Don Des Jarlais
Don Des Jarlais
Scroll
Professor of Epidemiology
-
Professional overview
-
Dr. Don Des Jarlais is a leader in the fields of AIDS and injecting drug use, and has published extensively on these topics including articles in The New England Journal of Medicine, JAMA, Science, and Nature.
He is active in international research, having collaborated on studies in many different countries. He serves as a consultant to various institutions, including the U.S. Centers for Disease Control and Prevention, the National Institute of Drug Abuse, the National Academy of Sciences, and the World Health Organization.
Dr. Des Jarlais’ research has received numerous awards, including a New York State Department of Health Commissioner’s award for promoting the health of persons who use drugs. He formerly served as avcommissioner for the National Commission on AIDS; as a core group member of the UNAIDS Reference Group on HIV and Injecting Drug Use; and as a member of the President’s Emergency Plan for AIDS Relief (PEPFAR) Scientific Advisory Board.
Dr. Des Jarlais is also an adjunct faculty of psychiatry and preventive medicine at Icahn School of Medicine at Mount Sinai, and guest investigator at Rockefeller University in New York.
-
Education
-
BA, Behavioral Science, Rice University, Houston, TXPhD, Social Psychology, University of Michigan, Ann Arbor, MI
-
Areas of research and study
-
EpidemiologyHIV/AIDSPsychology
-
Publications
Publications
The first and second decades of AIDS among injecting drug users
AbstractJARLAIS, D. C. (n.d.).Publication year
1992Journal title
British Journal of AddictionVolume
87Issue
3Page(s)
347-353AbstractThis paper examines findings and trends from the first decade of research on AIDS among injecting drug users as a basis for projecting into the next decade. One of the most disturbing aspects of AIDS and HIV infection among injecting drug users which emerged in the first decade is the globalization of the problem. Further geographic spread can be expected, particularly in developing countries. Rapid spread of HIV among drug injectors has occurred in many different cities, with a lack of AIDS awareness and mechanisms for efficient mixing of the at‐risk population appearing to be important contributing factors. Drug injectors have modified their behavior in response to a wide variety of AIDS prevention programs. No single type of prevention program should be viewed as a panacea, and a comprehensive system of programs will undoubtedly be needed. Changing sexual risk behavior has proven to be considerably more difficult than changing drug injection risk behavior, and is an area in need of much more research.The study of transitions in the route of drug use: the route from one route to another
AbstractSTRANG, J., JARLAIS, D. C., GRIFFITHS, P., & GOSSOP, M. (n.d.).Publication year
1992Journal title
British Journal of AddictionVolume
87Issue
3Page(s)
473-483AbstractRoute of administration of various drugs is an area of study to which specific attention must be paid in study of different HIV risks of drug use by various routes. If changes in route are seen in individuals or within populations, then study of these transitions in route may identify new approaches which could be developed in HIV prevention. The consideration in this paper is based around ten questions: (i) What is a transition? (ii) Do routes of administration vary by time and place? (Hi) Is choice of route influenced by availability of drug paraphernalia? (iv) How does the context influence initial choice of administration, and possible subsequent transitions? (v) Are lapse and relapse meaningful concepts? (vi) Transitions: how much of it is going on? (vii) How much does change of route (with the same drug) signify a change of drug effect, its significance, or its relationship with other risk behaviour? (viii) Is change of route of use of one drug always accompanied by the same change of route of other drugs? (ix) Injectors/non‐injectors and sharers/non‐sharers: do these behavioural characteristics exist as categories or are they distributed along a continuum? (x) Are transitions reversible? This paper is accompanied by two research reports which describe explorations into the extent and nature of transitions amongst heroin users.What is AIDS doing to the drug research agenda?
