Robert Heimer
Dados Biográficos
| ID | 171545 |
|---|---|
| NOME | Robert Heimer |
| PRENOMES | Robert |
| SOBRENOME | Heimer |
| ASSINATURA | HEIMER R |
| AFILIAÇÕES | Yale University |
| ORCID | 0000-0003-0589-6697 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 57 |
| TOTAL DE CITAÇÕES | 52 |
| TOTAL COMO AUTOR | 57 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1994 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 4 |
“Everybody’s Liking It”—Intentional Use of Xylazine in Fentanyl Among People Who Use Drugs
Background: Xylazine, a veterinary tranquilizer, is increasingly found in the unregulated fentanyl supply. Researchers and public health officials have generally characterized this substance as an unwanted adulterant, associated with outcomes such as extreme sedation and necrotic wounds. However, some literature suggests a small percentage of people who use drugs (PWUD) may prefer using xylazine. Thus, in this exploratory study, we aimed to under…
Allocative efficiency analysis of strategies to reduce overdose deaths among people with opioid use disorder and history of incarceration in Connecticut
Maximally scaling community MOUD and naloxone can reduce ODDs among people who are incarcerated by 39%. Considering societal costs, maximally scaling all three decreases ODDs while saving money
How Should the Use of Opioids Be Regulated to Motivate Better Clinical Practice
This article describes historical and political reasons for-and devastating consequences of-US opioid prescribing policy since the 1990s, which has restricted opioid prescribing for pain less than for treating opioid use disorder (OUD) treatment. This article considers merits and drawbacks of a new diagnostic category and proposes a regulatory and clinical framework for prescribing long-term opioid therapy for pain and for prescribing opioids to …
A place-based spatial analysis of racial inequities in overdose in St. Louis County Missouri, United States
These findings suggest that places of worship, the hospitality industry, and housing authorities may be physical features of the environment that reflect social conditions that are conducive to overdose. The scaling up of harm reduction strategies could be enhanced by targeting places where features are co-located
Xylazine in the drug supply
Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men
Stress, Marginalization, and Disruption
Lebanon is a diverse and dynamic nation of six million people that has experienced considerable disruption for the last two decades. The Syrian Civil War, which began in 2011, resulted in the displacement of 1.1 million Syrians to Lebanon. Today, Lebanon is the country with the largest per capita number of refugees in the world. In addition, the country experienced a social, economic, and political crisis in 2019 that destabilized the entire soci…
Sociodemographic characteristics and HIV risk behaviors of native-born and displaced Syrian men and transgender women who have sex with men in Lebanon
Behavioral patterns of people who use synthetic psychostimulants
Harm Reduction, By Mail
Physician and patient prediction of adherence to antiretroviral therapy in HIV positive people in Saint-Petersburg, Russia
Adherence to antiretroviral therapy (ART) results in HIV viral suppression, which is one of the main 90-90-90 targets. Little is known about the accuracy of provider and patient predictions of retention in care and adherence to ART. To address this gap, we conducted a longitudinal analysis of 100 HIV positive people newly eligible for ART initiation (based on the Russian guidelines of ART prescription) in St. Petersburg, Russia. We assessed the a…
Understanding motivations for large US cannabis firms' participation in the cannabis space
The HIV Care Continuum in Small Cities of Southern New England
A Community Responds to the Covid-19 Pandemic
Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalitio…
Polydrug Use and Heterogeneity in HIV Risk Among People Who Inject Drugs in Estonia and Russia
Non-medical drug injection is a major risk factor for HIV infection in Russia and Estonia. Multiple drug use (polydrug) has further been associated with increased harms. We compared HIV, injecting and sexual risk associated with polydrug use among people who injected drugs (PWID) in 2012-2013 in Kohtla-Järve (Estonia, n = 591) and St Petersburg (Russia, n = 811). Using latent class analysis, we identified five (poly)drug classes, the largest cons…
Early stages of HIV treatment cascade in people living with HIV in Saint-Petersburg, Russia
The proportion of people living with HIV (PLWH) in need of antiretroviral therapy (ART) is growing rapidly in Russia. Successful treatment outcomes reduces disease progression and contributes to HIV epidemic control. We conducted a pilot study following 100 PLWH newly found eligible for ART in St. Petersburg, Russia. We determined the proportion of PLWH who initiated ART, remained in treatment, and achieved an undetectable VL during 6-month follo…
HIV Testing and awareness of HIV status among people who inject drugs in greater Kuala Lumpur, Malaysia
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 Lumpu…
Differences in risk behaviours and HIV status between primary amphetamines and opioid injectors in Estonia and Russia
Drug Treatment Accessed through the Criminal Justice System
Overlooked Threats to Respondent Driven Sampling Estimators
