William A Zule
Datos Biográficos
| ID | 143173 |
|---|---|
| NOMBRE | William A Zule |
| NOMBRES | William A |
| APELLIDO | Zule |
| FIRMA | ZULE W A |
| AFILIACIONES | RTI International |
| ORCID | 0000-0002-6781-1030 |
| VERIFICADO | Sí |
| TOTAL DE OBRAS | 50 |
| TOTAL DE CITAS | 62 |
| TOTAL COMO AUTOR | 50 |
| TOTAL COMO EDITOR | 0 |
| PRIMER AÑO DE PUBLICACIÓN | 1992 |
| AÑO MÁS RECIENTE DE PUBLICACIÓN | 2025 |
| ÍNDICE H | 4 |
Associations of hepatitis C virus (HCV) antibody positivity with opioid, stimulant, and polysubstance injection among people who inject drugs (PWID) in rural U.S. communities
HCV antibody positivity, indicating prior exposure, was highest among those who had recently injected opioids, alone or with stimulants. Additional nucleic acid testing is necessary to confirm active infection. More research is needed to determine the underlying causes of HCV antibody positivity by injection use
Prevalence and correlates of multiple injections per injection episode among people who inject drugs in rural U.S. communities
Barriers to accessing medications for opioid use disorder among rural individuals
Access barriers vary by MOUD type for rural individuals with OUD. Compared to sublingual buprenorphine, methadone access was hindered more by transportation difficulties, while injectable long-acting buprenorphine was hindered more by affordability and finding a doctor or program. These barriers highlight the need to de-regulate and expand locations for methadone access and prescribing, and to improve affordability and prescriber uptake of newer …
The War on Drugs, Racialized Capitalism, and Health Care Utilization Among White People Who Use Drugs in 22 Rural Appalachian Counties
Objectives. To analyze War on Drugs encounters and their relationships to health care utilization among White people who use drugs (PWUD) in 22 Appalachian rural counties in Kentucky, West Virginia, Ohio, and North Carolina. Methods. We recruited White PWUD using chain referral sampling in 2018 to 2020. Surveys asked about criminal–legal encounters, unmet health care needs, and other covariates. We used generalized estimating equations to regress…
Medicaid Policy and Hepatitis C Treatment Among Rural People Who Use Drugs
BACKGROUND: Restrictive Medicaid policies regarding hepatitis C virus (HCV) treatment may exacerbate rural health care disparities for people who use drugs (PWUD). We assessed associations between Medicaid restrictions and HCV treatment among rural PWUD. METHODS: We compiled state-specific Medicaid treatment policies across 8 US rural sites in 10 states and merged these with participant survey data. We hypothesized that local restrictions regardi…
Barriers to opioid use disorder treatment among people who use drugs in the rural United States
Condom Use at Last Sex and Sexual Negotiation Among Young African American Women in North Carolina
African American women are 10.8 times more likely to be diagnosed with HIV compared with White women. This descriptive study fills a gap by examining associations among social and contextual factors and sexual communication, condom use, and safer sex negotiation among African American women. Study participants between 18 and 25 years of age and who reported recent substance use were recruited from three North Carolina counties. A risk behavior su…
HIV-related risk among justice-involved young African American women in the U.S. South
Incarceration rates have increased exponentially among women, and racial disparities in justice involvement persist. Coupled with disparities in HIV in the US South that begin early in the life course, it is important to explicate the relationship between justice involvement, HIV-related risk (such as illicit drug use and sexual risk), and service needs for young African American women. This study examined the association of previous arrest, biol…
Factors associated with perceived ease of access to syringes in Appalachian North Carolina
PURPOSE: To examine associations between perceived ease of syringe access, syringe sources, injection behaviors, and law enforcement (LE) interactions among people who inject drugs (PWID) in rural Appalachian North Carolina (NC). METHODS: Using respondent-driven sampling, a diverse sample of 309 self-reported PWID were recruited from rural Appalachian NC. Data were collected via audio computer-assisted self-interview technology from February 2019…
Substance use disorder treatment providers’ knowledge and opinions toward testing and treatment of chronic hepatitis C in rural North Carolina
Poor access to care has made western North Carolina vulnerable to an outbreak of hepatitis C viral infection (HCV), particularly among persons who inject drugs (PWID). As substance use disorder (SUD) treatment providers could potentially improve linkage to HCV testing and treatment, we sought to understand SUD providers, clinic and client characteristics; referral patterns; HCV knowledge; willingness to participate in additional trainings; and lo…
‘We have goals but [it is difficult]’. Barriers to antiretroviral therapy adherence among women using alcohol and other drugs living with HIV in South Africa
BACKGROUND: Women living with HIV who misuse alcohol and live in economically disadvantaged settings in South Africa experience a multitude of contextual barriers as they navigate the HIV care continuum. The Women's Health CoOp (WHC), a brief, woman-focused, behavioural, evidence-based intervention, has been shown to be effective in reducing heavy drinking and improving HIV-related outcomes among this key population. However, these women face oth…
