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Open research questions in HIV, Drug Use, Sexual Risk

99 unresolved questions extracted from the limitations and future-work sections of 1,690 HIV, Drug Use, Sexual Risk papers in our library. Each links back to the study that raised it.

What the literature leaves open

  • Despite escalating drug misuse in urban Ghana, integrated evidence on the drug-RSB-STI triad remains scarce, particularly for opioid substances such as tramadol and for the full spectrum of RSB practices.

    SUBSTANCE USE AS A PREDICTOR OF RISKY SEXUAL BEHAVIOR AND STI RISK AMONG URBAN YOUTH IN GHANA · 2026 · DOI

  • Although harm reduction strategies, such as syringe exchange and supervised consumption sites, have demon- strated strong evidence in reducing overdose deaths and infections such as HIV, hepatitis C, and syphilis, government responses in Mexico remain unclear and inconsistent.

    Qualitative-Intersectional Analysis of Access to Health Care for Pregnant Women Who Use Injectable Drugs in Mexico · 2026 · DOI

  • This study has several limitations that must be acknowl- edged. First, the sample size was small, comprising three PGWIDs and three key informants. However, this limita- tion reflects the reality that pregnant and formerly pregnant women who inject drugs are a highly mobile and marginal- ized population. According to data from the civil society organization Verter, they typically engage with only one or two PGWIDs per year, most of whom move frequently between cities. While previous studies have included a wider range of sample sizes—from single case studies (Griffiths et al., 2021) to over 300 participants (Cornford et al., 2015)—they consistently highlight the challenges of accessing this population through conventional research strategies. Second, recruitment relied on facility-based and chain sampling and existing relationships with a harm reduction organization, which may limit the diversity of participant experiences. Nonetheless, the goal of this research was not generalizability, but rather to explore the lived experi- ences of PGWIDs in depth, using a feminist qualitative and phenomenological approach. We do not consider our previous connection with Verter to be a weakness or limitation, given that it is one of only three organizations nationwide whose goal is harm reduc- tion and the only one at the local level. However, although we acknowledge that collaboration with Verter A.C. was essential for the study, it may have introduced selection bias. The participants recruited were already engaged in harm reduction, which could influence a more critical view of conventional health services compared to women who do not receive support from civil society. However, it was this collaboration that created the rapport necessary to address highly sensitive issues that would otherwise be inaccessible. An additional limitation is the absence of interviews with a broader range of public-sector health providers, such as staff from primary care clinics, maternity hospi- tals, or HIV treatment centers. While the inclusion of one nursing informant provided partial institutional insight, the lack of perspectives from other providers limits the ability to fully capture institutional constraints, decision-making processes, and systemic pressures shaping PGWIDs’ access to care. Finally, the lack of existing protocols and ethical guide- lines in Mexico for working with PGWIDs during pregnancy adds further complexity to both data collection and par- ticipant care. Future research should prioritize long-term, trust-based relationships with community organizations and employ participatory methods that center the voices of PGWIDs throughout all stages of the research process. Acknowledgements Authors acknowledge Integración Social Verter A.C. for all their support for the development of the study as well as the women who share their experiences. Author Contribution FAA collected and analyzed the data and drafted the work. VRAA conceptualized the study and developed methodology analyzed the data and drafted the work. MOG collected and analyzed the data. LAC, VMC and TMA analyzed the data and drafted the work. VMC drafted the work. Funding Not applicable. Data Availability Not applicable.

    Qualitative-Intersectional Analysis of Access to Health Care for Pregnant Women Who Use Injectable Drugs in Mexico · 2026 · DOI

  • Findings revealed that there is no standardized treatment specifically for women, and the available government treatment facility in Limpopo Province is not sufficient for the demand that arises from women in need of SUD treatment services.

    Social workers’ perspectives on the availability and scope of substance use disorder treatment for women in South Africa · 2026 · DOI

  • INTRODUCTION: Community Safety Response (CSR) programs increasingly provide non-police alternatives to behavioral health crises, but their role in addressing substance use calls remains poorly understood.

