Individual and Socio-Environmental Factors Associated with Unsafe Injection Practices Among Young Adult Injection Drug Users in San Diego

Muñoz, Fátima; Burgos, José Luis; Cuevas-Mota, Jazmine; Teshale, Eyasu H.; Garfein, Richard S.

doi:10.1007/s10461-014-0815-y

Cited by 20 publications

(24 citation statements)

References 54 publications

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“…In most high- and middle-income countries, hepatitis C virus (HCV) transmission occurs primarily through the direct and indirect sharing of contaminated needles/syringes and ancillary drug injecting equipment (Hagan et al, 2010; Nelson et al, 2011; Thorpe et al, 2002). Many structural and social constraints impact access to sterile injecting equipment, resulting in injection equipment sharing rates between 30–70% among people who inject drugs (PWID; Bruneau et al, 2008; Munoz et al, 2014; Pouget et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

More than just someone to inject drugs with: Injecting within primary injection partnerships

Morris¹,

Bates²,

Andrew

et al. 2015

Drug and Alcohol Dependence

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Background Studies have shown intimate injection partners engage in higher rates of syringe and injecting equipment sharing. We examined the drug use context and development of injection drug use behaviors within intimate injection partnerships. Methods In-depth interviews (n=18) were conducted with both members of nine injecting partnerships in Sydney, