{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:23:27Z","timestamp":1782361407744,"version":"3.54.5"},"reference-count":51,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Public Health Rep"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Hepatitis C virus (HCV) and HIV transmission in the United States may increase as a result of increasing rates of opioid use disorder (OUD) and associated injection drug use (IDU). Epidemiologic trends among American Indian\/Alaska Native (AI\/AN) persons are not well known.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 2010-2014 Indian Health Service data on health care encounters to assess regional and temporal trends in IDU indicators among adults aged \u226518 years. IDU indicators included acute or chronic HCV infection (only among adults aged 18-35 years), arm cellulitis and abscess, OUD, and opioid-related overdose. We calculated rates per 10\u2009000 AI\/AN adults for each IDU indicator overall and stratified by sex, age group, and region and evaluated rate ratios and trends by using Poisson regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Rates of HCV infection among adults aged 18-35 increased 9.4% per year, and rates of OUD among all adults increased 13.3% per year from 2010 to 2014. The rate of HCV infection among young women was approximately 1.3 times that among young men. Rates of opioid-related overdose among adults aged &lt;50 years were approximately 1.4 times the rates among adults aged \u226550 years. Among young adults with HCV infection, 25.6% had concurrent OUD. Among all adults with arm cellulitis and abscess, 5.6% had concurrent OUD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Rates of HCV infection and OUD increased significantly in the AI\/AN population. Strengthened public health efforts could ensure that AI\/AN communities can address increasing needs for culturally appropriate interventions, including comprehensive syringe services programs, medication-assisted treatment, and opioid-related overdose prevention and can meet the growing need for treatment of HCV infection.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0033354920937284","type":"journal-article","created":{"date-parts":[[2020,7,7]],"date-time":"2020-07-07T10:45:53Z","timestamp":1594118753000},"page":"461-471","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Trends in Indicators of Injection Drug Use, Indian Health Service, 2010-2014"],"prefix":"10.1177","volume":"135","author":[{"given":"Mary E.","family":"Evans","sequence":"first","affiliation":[{"name":"Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Division of HIV\/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marissa","family":"Person","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brigg","family":"Reilley","sequence":"additional","affiliation":[{"name":"Northwest Portland Area Indian Health Board, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Leston","sequence":"additional","affiliation":[{"name":"Northwest Portland Area Indian Health Board, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Haverkate","sequence":"additional","affiliation":[{"name":"Indian Health Service, Rockville, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey T.","family":"McCollum","sequence":"additional","affiliation":[{"name":"Indian Health Service, Rockville, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2440-9700","authenticated-orcid":false,"given":"Andria","family":"Apostolou","sequence":"additional","affiliation":[{"name":"Indian Health Service, Rockville, MD, USA"},{"name":"SciMetrika LLC, McLean, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele K.","family":"Bohm","sequence":"additional","affiliation":[{"name":"Division of Unintentional Injury Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Van Handel","sequence":"additional","affiliation":[{"name":"National Centers for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danae","family":"Bixler","sequence":"additional","affiliation":[{"name":"Division of Viral Hepatitis, National Centers for HIV\/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Mitsch","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana L.","family":"Haberling","sequence":"additional","affiliation":[{"name":"Division of High-Consequence Pathogens and Pathology, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4967-3463","authenticated-orcid":false,"given":"Sarah M.","family":"Hatcher","sequence":"additional","affiliation":[{"name":"Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA"},{"name":"Northwest Portland Area Indian Health Board, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Weiser","sequence":"additional","affiliation":[{"name":"Indian Health Service, Portland, OR, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Elmore","sequence":"additional","affiliation":[{"name":"Division of HIV\/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eyasu 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Accessed April 20, 2020. https:\/\/www.census.gov\/history\/pdf\/c2010br-10.pdf"}],"container-title":["Public Health Reports\u00ae"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354920937284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0033354920937284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0033354920937284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:36:16Z","timestamp":1777628176000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0033354920937284"}},"subtitle":["A Study of Health Care Encounter Data"],"short-title":[],"issued":{"date-parts":[[2020,7]]},"references-count":51,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2020,7]]}},"alternative-id":["10.1177\/0033354920937284"],"URL":"https:\/\/doi.org\/10.1177\/0033354920937284","relation":{},"ISSN":["0033-3549","1468-2877"],"issn-type":[{"value":"0033-3549","type":"print"},{"value":"1468-2877","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,7]]}}}