We propose to conduct and evaluate tuberculosis screening and directly observed preventive therapy efforts on populations of active drug users recruited a) at the time of admission to an inpatient detox facility and b) from participants of a needle exchange/HIV-risk reduction program. I) We will determine the prevalence of latent and active TB and anergy. We will analyze the sociodemographic, clinical and drug use variables associated with TB status and anergy. We will also examine the relative utility of various screening maneuvers for the detection of active and latent TB among active drug users in a high TB and HIV prevalence area. II) We will link the screening efforts to the recruitment to and provision of directly observed preventive therapy (DOPT) for tuberculin positive and anergic active drug users. DOPT will generally consist of twice weekly isoniazid (15 mg/kg) provided a) within the context of an HIV-primary care clinic (for those recruited through inpatient detox) and b) at the time of needle exchange (for those recruited from and continuing to participate in the needle exchange/harm reduction program). We will evaluate the feasibility and acceptance of providing DOPT in these settings. III) We will evaluate DOPT with respect to a) factors associated with and predictive of failure to engage in treatment, retention in treatment and treatment completion, b) the utility of a health contract in promoting treatment adherence, c) and the long term efficacy among those enrolled in DOPT by cross-match with NYCDOH and NYSDOH TB registries.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA009005-04
Application #
2458415
Study Section
Special Emphasis Panel (SRCD (18))
Project Start
1994-09-30
Project End
1999-07-31
Budget Start
1997-08-01
Budget End
1999-07-31
Support Year
4
Fiscal Year
1997
Total Cost
Indirect Cost
Name
Beth Israel Medical Center (New York)
Department
Type
DUNS #
075255364
City
New York
State
NY
Country
United States
Zip Code
10003
Perlman, David C; Leung, Chi Chiu; Yew, Wing Wai (2009) Diagnosing tuberculosis in patients with HIV: do we know enough? Am J Respir Crit Care Med 180:800-1
Carey, Jeanne; Perlman, David C; Friedmann, Patricia et al. (2005) Knowledge of hepatitis among active drug injectors at a syringe exchange program. J Subst Abuse Treat 29:47-53
Perlman, David C; Friedmann, Patricia; Horn, Leslie et al. (2003) Impact of monetary incentives on adherence to referral for screening chest x-rays after syringe exchange-based tuberculin skin testing. J Urban Health 80:428-37
Sorensen, James L; Masson, Carmen L; Perlman, David C (2002) HIV/hepatitis prevention in drug abuse treatment programs: guidance from research. Sci Pract Perspect 1:4-11
Perlman, D C; Gourevitch, M N; Trinh, C et al. (2001) Cost-effectiveness of tuberculosis screening and observed preventive therapy for active drug injectors at a syringe-exchange program. J Urban Health 78:550-67
Salomon, N; Perlman, D C; Friedmann, P et al. (2000) Prevalence and risk factors for positive tuberculin skin tests among active drug users at a syringe exchange program. Int J Tuberc Lung Dis 4:47-54
Perlman, D C; El-Helou, P; Salomon, N (1999) Tuberculosis in patients with human immunodeficiency virus infection. Semin Respir Infect 14:344-52
Perlman, D C; Henman, A R; Kochems, L et al. (1999) Doing a shotgun: a drug use practice and its relationship to sexual behaviors and infection risk. Soc Sci Med 48:1441-8
Salomon, N; Perlman, D C; Friedmann, P et al. (1999) Knowledge of tuberculosis among drug users. Relationship to return rates for tuberculosis screening at a syringe exchange. J Subst Abuse Treat 16:229-35
Salomon, N; Perlman, D C (1999) Cytomegalovirus pneumonia. Semin Respir Infect 14:353-8

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