<p>Between April 1997 and November 1999, I followed eight socially excluded female drug users in an attempt to describe their lives and living conditions. The study employs an ethnographic approach with the focus being directed at the specific woman and her life in relation to the social context where this life is lived.</p><p>The study’s objective has been to describe the lives and living conditions of the eight drug-using women, as well as the extent of the opportunities available to them, as being determined by mechanisms of social exclusion. Their lives are understood on the basis of a feminist and social constructionist perspective where perceptions of ‘the drug-abusing woman’ are regarded as the result of constructions of gender and deviance. The theoretical perspectives proceeds from the idea that one is not born a woman but rather becomes one. The fundamental idea is that women become women by means of processes of femininisation, in the context of which certain ways of interpreting and presenting oneself as a woman are regarded as good and others as bad. Our images of ‘the female drug addict’ are based on how we define and interpret deviance and on the cultural and social thought and behaviour patterns we ascribe to people on the basis of bodily differences. It is images of ‘the good woman’ that defines what we regard as characteristic of ‘the bad woman’ and vice versa.</p><p>The findings are organised into three main topics: femininity, living conditions and social control. The main findings are: The women described themselves as women by relating to normative messages about how women “are and should be”, and their drug use constituted a means of coping with life from their social position. Their life revolved to a large extent around money via a constant struggle to find enough to cover the rent, food and other basic necessities. And finally, how the women’s relations to societal institutions were formed by their social position as ‘female drug addicts’ and how the asymmetry of these relations produced certain fixed patterns of action for the parties involved.</p>

Background: Aboriginals are overrepresented in Canada’s HIV epidemic and are more likely to be infected with HIV through injection drug use (IDU) than non-Aboriginals. However, little research has investigated the outcomes of combination antiretroviral therapy (cART) among Aboriginal HIV-patients or compared outcomes between Aboriginal and non-Aboriginal HIV-patients. Objectives: The primary objectives of this research were to 1) compare all-cause and HIV-related mortality rates between Aboriginal and non-Aboriginal HIV-patients after they start cART, 2) determine if Aboriginal patients were less likely to achieve virological suppression and more likely to experience subsequent treatment failure after starting cART; 3) describe and compare the health-related quality of life (HRQL) of Aboriginal and non-Aboriginal HIV-patients; and 4) describe the life stability of Aboriginal and IDU HIV-patients treated with cART and explore associations between life stability, clinical status, and HRQL. Methods: This research was conducted in northern Alberta, Canada using a clinical database, vital statistics data, and data collected through interview and a self-administered HRQL questionnaire. Data analyses included multivariable Cox proportional hazards models and multiple linear and logistic regression models. Results: After starting cART, Aboriginals suffer higher rates of all-cause and HIV-related mortality than non-Aboriginals. Furthermore, Aboriginals are less likely to achieve virological suppression after starting cART and, among those who achieve suppression, Aboriginals experience higher rates of virological failure ≥1 year after suppression. Aboriginal IDUs, Aboriginal non-IDUs, and non-Aboriginal IDUs reported similarly worse physical HRQL compared to non-Aboriginals non-IDUs. Among Aboriginals and IDUs, factors significantly associated with poor clinical status were unemployment, lower income, not completing high school, homelessness, and perceiving that one’s current life was not much better compared to before starting cART. Similarly, factors significantly associated with lower HRQL in this group were unemployment, perceiving that one’s current health or one’s current life was not much better compared to before starting cART, and having a current CD4 cell count ≤350 cells/μL. Conclusions: Overall, after starting cART, Aboriginal HIV-patients suffer worse outcomes than non-Aboriginal HIV-patients. Future research should investigate adherence among Aboriginals and IDUs treated with cART and explore their treatment experiences to develop interventions to improve the prognosis of these vulnerable populations.

Between April 1997 and November 1999, I followed eight socially excluded female drug users in an attempt to describe their lives and living conditions. The study employs an ethnographic approach with the focus being directed at the specific woman and her life in relation to the social context where this life is lived. The study’s objective has been to describe the lives and living conditions of the eight drug-using women, as well as the extent of the opportunities available to them, as being determined by mechanisms of social exclusion. Their lives are understood on the basis of a feminist and social constructionist perspective where perceptions of ‘the drug-abusing woman’ are regarded as the result of constructions of gender and deviance. The theoretical perspectives proceeds from the idea that one is not born a woman but rather becomes one. The fundamental idea is that women become women by means of processes of femininisation, in the context of which certain ways of interpreting and presenting oneself as a woman are regarded as good and others as bad. Our images of ‘the female drug addict’ are based on how we define and interpret deviance and on the cultural and social thought and behaviour patterns we ascribe to people on the basis of bodily differences. It is images of ‘the good woman’ that defines what we regard as characteristic of ‘the bad woman’ and vice versa. The findings are organised into three main topics: femininity, living conditions and social control. The main findings are: The women described themselves as women by relating to normative messages about how women “are and should be”, and their drug use constituted a means of coping with life from their social position. Their life revolved to a large extent around money via a constant struggle to find enough to cover the rent, food and other basic necessities. And finally, how the women’s relations to societal institutions were formed by their social position as ‘female drug addicts’ and how the asymmetry of these relations produced certain fixed patterns of action for the parties involved.

