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Fulltext Prevalence of HIV, Hepatitis B and C Virus Co-infections among Iranian High-Risk Groups: A Systematic Review and Meta-Analysis

Hashiani AA, Sadeghi F, Ayubi E, Rezaeian S, Moradi Y, Mansori K, et al.

Malays J Med Sci, 2019 May;26(3):37-48.
PMID: 31303849 DOI: 10.21315/mjms2019.26.3.3

Co-infection with hepatitis B and C among HIV infected patients are prevalent among high-risk populations. This meta-analysis aimed to estimate the prevalence of HIV, HCV and HBV co-infections among high-risk populations in Iran. We systematically searched the national and international electronic databases until 2016. The primary outcome was the prevalence of HIV, HBV, HCV and HIV co-infections in different high-risk populations in Iran. All English and Persian studies conducted on Iranian high-risk groups were included in the study. The review was reported based on PRISMA guidelines and data were analysed at 95% confidence level using random effect models. Overall, 916 relevant papers were recognised and 14 articles were included in the meta-analysis. The pooled estimates of HBV/HCV, HCV/HIV, HBV/HIV and HBV/HCV/HIV were 1.3% (95%CI: 0.5-2.1), 16.3% (95%CI: 1.1-31.6), 0.5% (95%CI: 0-1.4) and 0.5% (95%CI: 0.2-0.8), respectively. Based on subgroup analysis, there was a higher proportion of all co-infections from the years 2010-2016 as compared to that of the years 2003-2009. Our results highlighted that HCV/HIV co-infection in Iranian high-risk groups including injection drug users (IDUs) and prisoners is common. In addition, the increasing trend of coinfections should be considered alarming for policymakers.

Matched MeSH terms: Drug Users
Fulltext Prevalence and Factors Associated with Tuberculosis Treatment Success among TB/HIV Co-Infection in North-East Malaysia

Jalal TMT, Abdullah S, Wahab FA, Dir S, Naing NN

Malays J Med Sci, 2017 Dec;24(6):75-82.
PMID: 29379389 DOI: 10.21315/mjms2017.24.6.9

Background: One of the six strategies developed by WHO, in order to stop Tuberculosis (TB) is addressing TB/HIV high-risk groups. This study aimed to determine the prevalence of successful TB treatment and factors associated with TB treatment success among TB/HIV co-infection patients in North-East Malaysia.
Methods: A cross-sectional study was carried out in the a-year period from 2003 to 2012 by reviewing TB/HIV records in all hospitals and health clinics. The outcome of interest was treatment success as defined by Ministry of Health (MOH) when the patients was cured or completed TB treatment.
Results: Out of 1510 total TB/HIV co-infection cases, 27.9% (95% CI: 25.2, 30.6) of the patients were having treatment success. A majority of TB/HIV co-infection cases were male (91.1%). Fifty-eight percent the patients were drug addicts and 6% were having positive tuberculin tests. The multiple logistic regression revealed that male (OR: 0.39, 95% CI: 0.22, 0.71) and positive tuberculin test result (OR: 2.61, 95% CI: 1.63, 4.19) were significantly associated with the treatment success of TB/HIV co-infection patients. Other factors such as age, comorbid, sputum smear and x-ray findings were not significantly factors in this study.
Conclusion: Female patients and those with negative tuberculin test should be emphasised for successful tuberculosis treatment.

Matched MeSH terms: Drug Users
Fulltext Personality and career preference of drug abusers in Sabah

Julianah Saguni, Puteri Hayati Megat Ahmad, Guan, Teik Ee

Malaysian Journal of Social Sciences and Humanities, 2018;3(3):31-37.
MyJurnal

Unemployment issue is becoming a factor which causes relapses especially among former drug addicts
that has undergone rehabilitation. Therefore, this paperwork seek to unfold and discuss degree of
relationships between introvert and extrovert personality with career interest according to six RIASEC
major field to drug addicts. Research objective are to identify the relationship between introvert and
extrovert personality with career interest among drug addicts in Sabah. Most of the respondent in
treatment center has no knowledge about their own personality in career development especially after
finishing treatment thus causing relapse due to failure of getting the right employment for themselves.
It is considered serious due to economic and life instability are one of the factor which contribute to
relapse among drug addicts. Occupation or career selection are constantly highlighted as one of the
major problem in former drug addict life. This shows that a careful career selection needs to be done. Career process are also continuous process of involvement to help self-development especially in line
of job they do. Therefore, it is hopeful that this research could give valuable impact and use to drug
addicts rehabilitation authority with implementation of career guidance to clients hence assisting them
in making effective career choice in the future.