Strang, J., Stimson, G. V., & Jarlais, D. C. (n.d.).Publication year
1992Journal title
British Journal of AddictionVolume
87Issue
3Page(s)
343-346A randomized trial of an interim methadone maintenance clinic
AbstractYancovitz, S. R., Des Jarlais, D. C., Peyser, N. P., Drew, E., Friedmann, P., Trigg, H. L., & Robinson, J. W. (n.d.).Publication year
1991Journal title
American journal of public healthVolume
81Issue
9Page(s)
1185-1191AbstractBackground. Interim methadone maintenance has been proposed as a method of providing clinically effective services to heroin addicts waiting for treatment in standard comprehensive methadone maintenance programs. Methods. A clinic that provided initial medical evaluation, methadone medication, and AIDS education, but did not include formal drug abuse counseling or other social support services was established in New York City. A sample of 301 volunteer subjects recruited from the waiting list for treatment in the Beth Israel methadone program were randomly assigned to immediate entry into the interim clinic or a control group. Results. There were no differences in initial levels of illicit drug use across the experimental and control groups. One-month urinalysis follow-up data showed a significant reduction in heroin use in the experimental group (from 63% positive at intake to 29% positive) with no change in the control group (62% to 60% positive). No significant change was observed in cocaine urinalyses (approximately 70% positive for both groups at intake and follow-up). A higher percentage of the experimental group were in treatment at 16-month follow-up (72% vs 56%). Conclusions. Limited services interim methadone maintenance can reduce heroin use among persons awaiting entry into comprehensive treatment and increase the percentage entering treatment.Crack use and multiple aids risk behaviors: To the editor:
Des Jarlais, D. C., Abdul-Quader, A., Minkoff, H., Hoegsberg, B., Landesman, S., & Tross, S. (n.d.).Publication year
1991Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
4Issue
4Page(s)
446-447Criteria for Judging Methadone Maintenance Programs
Newman, R. G., & Jarlais, D. C. (n.d.). In JAMA: The Journal of the American Medical Association (1–).Publication year
1991Volume
265Issue
17Page(s)
2190-2191Drug abuse
Des Jarlais, D. C. (n.d.).Publication year
1991Journal title
Bulletin of the New York Academy of Medicine: Journal of Urban HealthVolume
67Issue
1Page(s)
43-48High compliance with a hepatitis B virus vaccination program among intravenous drug users [4]
Mezzelani, P., Venturini, L., Turrina, G., Lugoboni, F., & Des Jarlais, D. C. (n.d.). In Journal of Infectious Diseases (1–).Publication year
1991Volume
163Issue
4Page(s)
923History, ethics, and politics in AIDS prevention research
Des Jarlais, D. C., & Stepherson, B. (n.d.).Publication year
1991Journal title
American journal of public healthVolume
81Issue
11Page(s)
1393-1394HIV among drug injectors: The epidemic and the response
Friedman, S. R., & Des Jarlais, D. C. (n.d.).Publication year
1991Journal title
AIDS CareVolume
3Issue
3Page(s)
239-250National aids incidence trends and the extent of zidovudine therapy in selected demographic and transmission groups
AbstractRosenberg, P. S., Gail, M. H., Schräger, L. K., Vermund, S. H., Creagh-Kirk, T., Andrews, E. B., Winkelstein, W., Marmor, M., Des Jarlais, D. C., Biggar, R. J., & Goedert, J. J. (n.d.).Publication year
1991Journal title
Journal of Acquired Immune Deficiency SyndromesVolume
4Issue
4Page(s)
392-401AbstractAfter mid-1987 fewer than the expected number of cases of AIDS were reported in the United States in some demographic and transmission groups but not in others. Gay men (regardless of intravenous drug use), adults with hemophilia, and transfusion recipients exhibited fewer cases than expected based on previously reliable models. These favorable trends could not be explained by assuming earlier cessation of human immunodeficiency virus (HIV) infection. Favorable AIDS incidence trends were not found in heterosexual intravenous drug users or in persons infected through heterosexual contact. White gay men from New York City, Los Angeles, and San Francisco experienced markedly favorable trends, whereas little change was observed for nonwhite gay men from nonurban areas. AIDS incidence trends were quantitatively consistent with the fraction of AIDS-free persons with severe immunodeficiency who received zidovudine in three cohorts. Gay men in San Francisco used zidovudine more frequently than did adults with hemophilia, while little was used by intravenous drug users in New York City. Data describing the initial national distribution of zidovudine (March 31-September 18, 1987) indicated relatively high use by patients with severe immunodeficiency in those groups, such as urban white gay men, that subsequently experienced fewer cases of AIDS than expected. Available data suggest that zidovudine, perhaps in combination with other therapies, has been one factor contributing to favorable AIDS incidence trends in some groups. Broader application of therapy might further retard the incidence of AIDS, especially in intravenous drug users, persons infected through heterosexual contact, minorities, women, and persons diagnosed outside major metropolitan areas.Potential cofactors in the outcomes of HIV infection in intravenous drug users
Des Jarlais, D. C. (n.d.).Publication year
1991Journal title
NIDA Research Monograph SeriesIssue
109Page(s)
115-123Response [4]
Menken, J., Miller, H. G., Turner, C. F., & Des Jarlais, D. C. (n.d.). In Science (1–).Publication year
1991Volume
251Issue
4992Page(s)
360-362Risk factors and HIV seropositivity among injecting drug users in Bangkok
AbstractChoopanya, K., Vanichseni, S., Des Jarlais, D. C., Plangsringarm, K., Sonchai, W., Carballo, M., Friedmann, P., & Friedman, S. R. (n.d.).Publication year
1991Journal title
AIDSVolume
5Issue
12Page(s)
1509-1513AbstractBangkok experienced an extremely rapid spread of HIV infection among drug injectors in 1987 and 1988. This study examines risk factors for HIV infection and deliberate risk-reduction efforts by drug injectors. Two subsamples of injecting drug users were recruited in November 1989, a group in drug-use treatment (n = 342) and a group new to the treatment system (n = 259). Subjects were interviewed about AIDS risk behavior, and a blood sample was collected for HIV testing. Seroprevalence was 39 and 27% in the in-treatment sample and the new-to-treatment sample, respectively. The in-treatment sample seroprevalence rate is similar to rates observed 6 and 12 months earlier. Three factors were independently associated with HIV infection: subsample, having been in prison, and sharing injection equipment with two or more individuals in the previous 6 months. Deliberate risk reduction was reported by 92% of individuals, with 59% reporting that they had stopped sharing injection equipment. It appears that large-scale risk reduction has greatly slowed HIV transmission among drug injectors in Bangkok.The epidemiology of cocaine use in New York State.