“It’s Crazy What Meth Can Help You Do”
BACKGROUND: Across the U.S., methamphetamine use is expanding among people who use illicit opioids (PWUIO). Motives for methamphetamine use must be contextualized within the experiences of PWUIO, who may use methamphetamine not only to achieve euphoria, but also as a tactic of self-management. The overall aim of this study is to contextualize lay beliefs, practices, and experiences of methamphetamine use as a form of self-treatment of symptoms re…
Sustainability of a gender-focused HIV and alcohol risk-reduction intervention in usual care settings in South Africa
Intervention sustainability is a critical yet understudied aspect of implementation science research. To address this gap, we examined the sustainability of the Women’s Health CoOp (WHC), a gender-focused, evidence-based, HIV and alcohol risk-reduction intervention, after an implementation trial. We used a mixed methods design consisting of questionnaires (n = 12), 3 focus groups (n = 11), and a semistructured interview conducted with interventio…
Outcomes of Implementing in the Real World the Women's Health CoOp Intervention in Cape Town, South Africa
Women in South Africa living with HIV who use alcohol may not adhere to ART, affecting the country's 90-90-90 targets. The Women's Health CoOp (WHC), a woman-focused HIV intervention, has shown efficacy in numerous trials with key populations of women in South Africa who use alcohol and drugs. In a hybrid implementation effectiveness study, the WHC was implemented in usual care clinics by healthcare providers in a modified stepped-wedge design. W…
Methamphetamine Use and Its Correlates among Individuals with Opioid Use Disorder in a Midwestern U.S. City
Background: U.S. is experiencing a surging trend of methamphetamine use among individuals who use opioids. More research is needed to characterize this emerging “twin epidemic.” Objectives: The study aims to identify social and behavioral characteristics associated with methamphetamine use among individuals with opioid use disorder (OUD) in the Dayton, Ohio, area, an epicenter of the opioid crisis and an emerging frontier of methamphetamine epide…
Mitigating the Risk of Infectious Diseases Among Rural Drug Users in Western North Carolina
PURPOSE: To characterize how health care providers in western North Carolina (NC) manage patients with substance use disorders and to inform strategies for preventing injection drug use (IDU)-associated outbreaks of bloodborne infectious diseases. METHODS: We collected data on practice characteristics, provider sociodemographics, and attitudes and beliefs about hepatitis C virus (HCV), human immunodeficiency virus (HIV), opioid use, and IDU via o…
Exploring the associations between physical and sexual gender-based violence and HIV among women who use substances in South Africa
Objective: South Africa has the highest prevalence of HIV among women, the highest prevalence of gender-based violence (GBV), and the highest rates of per capita alcohol consumption in the world. The nuanced associations between GBV, alcohol misuse, and HIV must be explored and protective factors identified. This study examines the associations between physical and sexual GBV and HIV infection and explores how alcohol misuse and sexual agency may…
Pharmacists’ attitudes and practices about selling syringes to people who inject drugs in Tajikistan
MHealth versus face-to-face
ClinicalTrials.gov: NCT02965014 . Registered November 16, 2016
Changing sex risk behaviors, gender norms, and relationship dynamics among couples in Cape Town, South Africa
Comprehensive Women-Centered Treatment for Psychoactive Substance Use in the Republic of Georgia
HIV Prevention Among Women Who Use Substances And Report Sex Work
Dead space in over-the-counter syringes
Women Who Inject Drugs in the Republic of Georgia
This study describes the initiation and maintenance of illicit drug use, risky behaviors, and the substance use treatment experiences of women in Georgia. Qualitative interviews with 55 drug-using women (mean age 36 years; SD = 9.52), were conducted during April-September 2011. Participants presented diverse histories of drug use initiation and substance use, risky behaviors, and drug treatment participation. All participants reported concurrent …
Using Pharmacies in a Structural Intervention to Distribute Low Dead Space Syringes to Reduce HIV and HCV Transmission in People Who Inject Drugs
Ongoing injection drug use contributes to the HIV and HCV epidemics in people who inject drugs. In many places, pharmacies are the primary source of sterile syringes for people who inject drugs; thus, pharmacies provide a viable public health service that reduces blood-borne disease transmission. Replacing the supply of high dead space syringes with low dead space syringes could have far-reaching benefits that include further prevention of diseas…
Simultaneous Recruitment of Drug Users and Men Who Have Sex with Men in the United States and Russia Using Respondent-Driven Sampling
