Online Program

Perceptions of genetic testing and genomic medicine among urban drug users

Tuesday, November 5, 2013 : 3:30 p.m. - 3:50 p.m.

David C. Perlman, MD, Department of Medicine, Mount Sinai Beth Israel, New York, NY
Camila Gelpí-Acosta, M.A., National Development and Rsearch Institutes, Inc., New York, NY
Holly Hagan, PhD, College of Nursing, New York University, New York, NY
Samuel R. Friedman, National Development and Research Institutes, New York, NY
Introduction: Genomic medicine may potentially improve health care. Genetic testing (GT) will soon enter care for HIV, HCV, and addiction. We explored New York City DUs' perceptions of GT and genomic medicine.

Methods: Six focus groups (FGs) were conducted with active DUs recruited from syringe exchanges and an HIV clinic. Individual interviews were conducted with 3 FG participants who reported previous GT and with 6 young illicit prescription opioids users.

Results: Of 40 participants, 50% were female; 10 Black, 14 Hispanic and 16 white; average age 43 years. Most had some awareness of GT, with television, prison and paternity testing the main sources of awareness. Some reported GT while in prison. All participants expressed support for GT if it improved treatment, but most had concerns regarding confidentiality and stigma Many were dubious about race-based GT/treatment (“race pills”) not understanding why efficacious treatments might not work for all groups (“we are all humans”); most expressed more comfort with treatments based on individual level GT vs. inferring outcomes based on race/ethnicity. Participants were generally more comfortable with GT in medical care than in drug treatment, citing disbelief that addiction is genetically based. GT-experienced peers were identified as important sources of trust in GT.

Conclusions: Although these DUs had a general sense of the potential value of genetic testing, concerns regarding breaches in confidentiality, stigma, and discrimination may reduce willingness to be tested. Safeguards against these risks, and peer outreach, may be critical in efforts to increase GT among DUs.

Learning Areas:

Assessment of individual and community needs for health education
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Provision of health care to the public

Learning Objectives:
Describe the perceptions urban drug users have of genetic testing and genomic medicine. Identify some potential barriers and facilitators to incorporating genetic tetsing and advances in genomic medicine to the care of drug users.

Keyword(s): Genetics, Drug Use

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have the principal or co-principal investigator on many federally funded grants on a range of many issues related to the medical care of drug users, including HIV and HCV infection and the integration of medical services in for drug users in drug treatment and other settings and I have particular expertise in sociobehavioral studies of new biomedical approaches.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.