Ruth Yuee Zhang

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OBJECTIVE To examine the relation between plasma HIV-1 RNA concentrations in the community and HIV incidence among injecting drug users. DESIGN Prospective cohort study. SETTING Inner city community in Vancouver, Canada. PARTICIPANTS Injecting drug users, with and without HIV, followed up every six months between 1 May 1996 and 30 June 2007. MAIN(More)
AIMS Despite proven benefits of antiretroviral therapy (ART), many human immunodeficiency virus (HIV)-infected injection drug users (IDU) do not access treatment even in settings with free health care. We examined whether methadone maintenance therapy (MMT) increased initiation and adherence to ART among an IDU population with free health care. DESIGN We(More)
OBJECTIVES We assessed the effects of syringe exchange program (SEP) policy on rates of HIV risk behavior and HIV incidence among injection drug users. METHODS Using a multivariate generalized estimating equation and Cox regression methods, we examined syringe borrowing, syringe lending, and HIV incidence among a prospective cohort of 1228 injection drug(More)
Previous studies of adherence to antiretroviral therapy (ART) for HIV among young injection drug users (IDU) have been limited because financial barriers to care disproportionately affect youth, thus confounding results. This study examines adherence among IDU in a unique setting where all medical care is provided free-of-charge. From May 1996 to April(More)
BACKGROUND Barriers to HIV treatment among injection drug users (IDU) are a major public health concern. However, there remain few long-term studies investigating key demographic and behavioral factors--and gender differences in particular--that may pose barriers to antiretroviral therapy (ART), especially in settings with universal healthcare. We evaluated(More)
Although research has examined the impacts of childhood maltreatment among various marginalized populations, few studies have explored the relationship between child abuse and subsequent involvement in sex work among drug-using street-involved youth. In the present study, the relationships between the level of childhood maltreatment and involvement in sex(More)
PROBLEM Illicit use of injected drugs is linked with high rates of HIV infection and fatal overdose, as well as community concerns about public drug use. Supervised injecting facilities have been proposed as a potential solution, but fears have been raised that they might encourage drug use. DESIGN A before and after study. Participants and setting 871(More)
Homelessness is prevalent among HIV-infected injection drug users (IDU) and may adversely affect access and adherence to antiretroviral therapy (ART). There are limited descriptions of the effect of homelessness on adherence to ART in long-term cohorts of HIV-infected IDU. We used data from a community-recruited prospective cohort of HIV-infected IDU,(More)
OBJECTIVES Exchanging sex for money, drugs, or other commodities for survival is associated with an array of HIV risks. We sought to determine if street-involved drug-using sexual minority youth are at greater risk for survival sex work and are more likely to engage in risk behaviors with clients. METHODS We examined factors associated with survival sex(More)
in a Canadian setting Thomas Kerr 1, 2 Brandon D. L. Marshall 1 Cari Miller 3 Kate Shannon 1, 2 Ruth Zhang 1 Julio S. G. Montaner 1, 2 Evan Wood 1, 2 1 British Columbia Centre for Excellence in(More)