    Access to non-police crisis response for people who use drugs: lessons from community safety response programs in two U.S. cities · 2026 · DOI

  • The results of this study should be interpreted in the context of several limitations. First, as with all survey studies, N-SUMHSS data are subject to recall bias. Next, N-SUMHSS wording in querying PrEP availability may also represent a limitation because it did not explicitly mention PrEP for HIV prevention. However, the 2 oral antiretroviral drugs approved for HIV PrEP are mentioned in the question text that likely mitigated misunderstanding. The N- SUMHSS did not include LAI-cabotegravir for PrEP, which is another limitation. Furthermore, specific details about the types of service and content of programming that is provided for specific groups (eg, young adults, LGBTQ people) were removed from the N-SUMHSS data release, which limits interpretation of these associations. 27 Finally, although the N-SUMHSS is a comprehensive survey with a high response rate, it does not capture every substance use and mental health care facility in the United States nor does it represent sole practitioner or small group practices. These additional practice settings may be additional points of access for screening and PrEP prescription and additional work is needed to fully  Journals (/journals)   characterize service availability and to assess the implementation context of colocation within care for StUD.

    Availability of Screening for Blood-Borne Viruses, Sexually Transmitted Infections, and HIV Pre-Exposure Prophylaxis at US Substance Use Treatment Facilities Treating Stimulant Use Disorder · 2026 · DOI

  • The PWID in this study reported that they require very limited information in their everyday lives and consult mainly other PWID and NGO workers to meet their information needs.

    Everyday Life Information Behavior, Health Information Seeking, and HIV and STI Awareness Among People Who Inject Drugs (PWID) · 2025 · DOI

  • While recent work has considered harm reduction for IPED users, the geographic and cultural impacts of rurality on IPED use and harms, particularly in relation to harm reduction service access, remains comparatively under-explored.

    Exploring the Impacts of Rurality on Service Access and Harm Among Image and Performance Enhancing Drug (IPED) Users in a Remote English Region · 2023 · DOI

  • Results indicate that, predominantly, staff opposition to PNEP is rooted in safety concerns, a perceived lack of evidence of PNEP’s benefits, and fears the program is not promoting recovery and rehabilitation.

    “That’s Not Rehabilitation, That’s Enabling”: Correctional Officer Perspectives on the Prison Needle Exchange Program · 2023 · DOI

  • Future research should explore whether the risk environment features identified also influence SSP fidelity in other rural areas and develop and test strategies to strengthen core components in these vulnerable areas.

    A qualitative analysis of rural syringe service program fidelity in Appalachian Kentucky: Staff and participant perspectives · 2022 · DOI

  • The current study seeks to address this gap in research by providing a county‐level longitudinal analysis of immigration and drug overdose deaths both overall and by substance type for the 2000 to 2015 period and provides an analysis of homicide for comparison with prior immigration–crime research.

    More immigrants, less death: An analysis of immigration effects on county‐level drug overdose deaths, 2000–2015 · 2022 · DOI

  • In the UK, there have been two high-profile recommendations for the piloting of DCRs, which have been rejected by the government for a number of reasons, including lack of evidence, legal problems, and negative media responses.

    Similar problems, divergent responses: drug consumption room policies in the UK and Germany · 2016 · DOI

  • Issues of concern were; no due legal process for the detention of drug users, lack of evidence-based drug treatment, lack of HIV prevention and treatment, abusive conditions, forced labour and exercise, arbitrary exit procedures and very high relapse rates.

    Compulsory treatment of drug users in Asia: designed to torture? · 2015 · DOI

  • As of 2013, medical marijuana is legal in 20 states and the District of Columbia, but few studies have investigated the consequences of the retail centers that sell the drug.

    Do medical marijuana centers behave like locally undesirable land uses? Implications for the geography of health and environmental justice · 2014 · DOI

  • Analyzing needle exchange from a morality policy perspective, focusing on the 21-year ban on federal funding for needle exchange, reveals how value-based arguments have been used in the needle exchange debate and explains why the issue is likely to remain controversial in the United States.

    Clean Needles and Bad Blood: Needle Exchange as Morality Policy · 2012 · DOI

  • To date, however, the effectiveness and efficacy of VRSDT has not been fully determined due to two main factors: 1) school districts just recently started to implement VRSDT; and 2) many researchers have assumed that all drug-testing are similar.

    Voluntary, Randomized, Student Drug-Testing: Impact in a Rural, Low-Income, Community. · 2008

  • ABSTRACT In the United Kingdom (UK) and elsewhere, little is known about problematic drug use among older people (defined here as aged 50–74 years), either because few older drug users exist or because they represent a ‘hidden’ population.

