Depressive Symptoms, Drug Network, and Their Synergistic Effect on Needle-Sharing Behavior Among Street Injection Drug Users

Abstract

In this study, we examined the relationship between depressive symptoms and needle-sharing behavior in a community sample of intravenous drug users (N = 499) in Baltimore, Maryland. Based on the polytomous logistic regression, higher depressive symptoms were positively associated both with needle sharing after cleaning with bleach and with needle sharing without first cleaning with bleach at the bivariate analyses. This relationship remained significant (OR = 1.66) even after adjusting for demographic characteristics, life events, drug use patterns, and social and drug networks. A significant synergistic effect of depressive symptoms and drug network on needle sharing after cleaning with bleach and needle sharing without cleaning was observed. More depressed intravenous drug users who also had a larger drug network were found to be at higher risk of needle sharing after cleaning with bleach, as well as needle sharing without cleaning (OR = 2.59). Depression status is discussed as a predisposing factor and drug network size as a precipitating factor for needle-sharing behavior. Implications for preventing needle-sharing behavior by reducing depressive symptoms are discussed.

Differing HIV Risks and Prevention Needs among Men and Women Injection Drug Users (IDU) in the District of Columbia

“…We found that men experienced HIV risk behaviors as well, with increased homelessness and incarceration relative to women, though these differences were attenuated after adjustment for confounders; indeed, the constellation of psychosocial issues including depression was greater among women than men, as other authors have found. 7,41,[44][45][46] Other authors have noted differences in injection rituals, practices, and injection partner selection between men and women 7,10,14,15,17,39 ; identification of needs that are fulfilled by such practices and that drive their selection, may inform development of innovative prevention approaches developed specifically for women. Our findings echo those of other authors, with some differences: in a convenience sample of younger IDU, Doherty et al 15,16 found women had elevated risk of HIV and while they had similar patterns of injection initiation, women were no more likely to be injected by sex partners at injection initiation.…”

The Effect of Intimate Partner Violence on Receptive Syringe Sharing Among Young Female Injection Drug Users: An Analysis of Mediation Effects

“…Female IDUs' self-efficacy for safer drug injection may be inhibited by a violent and/or controlling partner, thereby influencing syringe sharing. Similarly, studies have identified depression as a correlate of both syringe sharing (Johnson et al 2002;Mandell et al 1999;Perdue et al 2003;Stein et al 2004;Strathdee et al 1997) and IPV (Bonomi et al 2006;Lehrer et al 2006), suggesting its role as a mediator of the relationship between IPV and HIV risk. Finally, IPV has been associated with reductions in self-esteem (Zlotnick et al 2006), perhaps due to the social isolation resulting from victimization (Miller 1999.…”

Increasing Hepatitis C Knowledge Among Homeless Adults: Results of a Community-Based, Interdisciplinary Intervention

“…32,37,38 Poor coping behaviors such as use of drugs or alcohol are common and are associated with more risky behaviors for HCV infection. [39][40][41] A metaanalysis of interventions to prevent HCV seroconversion among IDUs indicated that multidisciplinary programs may be more beneficial than single intervention programs. 42 For instance, an HCV intervention program for homeless youth, focusing on problem solving skills and strategies to remain HCV uninfected, produced a 29 % greater decline in overall injection risk 6 months post-intervention relative to the control group.…”