Matched MeSH terms: Drug Users
Fulltext Perceptions of Health-Related Community Reentry Challenges among Incarcerated Drug Users in Azerbaijan, Kyrgyzstan, and Ukraine

Rozanova J, Morozova O, Azbel L, Bachireddy C, Izenberg JM, Kiriazova T, et al.

J Urban Health, 2018 Aug;95(4):508-522.
PMID: 29728898 DOI: 10.1007/s11524-018-0256-4

Facing competing demands with limited resources following release from prison, people who inject drugs (PWID) may neglect health needs, with grave implications including relapse, overdose, and non-continuous care. We examined the relative importance of health-related tasks after release compared to tasks of everyday life among a total sample of 577 drug users incarcerated in Ukraine, Azerbaijan, and Kyrgyzstan. A proxy measure of whether participants identified a task as applicable (easy or hard) versus not applicable was used to determine the importance of each task. Correlates of the importance of health-related reentry tasks were analyzed using logistic regression, with a parsimonious model being derived using Bayesian lasso method. Despite all participants having substance use disorders and high prevalence of comorbidities, participants in all three countries prioritized finding a source of income, reconnecting with family, and staying out of prison over receiving treatment for substance use disorders, general health conditions, and initiating methadone treatment. Participants with poorer general health were more likely to prioritize treatment for substance use disorders. While prior drug injection and opioid agonist treatment (OAT) correlated with any interest in methadone in all countries, only in Ukraine did a small number of participants prioritize getting methadone as the most important post-release task. While community-based OAT is available in all three countries and prison-based OAT only in Kyrgyzstan, Kyrgyz prisoners were less likely to choose help staying off drugs and getting methadone. Overall, prisoners consider methadone treatment inapplicable to their pre-release planning. Future studies that involve patient decision-making and scale-up of OAT within prison settings are needed to better improve individual and public health.

Matched MeSH terms: Drug Users/psychology*; Drug Users/statistics & numerical data*
Fulltext Peranan sokongan sosial terhadap kemurungan dalam kalangan remaja penagih dadah

Faizah Mat I, Norizan H, Rozmi I

Jurnal Psikologi Malaysia, 2018;32:109-118.

The number of adolescents involved in drug addiction increases every year. Statistic shows that in 2015 there were 6,406 addicts from age 13 to 24 years old compared to 4,954 detected in 2014. The majority of those addicts had major depression. It is predicted that by 2020, depression will be the second leading causes of global burden of diseases after heart disease. This study aims to identify the relationship between social support and depression among adolescent drug addicts. The study used quantitative method by distributing the questionnaires to respondents. A total of 367 adolescent drug adddicts were involved in this study. The results showed a significant negative relationship between social support and depression. The results of the study also showed that there were relationships between social support from guardian, friends and closed friends and depression. The implication of the study suggested that the role of social support such as family members and close friends are crucial to help adolecents cope with depression and addiction.

Matched MeSH terms: Drug Users
Fulltext Penentu faktor peramal pengekalan pekerjaan dalam kalangan klien AADK

Muhammad Ajib Abd R, Rozmi I, Noh A, Norhayati I, Faizah I

Jurnal Psikologi Malaysia, 2018;32:104-113.

Occupation is the most important element in changing the quality-of-life continuity and the recovery of drug addicts. This study aimed to measure the level of employment sustainability among ex-clients from the National Anti-Drug Agency (AADK). This study used a quantitative approach with a cross-sectional design. A total of 130 AADK ex-clients who were in employment were selected as respondents for this study. Our findings show that the majority of AADK ex-clients can survive relatively well enough for between 1 to 2 years depending on the factors of wages, work environment, interests and skills. The finding of this study implies that former clients tend to remain only 1 to 2 years in employment if their wages and jobs are not in line with their will. The findings also found that there was a significant relationship between the job-person fit and job satisfaction with motivation. Hence, this study is capable to modify the perceptions and views of employers towards clients' initiative for being persistent at the workplace as well as improving existing policies in providing incentives to clients for being consistent on the job.

