Changing Trends of Drug Initiation among People who Inject Drugs in the ALIVE Study

PWID;Infectious Diseases;HIV;AIDS;not listed

Cotarelo, Adrian AntonioMehta, Shruti H. ;

Johns Hopkins University

关键词: PWID;    Infectious Diseases;    HIV;    AIDS;    not listed;   

Others  :  https://jscholarship.library.jhu.edu/bitstream/handle/1774.2/39402/COTARELO-THESIS-2015.pdf?sequence=1&isAllowed=y

瑞士|英语

来源: JOHNS HOPKINS DSpace Repository

【 摘 要 】

This study assessed whether or not the initial drugs and routes of administrations of people who inject drugs (PWID) in Baltimore have changed over time.With over 2 million PWID in North America, injection drug use is an important public health problem.Recent studies suggest that the pathway towards injection drug use is changing, with younger PWID having first abused prescription opioids rather than non-injected cocaine or heroin, which has been the traditional pathway.In this study we characterized 1,005 participants of the AIDS Linked to the IntraVenous Experience (ALIVE) study, a community-based cohort of current and former PWID in Baltimore. We identified three distinct patterns of drug use initiation: those who initiated directly with injection drugs, those who initiated drug use with non-injected cocaine or heroin, and those who initiated with prescription opioid use.Of the 1005 participants, 211 (21%) initiated drug use with prescription opioid pills, 605 (60%) initiated with non-injected cocaine or heroin, and 189 (19%) directly with injection drug use (56% with heroin, 28% with cocaine and 16% with a combination of cocaine and heroin).Demographic and risk behaviors were compared across drug initiation groups. Participants 33 years of age were significantly more likely to have initiated with non-injected cocaine or heroin, or directly with injection drug use, while younger participants (25 years of age) were more likely to initiate with prescription pills obtained on the street. While time to injection drug use initiation was not significantly different across groups, participants who initiated with prescription opioid use differed with respect to other factors.Participants who initiated drug use with prescription drugs were mostly white, younger than those who initiated via injected drug use, and had a lower prevalence of HIV and HCV infections compared to those who initiated via non-injected cocaine or heroin.One limitation of this study is that as we only observed PWID, there may be people abusing prescription opioids who do not transition to injection drug use.Future studies should observe this transition more closely, and physicians and public health practitioners should be aware of these changing trends in injection drug use initiation.