The Role of Internalized Stigma in the Disclosure of Injecting Drug Use Among People Who Inject Drugs and Self-Report as HIV-Positive in Kohtla-Järve, Estonia
Psychiatric Distress, Drug Use, and HIV Viral Load Suppression in Russia
Emergence of methadone as a street drug in St. Petersburg, Russia
Comparison of satisfaction with care between two different models of HIV care delivery in St. Petersburg, Russia
Prior to 2010, medical care for people living with HIV/AIDS was provided at an outpatient facility near the center of St. Petersburg. Since then, HIV specialty clinics have been established in more outlying regions of the city. The study examined the effect of this decentralization of HIV care on patients' satisfaction with care in clinics of St. Petersburg, Russia. We conducted a cross-sectional study with 418 HIV-positive patients receiving car…
Non-fatal overdoses and related risk factors among people who inject drugs in St. Petersburg, Russia and Kohtla-Järve, Estonia
PWID are at high risk for overdose. Effective overdose prevention efforts at the public health scale are therefore warranted
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…
A decline in HIV-infected needles returned to New Haven's needle exchange program
The New Haven needle exchange program experienced a significant decline in the fraction of returned needles containing human immunodeficiency virus 1 (HIV-1) proviral DNA. Is this decline due to the operations of the needle exchange or to a shift in clients? Analysis of demographic and behavioral data revealed that only one variable, the race of participating clients, changed significantly over time. However, HIV-1 prevalences in needles given to…
Police Training to Align Law Enforcement and HIV Prevention
Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed…
A Community Responds to the Covid-19 Pandemic
Effective responses to a global pandemic require local action. In the face of a pandemic or similar emergencies, communities of people who use drugs face risks that result from their ongoing drug use, reduced ability to secure treatment for drug use and correlated maladies, lack of access to preventive hygiene, and the realities of homelessness, street-level policing, and criminal justice involvement. Herein, we document the efforts of a coalitio…
Experiences of stigma, mental health, and coping strategies in Lebanon among Lebanese and displaced Syrian men who have sex with men
Seroprevalence of HIV, Hepatitis B Virus, and HCV Among Injection Drug Users in Connecticut
Objectives. We examined HIV, hepatitis B virus (HBV), and HCV seroprevalence in an interim analysis and the potential risk factors associated with these infections among injection drug users (IDUs) residing in nonurban communities of southwestern Connecticut. Methods. We recruited and interviewed active adult IDUs about their injection-associated risk and conducted serological tests for HIV, HBV, and HCV. Regression analyses were performed to ide…
The Potential for Bridging of HIV Transmission in the Russian Federation
Assessment of HIV Testing of Urban Injection Drug Users
Objectives. We sought to determine the extent of HIV testing among urban injection drug users (IDUs) to assess whether an expansion of targeted testing programs would be consistent with national goals to identify previously undetected infections. Methods. IDUs in 5 US cities (Oakland, Calif; Chicago, Ill; Hartford and New Haven, Conn; and Springfield, Mass) were recruited either by chain referral or time–location sampling. The IDUs were questione…
A tale of two cities
Sexual Partners of Street-Based Female Sex Workers in St. Petersburg, Russia
Street-based sex work in Russia, as in many countries, carries with it a high risk for violence and the transmission of infectious diseases. The male partners of female sex workers are both cause and recipient of such risks. Because little is known about the men, we undertook a preliminary study to determine the feasibility of recruiting and interviewing them, develop typologies that describe partners, and derive hypotheses for further study and …
Potential Bridges of Heterosexual HIV Transmission from Drug Users to the General Population in St. Petersburg, Russia
A decline in HIV-infected needles returned to New Haven's needle exchange program
The New Haven needle exchange program experienced a significant decline in the fraction of returned needles containing human immunodeficiency virus 1 (HIV-1) proviral DNA. Is this decline due to the operations of the needle exchange or to a shift in clients? Analysis of demographic and behavioral data revealed that only one variable, the race of participating clients, changed significantly over time. However, HIV-1 prevalences in needles given to…
Doffing the cap
Effects of Increasing Syringe Availability on Syringe-Exchange Use and HIV Risk
Structural interventions to improve opiate maintenance
Expanding Harm Reduction Services Through a Wound and Abscess Clinic
A wound and abscess clinic, held concurrently with a syringe exchange, provided economical treatment and aftercare for injection-associated soft tissue infections. During 20 two-hour clinic sessions, 173 treatment episodes were logged, and the visit cost was estimated at $5 per patient. Increased patient–clinician interactions provided opportunities beyond those afforded by the syringe exchange for patients to obtain resources and referrals to se…
Maintaining Respectability and Responsibility
