Risk Behavior Harm Reduction

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This lesson focuses on primary prevention of HCV, including harm reduction education related to drug use, sexual behavior, tattooing, hormone/silicone injection practices, and perinatal transmission.


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  1. Harm reduction: An approach to reducing risky health behaviours in adolescents. Paediatrics & Child Health. 2008;13(1):53-56.
  2. What is harm reduction? Harm Reduction International Website. Accessed May 19, 2017.
  3. Centers for Disease Control and Prevention. HIV Transmission. Available at: https://www.cdc.gov/hiv/basics/transmission.html. Updated December 21, 2016. Accessed June 15, 2017.
  4. Heimer R, Abdala N. Viability of HIV-1 in syringes: implications for interventions among injection drug users. AIDS Read. 2000 Jul;10(7):410-7.
  5. Abdala N, Reyes R, Carney JM, Heimer R. Survival of HIV-1 in syringes: effects of temperature during storage. Subst Use Misuse. 2000 Aug;35(10):1369-83.
  6. Doerrbecker J, Friesland M, Ciesek S, et al. Inactivation and survival of hepatitis C virus on inanimate surfaces. J Infect Dis. 2011 Dec 15;204(12):1830-8.
  7. Paintsil E, Binka M, Patel A, Lindenbach B, Heimer R. Hepatitis C virus maintains infectivity for weeks after drying on inanimate surfaces at room temperature: implications for risks of transmission. J Infect Dis. 2014 Apr 15;209(8):1205-11.
  8. Paintsil E, He H, Peters C, Lindenbach B, Heimer R. Survival of hepatitis C virus in syringes: implication for transmission among injection drug users. J Infect Dis. 2010 Oct 1;202(7):984-90
  9. Binka M, Paintsil E, Patel A, Lindenbach B, Heimer R. Survival of hepatitis c virus in syringes is dependent on the design of the syringe-needle and dead space volume. PLoS One. 2015 Nov 4;10(11):e0139737.
  10. Doerrbecker J, Behrendt P, Mateu-Gelabert P, et al. Transmission of hepatitis C virus among people who inject drugs: viral stability and association with drug preparation equipment. J Infect Dis. 2013 Jan 15;207(2):281-7.
  11. Palmateer N, Hutchinson S, McAllister G, et al. Risk of transmission associated with sharing drug injecting paraphernalia: analysis of recent hepatitis C virus (HCV) infection using cross-sectional survey data. J Viral Hepat. 2014 Jan;21(1):25-32.
  12. Centers for Disease Control and Prevention. HIV Risk Reduction Tool: Injecting Drugs. Available at: https://wwwn.cdc.gov/hivrisk/transmit/needles/injecting_drugs.html. Accessed June 15, 2017.
  13. Centers for Disease Control and Prevention. Syringe Services Programs. Available at: https://www.cdc.gov/hiv/risk/ssps.html. Updated May 17, 2016. Accessed April 11, 2017.
  14. Oramasionwu C, Johnson T, Zule W, Carda-Auten J, Golin C. Using pharmacies in a structural intervention to distribute low dead space syringes to reduce HIV and HCV transmission in people who inject drugs. Am J Public Health. 2015 Jun;105(6):1066-71.
  15. Tortu S, McMahon J, Pouget E, Hamid R. Sharing of noninjection drug-use implements as a risk factor for hepatitis C. Subst Use Misuse. 2004 Jan;39(2):211-24.
  16. Des Jarlais DC, Arasteh K, McKnight C, Ringer M, Friedman SR. Syringe exchange, injecting and intranasal drug use. Addiction. 2010 Jan;105(1):155-8.
  17. Tohme RA, Holmberg SD. Transmission of hepatitis C virus infection through tattooing and piercing: a critical review. Clin Infect Dis. 2012 Apr;54(8):1167-78.
  18. Centers for Disease Control and Prevention. HIV Risk Reduction Tool: Sexual Behaviors. Available at: https://wwwn.cdc.gov/hivrisk/transmit/activities/. June 15, 2017.
  19. van de Laar T, Pybus O, Bruisten S, et al. Evidence of a large, international network of HCV transmission in HIV-positive men who have sex with men. Gastroenterology. 2009 May;136(5):1609-17.
  20. Hu J, Gu X, Tao X, et al. Prevalence and trends of HIV, syphilis, and HCV in migrant and resident men who have sex with men in Shandong, China: results from a serial cross-sectional study. Plos One. 2017 Jan 19;12(1):e0170443.
  21. Nadol P, O'Connor S, Duong H, et al. High hepatitis C virus (HCV) prevalence among men who have sex with men (MSM) in Vietnam and associated risk factors: 2010 Vietnam Integrated Behavioural and Biologic Cross-Sectional Survey. Sex Transm Infect. 2016 Apr 4. pii: sextrans-2015-052518. [Epub ahead of print]
  22. Centers for Disease Control and Prevention. HIV Risk Reduction Tool: Injecting Silicone (Pumping Silicone). Available at: https://wwwn.cdc.gov/hivrisk/transmit/needles/injecting_silicone.html. Accessed June 15, 2017.
  23. Siddharta A, Pfaender S, Malassa A, et al. Inactivation of HCV and HIV by microwave: a novel approach for prevention of virus transmission among people who inject drugs. Sci Rep. 2016 Nov 18;6:36619.