The Sexual Acquisition and Transmission of HIV Cooperative Agreement Program (SATHCAP) examined the role of drug use in the sexual transmission of the human immunodeficiency virus (HIV) from traditional high-risk groups, such as men who have sex with men (MSM) and drug users (DU), to lower risk groups in three US cities and in St. Petersburg, Russia. SATHCAP employed respondent-driven sampling (RDS) and a dual high-risk group sampling approach th…
Behaviorally Bisexual Men and their Risk Behaviors with Men and Women
Efficacy of a Woman-Focused Intervention to Reduce HIV Risk and Increase Self-Sufficiency Among African American Crack Abusers
Objectives. This study compares 3- and 6-month outcomes of a woman-focused HIV intervention for crack abusers, a revised National Institute on Drug Abuse standard intervention, and a control group. Methods. Out-of-drug-treatment African American women (n = 620) who use crack participated in a randomized field experiment. Risk behavior, employment, and housing status were assessed with linear and logistic regression. Results. All groups significan…
Transactional Sex among Men and Women in the South at High Risk for HIV and Other STIs
The War on Drugs, Racialized Capitalism, and Health Care Utilization Among White People Who Use Drugs in 22 Rural Appalachian Counties
Objectives. To analyze War on Drugs encounters and their relationships to health care utilization among White people who use drugs (PWUD) in 22 Appalachian rural counties in Kentucky, West Virginia, Ohio, and North Carolina. Methods. We recruited White PWUD using chain referral sampling in 2018 to 2020. Surveys asked about criminal–legal encounters, unmet health care needs, and other covariates. We used generalized estimating equations to regress…
Changing sex risk behaviors, gender norms, and relationship dynamics among couples in Cape Town, South Africa
Barriers to opioid use disorder treatment among people who use drugs in the rural United States
Risk and Reciprocity
Injecting practices of illicit drug users in San Antonio, Texas, were studied by means of informal field interviews and participant observation. The methods injection drug users (IDUs) employed to obtain drugs seemed to affect their HIV risk behaviors. Many of the methods involve reciprocal exchanges between a person who has drugs and a person who wants drugs. The exchanges frequently occur in the context of asymmetrical social interactions. The …
The Intravenous Injection of Illicit Drugs and Needle Sharing
This study reviewed the literature on the history of needle sharing and intravenous drug abuse. Reports suggest that needle sharing was practiced by drug abusers as early as 1902 in China and 1914 in the United States. Intravenous drug abuse was first mentioned in the literature in 1925. However other references suggest that some opioid users were injecting intravenously prior to 1920. Outbreaks of malaria in Egypt, the United States, and China b…
Attitudes Toward Methadone Maintenance
Attitudes of opioid users toward methadone maintenance were studied using semi-structured field interviews. One hundred and sixty-one heroin and speedball users in San Antonio, Texas, were interviewed between 1989 and 1992. Users were classified according to whether or not they had ever been on methadone maintenance. Opioid users who had never been on methadone maintenance were more likely to express a negative attitude toward methadone maintenan…
Development and validation of a brief screening version of the Childhood Trauma Questionnaire
Treatment Readiness Among Out-of-Treatment African-American Crack Users
Crack cocaine use is linked to high rates of HIV and other sexually transmitted infections, as well as violence and criminal activity. Substance abuse treatment can play an important role in reducing drug use and related problems. However, many crack users do not want treatment, and those who do often encounter significant obstacles to access. This study compares 216 out-of-treatment African-American crack users who reported wanting to enter trea…
Efficacy of a Woman-Focused Intervention to Reduce HIV Risk and Increase Self-Sufficiency Among African American Crack Abusers
Objectives. This study compares 3- and 6-month outcomes of a woman-focused HIV intervention for crack abusers, a revised National Institute on Drug Abuse standard intervention, and a control group. Methods. Out-of-drug-treatment African American women (n = 620) who use crack participated in a randomized field experiment. Risk behavior, employment, and housing status were assessed with linear and logistic regression. Results. All groups significan…
Stimulant Use and Sexual Risk Behaviors for HIV in Rural North Carolina
Context: While literature exists on sexual risks for HIV among rural populations, the specific role of stimulants in increasing these risks has primarily been studied in the context of a single drug and/or racial group. Purpose: This study explores the use of multiple stimulants and sexual risk behaviors among individuals of different races and sexual identities in rural North Carolina. Methods: In‐depth interviews were conducted with 41 individu…
Secrecy and risk among MSM in Tbilisi, Georgia
There is concern that the tremendous economic, social, and political upheavals that the Republic of Georgia has undergone in the years since the fall of the Soviet Union may have created an environment fertile for HIV transmission. Notably absent from official statistics and HIV-related research in Georgia is discussion of men who have sex with men (MSM) and, therefore, little is known about the MSM population or its potential to acquire or trans…