    Problematic drug use, ageing and older people: trends in the age of drug users in northwest England · 2007 · DOI

  • SUMMARY Following a 2003 community forum on unsafe sexual practices among gay men, a follow up community forum was held on February 8, 2004 to address the insufficiently studied linkage between unsafe sexual practices, HIV transmission and crystal methamphetamine abuse.

    A Public Forum– Challenging the Culture of Disease: The Crystal Meth-HIV Connection · 2006 · DOI

  • Despite several provisions within PRWORA that focus on the use of illegal drugs, few studies have attempted to identify the prevalence of illegal drug use among welfare recipients.

    Comparing Drug Use between Welfare-Receiving Arrestees and Non-Welfare-Receiving Arrestees · 2002 · DOI

  • However, little is known about specific interpersonal acts of violence perpetrated by male and female crack users or the association of HIV risk behavior with interpersonal violence among male and female crack users.

    Violence and HIV Risk Behavior among Male and Female Crack Users · 2000 · DOI

  • While many studies examine factors related to drug use practices and AIDS among young and middle-aged substance abusers, few studies have considered how HIV is contracted or experienced among older addicts.

    AIDS and Injecting Drug Use in Later Life · 1998 · DOI

  • Despite the central role played by female intravenous drug users (IVDUs) in the worsening AIDS statistics of states in the northeastern United States, the relative paucity of research into the HIV risk behaviors--particularly risky needle practices--of female drug injections has left significant gaps in researchers' understanding of how and to what extent such women may differ in their risks from their better-studied male counterparts.

    A Comparison of Male and Female Intravenous Drug Users' Risk Behaviors for HIV Infection · 1994 · DOI

  • The overall strategies for research into dependence were examined in a paper by Dr D. C. Cameron. He suggested that there was a particular need for intensified research efforts in the following important areas (1) the effects on man of taking dependence-producing drugs, (2) the natural history of drug taking (particularly with use for long periods of time), (3) the effectiveness of various preventive treat- ment, and rehabilitation measures, and (4) means of identifying substances that, because of their dependence-producing properties, are apt to lead to sufEciently adverse effects in man to constitute individual or public health problems. Suxt&inary The changes in the United Kingdom are not isolated changes, but part of a world wide pattern. In many countries there is evidence of an increase in the misuse of psycho-active drugs. This type of misuse can perhaps be described as drug use for "recreational" purposes, in that these are drugs taken for other reasons than therapeutic treatment. Where there has been an increase in travel and communica- tion there has been an increase in the use of cannabis and there is evidence of an increase in misuse of "hard" drugs taken intravenously in many countries. The use of drugs appears to be part of a wider social change with changes in the attitudes of some young people to social institutions. It would appear that in many countries young people are prepared to experiment with drugs which causes alteration in consciousness. Among many young people there is a readiness to find out personally what the effects of drugs will be. There is evidence of increasing overdoses of sedatives for non-suicidal purposes, misuse of stimulants in athletics and misuse of drugs in certain subcultural groups, such as criminals. Although the number of people misusing drugs in most European countries remains small in absolute terms, nevertheless, there has been an increase (in some areas very marked), and a change in the type of drug dependence. The situation is in many ways similar to that in England and Scandinavian countries ten years ago, where small changes in patterns of abuse led to an escalation in the number of people misusing drugs, particularly young people. It does not appear that any of the changes that have occurred can easily be reversed, and it may be that we will have to live with drug dependence (on the socially unacceptable drugs) in the way we live with drug dependence on the socially acceptable ones (alcohol and tobacco).

    Afterword · 1972 · DOI

  • ConclusionTramadol is an underrecognized and high-magnitude driver of sexual risk in urban Ghana.

    SUBSTANCE USE AS A PREDICTOR OF RISKY SEXUAL BEHAVIOR AND STI RISK AMONG URBAN YOUTH IN GHANA · 2026 · DOI

  • Abstract Background Despite increased methamphetamine-related harms in Australia, little is known about healthcare contacts amongst those who die from methamphetamine-related causes.

    Acute health service use among people who died from methamphetamine-related causes in New South Wales and Victoria · 2026 · DOI

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