Context & Rationale: Individuals with similar CD4 cell counts and RNA levels can vary considerably with regards to clinical progression. This variation is likely the result of a complex interplay between viral, host and environmental factors. This study aimed to characterize and identify predictors associated with disease progression to AIDS or death in Saskatoon, Saskatchewan. Methods: This is a retrospective cohort study of 343 seroprevalent HIV positive patients diagnosed from Jan 2005 to Dec 2010. Of these, 73 had an estimated seroconversion date. Data was extracted from medical charts at two clinics specialized in HIV/AIDS care. Disease progression was measured as time from HIV diagnosis (or seroconversion) to immunological AIDS and death. The Cox hazard model was used. Results: The 3-year and 5-year immunological AIDS free probability was 53% and 33%, respectively. The 3-year and 5-year survival probability was 89% and 77%, respectively. Among the seroconversion cohort, the 3-year immunological AIDS free probability was 76%. Due to multicollinearity, separate models were built for IDU, hepatitis C and ethnicity. A history of IDU (HR, 3.0; 95%CI, 1.2-7.1), hepatitis C coinfection (HR, 2.9; 95%CI, 1.2-6.9), baseline CD4 counts (HR, 0.95; 95%CI, 0.92-0.98, per ever 10 unit increase), ever on ART, and year of diagnosis were significant predictors of progression to immunological AIDS among the seroprevalent cohort. Age at diagnosis, sex and ethnicity were not. For survival, only treatment use was a significant predictor (HR, 0.34; 95%CI, 0.1-0.8). Hepatitis C coinfection was marginally significant (p=0.067), while a history of IDU, ethnicity, gender, age at diagnosis, and year of diagnosis were not. Among the seroconversion cohort, no predictors of progression to immunological AIDS were identified. Ethnicity, hepatitis C coinfection and history of IDU could not be assessed. Conclusion: Our study found that IDU, HCV coinfections, baseline CD4 counts, and ART use were significant predictors of disease progression. This highlights the need for increased testing and early detection and for targeted interventions for these particularly vulnerable populations to slow disease progression.

The purpose of this study was to compare the delinquent behavior, psychological health, and emotional wellbeing of maltreated and nonmaltreated adolescents in a chemical dependency treatment program. Data were collected over a seven year period from intake interviews and Minnesota Multiphasic Personality Inventory (MMPI) scores of 522 adolescent patients at a chemical dependency treatment program in a Northwest city of about 100,000. The subjects consisted of 220 females and 302 males. Maltreatment was selfreported by 43% of the females and 17% of the males. Results indicated that maltreated, drugaddicted adolescents engaged in significantly more delinquent behavior, including arrests and drugrelated arrests, suicide attempts, runaway behavior and illicit drug use than nonmaltreated adolescents in the program. Results of the MMPI scores revealed that maltreated adolescents scored significantly higher than nonmaltreated adolescents on eight of the ten clinical scales, indicating that maltreated adolescents entered the drug treatment program with higher levels of psychological and emotional distress than did their peers. Analyses run separately for males and females revealed that differences between maltreated and nonmaltreated patients could be accounted for, in large part, by differences between maltreated and nonmaltreated females. Maltreated females, but not males, scored significantly higher on total drug use, and on the Hypochondriasis (Hs), Hysteria (Hy), Psychasthenia (Pt), and Schizophrenia (Sc) scales of the MMPI. The unique needs of maltreated adolescents, in particular maltreated females, in drug treatment programs are discussed. / Graduation date: 1992

Context & Rationale: Individuals with similar CD4 cell counts and RNA levels can vary considerably with regards to clinical progression. This variation is likely the result of a complex interplay between viral, host and environmental factors. This study aimed to characterize and identify predictors associated with disease progression to AIDS or death in Saskatoon, Saskatchewan. Methods: This is a retrospective cohort study of 343 seroprevalent HIV positive patients diagnosed from Jan 2005 to Dec 2010. Of these, 73 had an estimated seroconversion date. Data was extracted from medical charts at two clinics specialized in HIV/AIDS care. Disease progression was measured as time from HIV diagnosis (or seroconversion) to immunological AIDS and death. The Cox hazard model was used. Results: The 3-year and 5-year immunological AIDS free probability was 53% and 33%, respectively. The 3-year and 5-year survival probability was 89% and 77%, respectively. Among the seroconversion cohort, the 3-year immunological AIDS free probability was 76%. Due to multicollinearity, separate models were built for IDU, hepatitis C and ethnicity. A history of IDU (HR, 3.0; 95%CI, 1.2-7.1), hepatitis C coinfection (HR, 2.9; 95%CI, 1.2-6.9), baseline CD4 counts (HR, 0.95; 95%CI, 0.92-0.98, per ever 10 unit increase), ever on ART, and year of diagnosis were significant predictors of progression to immunological AIDS among the seroprevalent cohort. Age at diagnosis, sex and ethnicity were not. For survival, only treatment use was a significant predictor (HR, 0.34; 95%CI, 0.1-0.8). Hepatitis C coinfection was marginally significant (p=0.067), while a history of IDU, ethnicity, gender, age at diagnosis, and year of diagnosis were not. Among the seroconversion cohort, no predictors of progression to immunological AIDS were identified. Ethnicity, hepatitis C coinfection and history of IDU could not be assessed. Conclusion: Our study found that IDU, HCV coinfections, baseline CD4 counts, and ART use were significant predictors of disease progression. This highlights the need for increased testing and early detection and for targeted interventions for these particularly vulnerable populations to slow disease progression.