Transactional Sex among Men and Women in the South at High Risk for HIV and Other STIs
Behaviorally Bisexual Men and their Risk Behaviors with Men and Women
Simultaneous Recruitment of Drug Users and Men Who Have Sex with Men in the United States and Russia Using Respondent-Driven Sampling
The Sexual Acquisition and Transmission of HIV Cooperative Agreement Program (SATHCAP) examined the role of drug use in the sexual transmission of the human immunodeficiency virus (HIV) from traditional high-risk groups, such as men who have sex with men (MSM) and drug users (DU), to lower risk groups in three US cities and in St. Petersburg, Russia. SATHCAP employed respondent-driven sampling (RDS) and a dual high-risk group sampling approach th…
Effects of a Hepatitis C Virus Educational Intervention or a Motivational Intervention on Alcohol Use, Injection Drug Use, and Sexual Risk Behaviors Among Injection Drug Users
Objectives. We compared the effects of 2 interventions on alcohol use, use of a new syringe at last injection, and condom use at last sexual encounter in a community sample of injection drug users. Methods. Between 2003 and 2006, 851 out-of-treatment injection drug users were recruited in Raleigh, NC, and Durham, NC, through street outreach and were randomly assigned to either a 6-session educational intervention or a 6-session motivational inter…
The Relative Role of Perceived Partner Risks in Promoting Condom Use in a Three-City Sample of High-Risk, Low-Income Women
We examined the effect of women's perceptions of sexual partner risks on condom use. Women from three US cities (n = 1,967) were recruited to provide data on HIV risks. In univariate models, increased odds of condom use were associated with perceiving that partners had concurrent partners and being unaware of partners': (a) HIV status, (b) bisexuality, (c) concurrency; and/or (d) injection drug use. In multivariate models, neither being unaware o…
We are ordinary men’
Men who have sex with men remain largely absent from the health statistics of many Eastern European countries. This relative dearth compared to other parts of the world may be attributed to the generally hidden nature of this population. The tendency to employ Western sexual identity labels, rather than locally meaningful categories of identity, may also make it difficult to identify men who have sex with other men. In a pilot study of HIV risk i…
Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales
Results of a Pilot Study to Reduce Methamphetamine Use and Sexual Risk Behaviors Among Methamphetamine-Using Men Who Have Sex with Men (MSM) Not Currently in Treatment
Methamphetamine use, which has been linked to unprotected anal intercourse and incident HIV infection, is an important contributor to HIV transmission among men who have sex with men (MSM). The purpose of this study was to develop and pilot test a single-session motivational interviewing (MI) intervention for reducing HIV risk among an out-of-treatment sample of MSM who use methamphetamine. MSM who use methamphetamine (n = 39) were recruited in 2…
Results of a Pilot Test of a Brief Computer-Assisted Tailored HIV Prevention Intervention for Use with a Range of Demographic and Risk Groups
Low dead space syringes
Are major reductions in new HIV infections possible with people who inject drugs? The case for low dead-space syringes in highly affected countries
Access to treatment for substance-using women in the Republic of Georgia
Twice Stigmatized
This study examined attitudes and perspectives of 34 health service providers through in-depth interviews in the Republic of Georgia who encountered an injection drug-using woman at least once in the past two months. Most participants' concept of drug dependence treatment was detoxification, as medication-assisted therapy was considered part of harm reduction, although it was thought to have relatively better treatment outcomes compared to detoxi…
Alcohol and drug use outcomes among vulnerable women living with HIV
Alcohol and other drug use can negatively affect adherence to and retention in antiretroviral therapy (ART) among people living with HIV/AIDS. Yet, there are few brief interventions that reduce these behaviors among this population. This article presents the findings from a randomized field experiment that assessed the effects of a woman-focused intervention (the Women's Health CoOp [WHC]) on reducing alcohol and other drug use among vulnerable w…
The biobehavioral Women’s Health CoOp in Pretoria, South Africa
Trial registration no: NCT01497405
Drug scene, drug use and drug-related health consequences and responses in Kulob and Khorog, Tajikistan
Contextualizing gender differences and methamphetamine use with HIV prevalence within a South African community
Findings from this study underscore the need for policy makers to direct scarce resources to the communities, places within communities, and populations, especially vulnerable women, where the impact on HIV prevention and onward transmission will be greatest
Medicine (50 obras) · Psychiatry (35 obras) · HIV, Drug Use, Sexual Risk (33 obras) · Family medicine (31 obras) · Psychology (26 obras) · HIV/AIDS Research and Interventions (24 obras) · Environmental health (20 obras) · Human immunodeficiency virus (HIV (19 obras) · Demography (18 obras) · Sociology (16 obras)