Correlates of Injection Drug Use Among Rural Appalachian Women

Abstract

This study makes an important contribution to understanding factors associated with IDU among rural Appalachian women drug users, which are strongly associated with both relational and health factors. Study findings on the specific factors associated with IDU risk have important implications for tailoring and targeting interventions that should include a focus on the relationship context reducing high-risk injection practices.

Partner Relationships and Injection Sharing Practices among Rural Appalachian Women

“…These covariates were selected for their potential association with IDU practices and relationship power (e.g., Staton et al, 2017). Race was not included as a covariate because all but two participants were White/Caucasian (99.0%).…”

HIV Prevention in Rural Appalachian Jails: Implications for Re-entry Risk Reduction Among Women Who Use Drugs

“…Randomly selected women were screened for drug use and risky sexual practices using standardized criteria which included: 1) moderate need for substance misuse intervention based on the NIDA-modified Alcohol, Smoking and Substance Involvement Screening Test (NM-ASSIST) score of 4+ for any drug (32); 2) self-reported sexual risk behavior in the 3 months before incarceration (i.e., unprotected sex, sex while high); 3) residing in a designated Appalachian county before incarceration; and 4) willingness to participate. Participant enrollment is described in the study CONSORT (See Figure 1; see also [2]). During the study recruitment phase between December 2012 and August 2015, 900 women were randomly selected, 688 (76.4%) participated in the study screening sessions in the jails, 440 (64%) met study criteria for study enrollment, and 400 completed a baseline interview.…”

“…Random selection, screening, and interviewing procedures are described in detail elsewhere (2). In summary, this study used a random sampling approach to recruit hard-to-reach, out-of-treatment, rural drug-using women in three Appalachian area jails.…”

“…The opioid epidemic is also associated with increased rates of injection drug use (IDU) in rural areas of Appalachian, particularly in Kentucky (2), as well as alarming trends in infectious disease transmission [such as Hepatitis C (HCV)] (3, 4, 5, 6). In fact, Kentucky (KY) had the highest proportionate rate of new HCV infections in the nation from 2008–2015 (3) and an overall prevalence rate nearly seven times higher than the national average (6).…”

Portraying a More Complete Picture of Illicit Drug Use Epidemiology and Policy for Rural America: A Competing Viewpoint to the CDC's MMWR Report

“…Illicit drug use poses other serious public health concerns in rural America, as pointed out in the article by Staton and associates. 5 They found an alarmingly high rate of injection drug use, which has been found to be associated with Hepatitis C and HIV transmission, among women in rural jails in the Appalachian region of Kentucky. The paper by Brown and colleagues shows that neonatal abstinence syndrome (NAS) rates are substantially higher in rural than large metropolitan areas nationally.…”