Matched MeSH terms: Drug Users
Fulltext Patterns of polysubstance use among adults in Malaysia-A latent class analysis

Rodzlan Hasani WS, Robert Lourdes TG, Ganapathy SS, Ab Majid NL, Abd Hamid HA, Mohd Yusoff MF

PLoS One, 2023;18(1):e0264593.
PMID: 36649298 DOI: 10.1371/journal.pone.0264593

INTRODUCTION: Polysubstance use is the use of more than one non-prescribed licit or illicit substance at one time. This is a common phenomenon, but little is known about the severity and the various substances used by adults in Malaysia.
OBJECTIVE: To determine the pattern of polysubstance use and its associated factors among general adults in Malaysia.
METHODOLOGY: This was a secondary data analysis from the National Health and Morbidity Survey (NHMS) 2019), a cross-sectional population survey with a two-stage stratified random sampling design. A total of 10,472 Malaysians aged 18 years and above participated in this survey. Polysubstance use was defined as concurrent use of more than one substance, either alcohol, tobacco, or drugs (opioids, marijuana, amphetamine/ methamphetamine or kratom). A latent class analysis (LCA) was used to identify the membership of polysubstance groups. The association of class membership with demographic profiles was examined using Multinomial Logistic Regression analysis.
RESULTS: Fit indices (AIC = 16458.9, BIC = 16443.6) from LCA supported 3 classes solution: Class 1; "moderate-drug" group primarily combination used of tobacco and alcohol (2.4%), Class 2; "high-drug" group using multiple substance including kratom (0.3%) and Class 3; "low-drug" group reporting minimal alcohol and tobacco use or non-user (97.3%). The multinomial model showed young adults (18-40 years) had a higher likelihood of being polysubstance users both for moderate-drug class (OR = 4.1) and high-drug class (OR = 3.9) compared to older age (≥60 years). Chinese (OR = 18.9), Indian (OR = 23.3), Indigenous Sabah & Sarawak (OR = 34.6) and others ethnicity (OR = 8.9) showed higher odds of being moderate-drug users than Malays. The greater odds of moderate-drug use for males (OR = 35.5), working groups (OR = 1.5) and low education level group (OR = 3.2).
CONCLUSION: Our study highlights patterns and demographics related to the use of polysubstances among adults in Malaysia. These results would help formulate specific prevention programmes for these high-risk groups.

Matched MeSH terms: Drug Users*
Patterns and reasons for kratom (Mitragyna speciosa) use among current and former opioid poly-drug users

Singh D, Yeou Chear NJ, Narayanan S, Leon F, Sharma A, McCurdy CR, et al.

J Ethnopharmacol, 2020 Mar 01;249:112462.
PMID: 31816368 DOI: 10.1016/j.jep.2019.112462

ETHNOPHARMACOLOGICAL RELEVANCE: Kratom (Mitragyna speciosa) is a native medicinal plant of Southeast Asia widely reported to be used to reduce opioid dependence and mitigate withdrawal symptoms. There is also evidence to suggest that opioid poly-drug users were using kratom to abstain from opioids.
AIM OF THE STUDY: To determine the patterns and reasons for kratom use among current and former opioid poly-drug users in Malaysia.
MATERIALS AND METHODS: A total of 204 opioid poly-drug users (142 current users vs. 62 former users) with current kratom use history were enrolled into this cross-sectional study. A validated UPLC-MS/MS method was used to evaluate the alkaloid content of a kratom street sample.
RESULTS: Results from Chi-square analysis showed that there were no significant differences in demographic characteristics between current and former opioid poly-drug users except with respect to marital status. Current users had higher odds of being single (OR: 2.2: 95%CI: 1.21-4.11; p drug users (OR: 1.1: 0.62-2.06; p drug users regularly used kratom (three glasses or about 900 mL daily or the equivalent of 170.19 mg of mitragynine) to overcome opioid poly-drug use problems.

Matched MeSH terms: Drug Users/statistics & numerical data
Fulltext Oral Health Profile Of A Group Of Malayasian Drug Addicts

Sujak, S.L., Abdul Kadir, R.