Frank, B., Des Jarlais, D. C., Marel, R., Schmeidler, J., & Maranda, M. (n.d.).Publication year
1991Journal title
The Mount Sinai journal of medicine, New YorkVolume
58Issue
5Page(s)
406-411; discussion 437-442The Incidence of HBV Infection and Syringe Exchange Programs
Hagan, H., Reid, T., Des Jarlais, D. C., Purchase, D., Friedman, S. R., & Bell, T. A. (n.d.). In JAMA: The Journal of the American Medical Association (1–).Publication year
1991Volume
266Issue
12Page(s)
1646-1647The next problem: Maintenance of AIDS risk reduction among intravenous drug users
AbstractDes Jarlais, D. C., Abdul-Quader, A., & Tross, S. (n.d.).Publication year
1991Journal title
Substance Use and MisuseVolume
26Issue
12Page(s)
1279-1292AbstractIntravenous drag users have surprised many policymakers and researchers by exhibiting large-scale AIDS risk reduction. Relapse from desired behavior change has been a traditional problem in treatment for drug misuse/dependence. Failure to maintain AIDS risk reduction was examined in a study of 399 intravenous drug users from New York City. Over 80% of the subjects reported initiating risk reduction, but 36% of those also reported that they did not fully maintain the risk reduction. Factors associated with initiating risk reduction were not necessarily associated with maintenance, indicating that different types of change processes may be occurring. At the policy level, one needs to think of long-term efforts to reduce the spread of HIV among drag users; "quick fix" programs are not likely to be effective.The tacoma syringe exchange
AbstractHagan, H., Des Jarlais, D. C., Purchase, D., Reid, T., & Friedman, S. R. (n.d.).Publication year
1991Journal title
Journal of Addictive DiseasesVolume
10Issue
4Page(s)
81-88AbstractFor over a year, the Tacoma Syringe Exchange has been operating in spite of existing drug paraphernalia laws. One hundred fifty-four subjects have been interviewed regarding drug injection practices for the month prior to first use of the exchange and for the most recent month since using the exchange. Statistically significant reductions in mean frequency of obtaining used syringes, and in mean rate of passing on used syringes, have been reported. Mean number of times bleach was used to disinfect contaminated syringes has risen. The exchange continues to attract mainly men, median age 35, with a long history of injection. No differences have been observed in mean number of injections per month. In order to increase utilization, new sites are planned, but expansion has been hampered by a series of legal problems. Since the exchange draws many difficult to reach individuals, it is an important location for STD screening and drug treatment recruitment. Documentation of participation patterns and barriers to exchange use, and effects upon HIV serological status are recommended.The transition from opium smoking to heroin injection in the United States
Des Jarlais, D. C., Courtwright, D. T., & Joseph, H. (n.d.).Publication year
1991Journal title
AIDS and Public Policy JournalVolume
6Issue
2Page(s)
88-90AIDS and the social relations of intravenous drug users
Friedman, S. R., Des Jarlais, D. C., & Sterk, C. E. (n.d.).Publication year
1990Journal title
Milbank QuarterlyVolume
68Page(s)
85-110Contrasting prevalence of delta hepatitis markers in parenteral drug abusers with and without AIDS
AbstractKreek, M. J., Des Jarlais, D. C., Trepo, C. L., Novick, D. M., Abdul-Quader, A., & Raghunath, J. (n.d.).Publication year
1990Journal title
Journal of Infectious DiseasesVolume
162Issue
2Page(s)
