-19AbstractCurrent approaches to prevention of blood-borne infections in injection drug users include referral to drug abuse treatment, access to sterile syringes, bleach disinfection of injection equipment, and education about not sharing equipment. However, rates of some blood-borne infections (e.g., hepatitis C virus) remain elevated among injection drug users, especially early after initiation into injection drug use. With lower infection rates in noninjectors and transition into injection drug use occurring most commonly among these noninjectors, prevention of transition into injection drug use as an additional step to reduce risk for acquisition and transmission of blood-borne infections merits closer attention.