Addiction Science & Clinical Practice | |
Age and sharing of needle injection equipment in a cohort of Massachusetts injection drug users: an observational study | |
Katherine Tassiopoulos1  Judith Bernstein2  Edward Bernstein3  | |
[1] Department of Epidemiology, Harvard School of Public Health, 677 Huntington Ave., Boston MA, USA | |
[2] Department of Community Health Sciences, Boston University School of Public Health, 801 Massachusetts Ave., Boston MA, USA | |
[3] Department of Emergency Medicine, Boston University School of Medicine, Boston Medical Center, 1 Boston Medical Center Place, Boston MA, USA | |
关键词: Hepatitis C; Young age; Injection equipment sharing; Injection drug use; | |
Others : 789282 DOI : 10.1186/1940-0640-8-20 |
|
received in 2013-02-08, accepted in 2013-12-02, 发布年份 2013 | |
【 摘 要 】
Background
Hepatitis C infection (HCV) among individuals aged 15–24 years has increased in Massachusetts, likely due to injection drug use. The prevalence of injection equipment sharing (sharing) and its association with age was examined in a cohort of out-of-treatment Massachusetts substance users.
Methods
This analysis included baseline data from a behavioral intervention with substance users. Younger and older (<25 versus ≥25 years) injection drug users were compared on demographic characteristics, substance use practices, including factors present during the most recent sharing event (“event-level factors”), and HCV testing history.
Results
Sharing was reported by 41% of the 484 individuals who reported injection drug use in the past 30 days. Prevalence of sharing varied by age (50% <25 years old versus 38% ≥25 years, p = 0.02). In a multivariable logistic regression model younger versus older individuals had twice the odds of sharing (95% CI = 1.26, 3.19). During their most recent sharing event, fewer younger individuals than older had their own drugs available (50% versus 75%, p < 0.001); other injection event-level factors did not vary by age. In the presence of PTSD, history of exchanging sex for money, or not being US born, prevalence of sharing by older users was higher and was similar to that of younger users, such that there was no association between age and sharing.
Conclusions
In this cohort of injection drug users, younger age was associated with higher prevalence of sharing, but only in the absence of certain stressors. Harm reduction efforts might benefit from intervening on mental health and other stressors in addition to substance use. Study findings suggest a particular need to address the dangers of sharing with young individuals initiating injection drug use.
【 授权许可】
2013 Tassiopoulos et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20140704173428233.pdf | 206KB | download |
【 参考文献 】
- [1]Centers for Disease Control and Prevention (CDC): Hepatitis C virus infection among adolescents and young adults—Massachusetts, 2002–2009. MMWR Morb Mortal Wkly Rep 2011, 60:537-541.
- [2]National Drug Intelligence Center, US Department of Justice: National Drug Threat Assessment 2010. 2010. [http://www.justice.gov/archive/ndic/pubs38/38661/ webcite]
- [3]Hagan H, Thiede H, Weiss NS, Hopkins SG, Duchin JS, Alexander ER: Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health 2001, 91:42-46.
- [4]Latkin C, Buchanan A, Metsch L, Knight K, Latka M, Mizuno Y, Knowlton A, for the Intervention for Seropositive Injectors-Research Evaluation Team: Predictors of sharing injection equipment by HIV-seropositive injection drug users. J Acquir Immune Defic Syndr 2008, 49:447-450.
- [5]Stein M, Solomon D, Herman D, Anderson B, Miller I: Depression severity and drug injection HIV risk behaviors. Am J Psychiatry 2003, 160:1659-1662.
- [6]Delgado M, Lundgren L, Deshpande A, Lonsdale J, Purington T: The association between acculturation and needle sharing among Puerto Rican injection drug users. Eval Program Plann 2008, 31:83-91.
- [7]Booth R, Kwiatkowski C, Mikulich-Gilbertson S, Brewster J, Salomonsen-Sautel S, Corski K, Sinitsyna L: Predictors of risky needle use following interventions with injection drug users in Ukraine. Drug Alcohol Depend 2006, 82(Suppl 1):49-55.
- [8]Buxton M, Vlahov D, Strathdee C, Des Jarlais D, Morse E, Ouellet L, Kerndt P, Garfein R: Association between injection practices and duration of injection among recently initiated injection drug users. Drug Alcohol Depend 2004, 75:177.
- [9]De P, Cox J, Boivin J, Platt R, Jolly A, Alexander P: HIV and HCV discordant injecting partners and their association to drug equipment sharing. Scand J Infect Dis 2009, 41:206-214.