Research has documented that Episodic Heavy Drinking (EHD), defined as consuming four or more and five or more alcoholic drinks per drinking episode among females and males, respectively, is a prevalent risk behavior among undergraduate college students throughout the United States. Moreover, studies have shown that EHD is the leading cause of preventable morbidity and mortality among college students as unintentional injuries, sexual assaults, and unsafe sexual behaviors among this population have been linked to this risk behavior. Illicit substance use, although often portrayed as a separate risk behavior, is also associated with EHD. Nationally, the most frequently used illicit substance among college students is marijuana. Research suggests that college students who engage in EHD are several times more likely to be current marijuana users or to have used marijuana during their lifetime. Furthermore, EHD has been identified as a predictor of marijuana use and other substances, illicit or otherwise. With regard to this particular investigation, three specific risk behaviors among undergraduate students at Western Kentucky University (WKU) were the primary foci: 1) the prevalence of alcohol use and episodic heavy drinking (EHD), 2) the prevalence of illicit substance use, particularly marijuana use, and 3) concomitant EHD and marijuana use. In addition, WKU students' personal characteristics and certain behaviors were examined to determine their association with alcohol and marijuana use. This study was a secondary analysis of data gathered through the Western Kentucky Student Health Assessment (WKU-SHA 2002)administered during the fall semester of 2002. The WKU-SHA 2002 utilized the American College Health Association's (ACHA) National College Health Assessment (NCHA) survey instrument to investigate overall health status and health risk behaviors of WKU undergraduate students. It used a cross- ectional, random cluster sampling of 100, 200, 300 and 400 level undergraduate classes held on WKU's main campus. Results of this investigation were similar to findings reported in current literature. Seventy-three percent of respondents reported consuming alcohol during the last 30 days. Fortysix percent reported engaging in episodic heavy drinking the last time they "partied" and approximately 20% reported using marijuana during the last 30 days. Episodic heavy drinkers were more likely to report 30-day marijuana use than students who did not engage in EHD. Significant associations were reported between risk behaviors and respondents' characteristics. It is anticipated that the information provided through this investigation may be particularly useful to the planning of future health programs and services designed to address EHD and marijuana use among WKU undergraduate college students.

This study examined the behaviors relating to the utilization of prescription and over-the-counter medications in a small group of elderly subjects in the 65 years and over age range. This group was attending an Elderhostel at Western Oregon State College during the summer of 1991, when the information was obtained. The objectives of this study were to ascertain specific medication taking behaviors, and whether or not directions were adhered to as prescribed by physicians for this highly educated group, or if their behaviors were similar to those referred to in the literature for all elderly. A sample of 38 elderly was obtained during an Elderhostel Wellness Vacation at Western Oregon State College in Monmouth, Oregon during July, 1991. Subjects completed questionnaires regarding medication-taking behaviors as part of a wellness class session regarding the safe use of medications. Questionnaires were filled out prior to the class discussion. Data were assembled using one survey instrument with questions relating to medication usage. Descriptive statistics using histograms showing frequency distributions were used for data analysis. Sixty-five percent of this group were taking prescription medications and sixty-eight percent of this group were taking over-the-counter medications. Medications were being obtained from more than one physician and more than one pharmacy. The subjects took fewer doses of medications per day and less medication per dose than prescribed. Medications were discontinued prematurely if feeling better or worse. Leftover medications from previous prescriptions were being taken. Outdated or expired medications were being taken. Alcoholic beverages were being used in conjunction with the use of prescription medications. In some cases, prescriptions were not filled because they were considered to be unnecessary. Recommendations for education and future research in the problematic area of drug use in the elderly include: 1) More time spent by health care professionals to educate the elderly in the correct and safe use of medications; 2) Community health promotion programs targeted at the well elderly; 3) Personalized "brown bag" medication counselling sessions; 4) Medication education programs at Elderhostels throughout the country; 5) Education programs through the American Association of Retired Persons; and 6) Further studies of larger groups of well-educated, healthy and active elderly. / Graduation date: 1993

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