Ann Dent, 1999;6(1):-.
MyJurnal

A study was undertaken to identify the oral health status and treatment needs of 403 drug abusers enrolled in a drug rehabilitation center in Perak, Malaysia. The prevalence of dental caries was 97.0%. Calculus was present in 82.1% of the dentate individuals, but only 14.6% had pockets greater than 3mm. The mean DMFT observed was 11.7, with missing teeth (MT=9.6) constituting the major component. Denture needs were high (67.2%), but only 11.4% of individuals had prostheses.

Matched MeSH terms: Drug Users
Opening up the HIV epidemic: a review of HIV seropositive status disclosure among people who inject drugs

Nasarruddin AM, Saifi RA, Othman S, Kamarulzaman A

AIDS Care, 2017 May;29(5):533-540.
PMID: 27530678 DOI: 10.1080/09540121.2016.1220485

HIV status disclosure plays a crucial role in reducing risk behaviors of drug and sexual partners and thereby limiting HIV transmission. As people who inject drugs (PWID) bear a significant HIV burden and disclosure research among PWID is relatively few, we reviewed the literature to highlight what is known about disclosure among HIV-positive PWID. Searches of articles published from 2000 to 2015 yielded 17 studies addressing different aspects of disclosure, and results are presented by major themes. Our results suggest that despite the difficulties, most PWID (64-86%) disclose their HIV-positive status to trusted individuals (family members and intimate sexual partners) and to those who are known to be HIV-positive. Disclosure to non-intimate sexual partners and fellow drug users is relatively lower. Disclosure decision-making is primarily driven by the perceived positive and negative consequences of disclosure. Subsequent risk reduction practices following disclosure are influenced by the feeling of responsibility, as well as partners' willingness to accept risk. Cultural family values, ethnicity, and different localities were several contextual factors that affect patterns of disclosure and risk behaviors of PWID. Areas for future research are recommended.

Matched MeSH terms: Drug Users/psychology*
Fulltext Material security and adherence to antiretroviral therapy among HIV-positive people who use illicit drugs

Mohd Salleh NA, Van Draanen J, Nosova E, Barrios R, Milloy MJ, Richardson L

AIDS, 2020 06 01;34(7):1037-1045.
PMID: 32073444 DOI: 10.1097/QAD.0000000000002501

OBJECTIVE: To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care.
DESIGN: We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 to 2017.
METHODS: We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score. We then estimated the association between achieving at least 95% adherence to ART and overall mean material score, as well as mean score for three factors derived from a factor analysis. The three-factor structure, employed in the current analyses, were factor 1 (basic needs); factor 2 (housing-related variables) and factor 3 (economic resources).
RESULTS: Recent incarceration [β-coefficient (β) = -0.176, 95% confidence interval (95% CI): -0.288 to -0.063], unmet health needs [β = -0.110, 95% CI: -0.178 to -0.042), unmet social service needs (β = -0.264, 95% CI: -0.336 to -0.193) and having access to social services (β= -0.102, 95% CI: -0.1586 to -0.0465) were among the factors associated with lower material security scores. Contrary to expectations that low levels of material security in this population would lead to poor ART adherence, we did not observe a significant relationship between adherence and overall material security score, or for each factor individually.
CONCLUSION: Our findings highlight the potentially important role of no-cost, universal access to HIV prevention and treatment, in mitigating the impact of socioeconomic disadvantage on ART adherence.

Matched MeSH terms: Drug Users/psychology*
Malaysia. Malaysia tries to follow Australia's path

Science, 2014 Jul 11;345(6193):164-5.
PMID: 25013064 DOI: 10.1126/science.345.6193.164
Matched MeSH terms: Drug Users
Fulltext Isu dan halangan bagi bekas pesalah untuk bekerja: satu perspektif

Nur Diyanah H, Siti Marziah Z

Jurnal Psikologi Malaysia, 2018;32:62-68.

Ex-offenders are facing major challenges after their release to survive in the community. Among the challenges are stigma from the community, physical and mental health issues, financial problem because of unemployment and loss of significant others. They need to be guided to manage issues regarding employment, family, interpersonal relationship, and self-management. This article will discuss issues and barriers for ex-offenders to return to work or join the workforce. Past findings showed that ex-convicts and ex-drug addicts are still facing with barriers which withhold them from joining the job market. They frequently become the victims of rejection, bias, being bullied, and being segregated by co-workers. Barriers in employment may also be rooted from themselves, such as attitude problem, bad work culture, aggressive personality, and disciplinary issue. Thus, effective programmes and interventions need to be implemented for ex-offenders to increase their employability, and hence joining the community.