Gender-related factors and the social and economic conditions that impact the lives and health of women injection drug users (IDUs) in Chicago are described. Although study participants are highly imaginative and resourceful in terms of income-generating self-sufficiency, they engage in a variety of behaviors that put them at risk of contracting infectious diseases such as HIV and hepatitis B and C viruses. We point out that labor inequalities ex…
Model phobia
Lessons from the Field
Social and behavioral research has made signi?cant contributions to AIDS prevention. These contributions are multiple and have helped to make prevention more effective. Still, interventionists commonly bemoan barriers that diminish timely access to AIDS research ?ndings and recognition of the programmatic and advocacy implications of research ?ndings. This paper responds to these concerns by presenting a set of intervention and policy lessons lea…
Psychosocial and Behavioral Differences Among Drug Injectors who Use and do not Use Syringe Exchange Programs
Assessment of HIV Testing of Urban Injection Drug Users
Objectives. We sought to determine the extent of HIV testing among urban injection drug users (IDUs) to assess whether an expansion of targeted testing programs would be consistent with national goals to identify previously undetected infections. Methods. IDUs in 5 US cities (Oakland, Calif; Chicago, Ill; Hartford and New Haven, Conn; and Springfield, Mass) were recruited either by chain referral or time–location sampling. The IDUs were questione…
High HIV Prevalence, Suboptimal HIV Testing, and Low Knowledge of HIV-Positive Serostatus Among Injection Drug Users in St. Petersburg, Russia
Community coverage and HIV prevention
Social and structural aspects of the overdose risk environment in St. Petersburg, Russia
Potential Bridges of Heterosexual HIV Transmission from Drug Users to the General Population in St. Petersburg, Russia
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…
The Potential for Bridging of HIV Transmission in the Russian Federation
Drug Network Characteristics and HIV Risk Among Injection Drug Users in Russia
HIV Disclosure, Condom Use, and Awareness of HIV Infection Among HIV-Positive, Heterosexual Drug Injectors in St. Petersburg, Russian Federation
We examined the prevalence of HIV disclosure to sexual partners by HIV-positive drug injectors (IDUs) in St. Petersburg, Russia and compared the magnitude and direction of associations of condom use with awareness of one's HIV infection and disclosure to partners. Among 157 HIV-infected participants, awareness of infection at time of last intercourse was associated with condom use with partners perceived to be HIV-negative (aOR 6.68, 95% CI 1.60-…
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…
Police Training to Align Law Enforcement and HIV Prevention
Having identified gaps in implementation of Rhode Island's syringe access law and police occupational safety education, public health and police professionals developed police training to boost legal knowledge, improve syringe access attitudes, and address needlestick injuries. Baseline data (94 officers) confirmed anxiety about needlestick injuries, poor legal knowledge, and occupational risk overestimation. Before training, respondents believed…
Age at First Alcoholic Drink as Predictor of Current HIV Sexual Risk Behaviors Among a Sample of Injection Drug Users (IDUs) and Non-IDUs who are Sexual Partners of IDUs, in St. Petersburg, Russia
Clients of street-based female sex workers and potential bridging of HIV/STI in Russia
In Russia, sexual transmission of HIV is increasing and street-based female sex workers (FSW) have a high HIV prevalence, but the role of male clients of FSW in HIV transmission and bridging to the general population has not been studied. Sixty-two male clients completed structured interviews during February-March of 2010 in St. Petersburg Russia. Descriptive analyses focused on condom use with different types of sex partners, substance use, and …
Sexual Partners of Street-Based Female Sex Workers in St. Petersburg, Russia
Street-based sex work in Russia, as in many countries, carries with it a high risk for violence and the transmission of infectious diseases. The male partners of female sex workers are both cause and recipient of such risks. Because little is known about the men, we undertook a preliminary study to determine the feasibility of recruiting and interviewing them, develop typologies that describe partners, and derive hypotheses for further study and …
Access to syringes for HIV prevention for injection drug users in St. Petersburg, Russia
Trainings for pharmacists need to be conducted to reduce negative attitudes towards IDUs and increase pharmacists' willingness to sell syringes. At a structural level, access to safe injection supplies for IDUs could be increased by including syringes in the federal list of mandatory medical products sold by pharmacies
Associations Between Injection Risk and Community Disadvantage Among Suburban Injection Drug Users in Southwestern Connecticut, USA
Medicine (51 obras) · HIV, Drug Use, Sexual Risk (48 obras) · HIV/AIDS Research and Interventions (32 obras) · Psychiatry (32 obras) · Environmental health (26 obras) · Family medicine (26 obras) · Psychology (24 obras) · Opioid Use Disorder Treatment (21 obras) · Public health (20 obras) · Human immunodeficiency virus (HIV (18 obras)