538-541AbstractParenteral drug abusers are the second largest group at risk for developing AIDS (25% of US cases) and a major risk group for infection with both hepatitis B virus (HBV) and the HBV-dependent RNA hepatitis delta virus (HDV). This study was conducted to determine the prevalence in 1984–1985 and relationships of HDV and HBV infections in 372 unselected parenteral drug abusers without AIDS or symptoms related to human immunodeficiency virus type 1 (HIV1) infection (but 49% of whom were positive for HIV-1 antibodies) and in 53 drug abusers hospitalized with AIDS. The prevalence of HDV markers in the combined study groups was 20%;81% of study subjects with hepatitis B surface antigenemia (HBsAg) had one marker for HDV infection. Significant differences were found between patients with and without AIDS with respect to the prevalence of hepatitis delta antigen (5.7% vs. 0.8%, P<.05) and antibody (0 vs. 21.4%, P <.01) and HBsAg (15.1% vs. 5.1%, P <.05). The significantly higher prevalence of hepatitis delta antigen and HBsAg in subjects with AIDS suggests that persistence or reactivation of these viruses is significantly greater among parenteral drug abusers with AIDS than among those without AIDS. These findings, along with the absence of hepatitis delta antibodies in the drug abusers with AIDS, are probably related to the profound general immunosuppression that occurs in AIDS.Drug use and AIDS in New York City. Health policy for the '90s--discussion.
Brambill, K., Des Jarlais, D., Eaton, C., Elovich, R., Ford, C., Levin, A., Rosen, Z., Siegel, L., & Sorge, R. (n.d.).Publication year
1990Journal title
Health PAC bulletinVolume
20Issue
3Page(s)
23-31Effects of outreach intervention on risk reduction among intravenous drug users
Neaigus, A., Sufian, M., Friedman, S. R., Goldsmith, D. S., Stepherson, B., Mota, P., Pascal, J., & Des Jarlais, D. C. (n.d.).Publication year
1990Journal title
AIDS Education and PreventionVolume
2Issue
4Page(s)
253-271Impact of AIDS on Puerto Rican Intravenous Drug Users
AbstractSufian, M., Friedman, S. R., Neaigus, A., Stepherson, B., Rivera-Beckman, J., & Jarlais, D. D. (n.d.).Publication year
1990Journal title
Hispanic Journal of Behavioral SciencesVolume
12Issue
2Page(s)
122-134AbstractThis article examines HIV risk for Hispanics, particularly Puerto Ricans who are intravenous (IV) drug users. First, national statistics on AIDS cases as well as major epidemiological studies are analyzed to establish risk, in general, for Hispanics. There are epidemiological differences when the authors compare ethnic minority groups to whites in the incidence of the disease, the relative importance of transmission routes, and the length of survival once the disease is diagnosed. The authors report on risk behaviors and risk reduction based on the preliminary findings from a project which targets IV drug users and their sexual partners for interventions aimed at AIDS risk reduction in New York City. The subjects, Puerto Rican, Black and white men and women, are recruited off the street and have used drugs in the past six months. The findings suggest that Puerto Rican IV drug users are at substantial risk for AIDS both through their drug use and their sexual behaviors. Since Puerto Rican PVdrug users are particularly likely to inject drugs frequently and in high-risk ways, an urgent case can be made for culturally sensitive intervention programs that are aimed at reducing the risk of HIV transmission among them and their sexual partners.Knowledge about and behaviors affecting the spread of AIDS: A Street survey of intravenous drug users and their associates in new york city
AbstractKleinman, P. H., Goldsmith, D. S., Friedman, S. R., Hopkins, W., & Des Jarlais, D. C. (n.d.).Publication year
1990Journal title
Substance Use and MisuseVolume
25Issue
4Page(s)
345-361AbstractAn informal survey of knowledge about and behaviors relevant to the spread of AIDS was conducted on the street in New York City during October 1986. The sample (n = 204) includes IV drug users (60% and others (40% The informal nature of the interview suggests that respondents gave "salient" answers rather than the complete answers that would be expected in a formal interview situation. A smaller proportion of respondents reported salient knowledge about drug-related transmission of AIDS than had been found in other populations, using formal interview methods. A close association was found between any accurate knowledge about spread of AIDS and likelihood of practicing one or more risk reduction behaviors. New users (persons who had been using drugs for only 1 or 2 years) were significantly less likely than others to have salient knowledge about AIDS transmission and also less likely to practice risk reduction measures