Matched MeSH terms: Drug Users
Fulltext Issues And challenges in the management Of methamphetamine dependence in pregnancy

Farid Yusof, Suzaily Wahab

Malaysian Journal of Medicine and Health Sciences, 2015;11(1):89-92.
MyJurnal

Data from the Malaysian National Drugs Agency December 2013 Report, showed that among 7864 drug users, 632 were abusing Amphetamine Type Stimulant. Rates of admission due to Methamphetamine abuse in pregnancy are higher compared with men and non- pregnant lady in the United States.1 A number of issues may complicate the management of pregnant women who abused methamphetamine such as the low motivation for them to come forward voluntarily for treatment, the high rates of fetal and maternal complications due to methamphetamine abuse,2,3 and the inavailabiliy of effective treatment for methamphetamine dependence.

Matched MeSH terms: Drug Users
Impact of HIV prevention programs on drug users in Malaysia

Kamarulzaman A

J Acquir Immune Defic Syndr, 2009 Nov;52 Suppl 1:S17-9.
PMID: 19858930 DOI: 10.1097/QAI.0b013e3181bbc9af

Faced with a rising HIV epidemic among injecting drug users, harm reduction policies and programs were introduced in Malaysia in 2005. The positive impact seen since the introduction of these programs comprise the inclusion of the health aspects of illicit drug use in the country's drug policies; better access to antiretroviral therapy for injecting drug users who are HIV infected; reduction in HIV-risk behavior; and greater social benefits, including increased employment. Despite these achievements, tension between law enforcement and public health persists, as harm reduction exists alongside an overall drug policy that is based on abstinence and zero tolerance. Unless there is harmonization of this policy, sustainability and scale-up of harm reduction programs will remain a challenge.

Matched MeSH terms: Drug Users
Fulltext Human herpes virus 8 antibodies in HIV-positive patients in Surabaya, Indonesia

Oktafiani D, Megasari NL, Fitriana E, Nasronudin, Lusida MI, Soetjipto

Infect Dis Rep, 2020 07 07;12(Suppl 1):8746.
PMID: 32874472 DOI: 10.4081/idr.2020.8746

Background: Human herpesvirus 8 (HHV-8) infection is etiologically related to Kaposi's sarcoma. Antibodies directed against HHV-8 can be detected in 80-95% of HIV-seropositive patients with KS. HHV-8 serological tests have been done in several countries in Southeast Asia such as Malaysia, and Thailand however no serological data is available in Indonesia. This study was to examine the presence of HHV- 8 antibodies in HIV-positive patients in Surabaya, Indonesia.
Material and methods: Ninety-one serum samples were collected from HIVpositive patients in Surabaya, Indonesia. Human immunodeficiency virus-positive serum samples were collected from 10 homosexual men, 25 intravenous drug users (IVDUs) and 56 heterosexuals. Serums were then tested for the presence of HHV-8 antibody by using sandwich ELISA (Abbexa Ltd, Cambridge, UK).
Results: The total of 91 HIV-infected were testing with antibodies to HHV-8 using enzyme-linked immunosorbent assay. Antibodies of HHV-8 were detected in 7/91 (7.7%) of the samples. According to a gender, six men (85.7%) and a women (14.3%) were positive of HHV-8 antibodies. No correlation regarding the gender and age from this study. The antibodies of HHV-8 was detected among intravenous drug users (IVDUs) men 5/7 (42.8%) and 2/7 (28.6%) from homosexual and heterosexual, respectively.
Conclusion: This study found the presence of HHV-8 antibodies in 7.7% of patients in Surabaya, Indonesia. This finding was higher more than Southeast Asian countries. The patients with a positive result could suggest measures to prevent HHV-8 infection.