- [10]Mandell W, Vlahov D, Latkin C, Oziemkowska M, Cohn S: Correlates of needle sharing among injection drug users. Am J Public Health 1994, 84:920-923.
- [11]Metsch L, Pereyra M, Purcell D, Latkin C, Malow R, Gomez C, Latka M, for the INSPIRE Study Team: Correlates of lending needles/syringes among HIV-seropositive injection drug users. J Acquir Immune Defic Syndr 2007, 46(Suppl 2):72-79.
- [12]Seal K, Edlin B, Ochoa K, Tulsky J, Moss A, Hahn J: Risk of hepatitis B infection among young injection drug users in San Francisco: opportunities for intervention. West J Med 2000, 172:16-20.
- [13]Watters J, Estilo M, Clark G, Lorvick J: Syringe and needle exchange as HIV/AIDS prevention for injection drug users. JAMA 1994, 271:115-120.
- [14]Doherty M, Garfein R, Monterosso E, Brown D, Vlahov D: Correlates of HIV infection among young adult short-term injection drug users. AIDS 2000, 14:717-726.
- [15]Garfein R, Doherty M, Monterroso E, Thomas D, Nelson K, Vlahov D: Prevalence and incidence of hepatitis C virus infection among young adult injection drug users. J Acquir Immune Defic Syndr Hum Retrovirol 1998, 18(Suppl 1):11-199.
- [16]Miller CL, Johnston C, Spittal PM, Li K, LaLiberte N, Montaner J, Schechter M: Opportunities for prevention: hepatitis C prevalence and incidence in a cohort of young injection drug users. Hepatol 2002, 36:737-742.
- [17]Bernstein E, Bernstein J, Levenson S: Project ASSERT: an ED based intervention to increase access to primary care, preventive services, and the substance abuse treatment system. Ann Emerg Med 1997, 30:181-189.
- [18]Skinner HA: The Drug Abuse Screening Test (DAST-10): Guidelines for administration and scoring. Toronto: Addiction Research Foundation; 1995.
- [19]Bernstein E, Ashong D, Heeren T, Winter M, Bliss C, Madico G, Bernstein J: The impact of a brief motivational intervention on unprotected sex and sex while high among drug-positive emergency department patients who receive STI/HIV VC/T and drug treatment referral as standard of care. AIDS Behav 2012, 16:1203-1216.
- [20]Ruggiero KJ, DelBen K, Scotti JR, Rabalais AF: Psychometric properties of the PTSD checklist-civilian version. J Trauma Stress 2003, 16:495-502.
- [21]Lankenau S, Teti M, Silva K, Bloom J, Harocopos A, Treese M: Initiation into prescription opioid misuse among young injection drug users. Int J Drug Policy 2012, 23:37-44.
- [22]Page K, Morris M, Hahn J, Maher L, Prins M: Injection drug use and hepatitis C virus infection in young adult injectors: using evidence to inform comprehensive prevention. Clin Infect Dis 2013, 57(Suppl 2):32-38.
- [23]Peters A, Davies T, Richardson A: Multi-site samples of injecting drug users in Edinburgh: prevalence and correlates of risky injecting practices. Addiction 1998, 93:253-267.
- [24]Costenbader EC, Astone NM, Latkin CA: The dynamics of injection drug users’ personal networks and HIV risk behaviors. Addiction 2006, 101:1003-1013.
- [25]Hoffmann JP, Su SS, Pach A: Changes in network characteristics and HIV risk behavior among injection drug users. Drug Alcohol Depend 1997, 46:41-51.
- [26]Zerden L, López LM, Lundgren L: Needle sharing among Puerto Rican injection drug users in Puerto Rico and Massachusetts: place of birth and residence matter. Subst Use Misuse 2010, 45:1605-1622.
- [27]Centers for Disease Control and Prevention (CDC): HIV-associated behaviors among injecting-drug users – 23 cities, United States, May 2005-February 2006. MMWR Morb Mortal Wkly Rep 2009, 58:329-332.
- [28]Des Jarlais D, Diaz T, Perlis T, Vlahov D, Maslow C, Latka M, Rockwell R, Edwards V, Friedman S, Monterroso E, Williams I, Garfein R: Variability in the incidence of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infection among young injecting drug users in New York City. Am J Epidemiol 2003, 157:467-471.
- [29]Thorpe L, Ouellet L, Hershow R, Bailey S, Williams I, Williamson J, Monterroso E, Garfein R: Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. Am J Epidemiol 2002, 155:645-653.