Matched MeSH terms: Drug Users
Hepatitis C Transmission among Intravenous Drug Users in Pakistan: Time to Intervene

Rehman IU, Khan TM

J Coll Physicians Surg Pak, 2017 Nov;27(11):735.
PMID: 29132493 DOI: 2758
Matched MeSH terms: Drug Users/psychology*
Fulltext Healthcare Student Attitudes Toward Vulnerable Patient Populations: Potential Impact For Perpetuating Suboptimal Care [Thesis]

Jin H

Citation: Jin H. Healthcare Student Attitudes Toward Vulnerable Patient Populations: Potential Impact For Perpetuating Suboptimal Care. PhD Thesis. Yale University, United States, 2013.
Objective: Stigma endorsed by healthcare providers has been found to be a barrier to care for vulnerable populations, including HIV-infected, people who inject drugs (PWID), and men who have sex with men (MSM) in multiple clinical contexts. We therefore sought to better understand the extent to which stigma is levied toward these three populations by medical and dental students.
Design: This cross-sectional study assessed the attitudes of 1,296 medical and dental students towards HIV-infected, PWID, and MSM patients.
Methods: Students were asked to score their attitudes towards these patient groups using a feeling thermometer, indicating their attitudes on a sliding scale from 0, meaning very negative, to 100, meaning very positive.
Results: The mean attitude score towards the general patient population (M = 76.50, SD = 20.35) was significantly higher than the scores for HIV-infected patients (M = 54.04, SD = 20.99), PWID patients (M = 37.50, SD = 24.41), and MSM patients (M = 32.13, SD = 29.33).Further, certain demographic variables, most notably religion, ethnicity, and personally knowing someone of these populations, were associated with significant differences in attitudes.
Conclusion: Healthcare students represent the next generation of clinicians who will be responsible for HIV prevention and treatment efforts in the future. Our findings suggest that negative attitudes towards these patients is extremely high, and it is therefore crucial to design interventions to ameliorate the negative attitudes of medical students towards vulnerable populations.

Matched MeSH terms: Drug Users
Fulltext HIV Testing and awareness of HIV status among people who inject drugs in greater Kuala Lumpur, Malaysia

Bazazi AR, Vijay A, Crawford FW, Heimer R, Kamarulzaman A, Altice FL

AIDS Care, 2018 Jan;30(1):59-64.
PMID: 28803503 DOI: 10.1080/09540121.2017.1363852

HIV testing services are the gateway into HIV treatment and are critical for monitoring the epidemic. HIV testing is recommended at least annually in high-risk populations, including people who inject drugs (PWID). In Malaysia, the HIV epidemic is concentrated among PWID, but their adherence to testing recommendations and the proportion of HIV-positive PWID who are aware of their status remain unknown. We recruited 460 PWID in Greater Kuala Lumpur using respondent-driven sampling and conducted HIV testing. We examined past testing behaviors, estimating testing frequency, correlates of testing in the past 12 months, and the proportion of those living with HIV who were aware of their status. Results showed that most PWID living with HIV (90.4%, 95% CI: 83.6%-95.9%) were aware of their status. Among those never previously diagnosed with HIV, few had accessed HIV testing in the past 12 months (14.3%, 95% CI: 11.1%-18.0%). Prison (57.0%) and compulsory drug detention centers (36.1%) were the primary locations where PWID reported ever being HIV tested, and the main correlate of recent testing in regression was recent criminal justice involvement. Although awareness of HIV status may be high among PWID living with HIV in Kuala Lumpur, testing occurs primarily in prisons and compulsory drug detention centers, where it is involuntary and linkage to care is limited. A shift in HIV testing policy is needed to align health and human rights objectives, replacing mandatory testing with voluntary testing in settings where individuals can be rapidly linked to HIV care.

Matched MeSH terms: Drug Users/psychology*
Fulltext Genome Sequence of a Complex HIV-1 Unique Recombinant Form Involving CRF01_AE, Subtype B, and Subtype B' Identified in Malaysia

Chow WZ, Nizam S, Ong LY, Ng KT, Chan KG, Takebe Y, et al.

Genome Announc, 2014;2(2).
PMID: 24675847 DOI: 10.1128/genomeA.00139-14

A complex HIV-1 unique recombinant form involving subtypes CRF01_AE, B, and B' was recently identified from an injecting drug user in Malaysia. A total of 13 recombination breakpoints were mapped across the near-full-length genome of isolate 10MYPR226, indicating the increasingly diverse molecular epidemiology and frequent linkage among various high-risk groups.

Matched MeSH terms: Drug Users

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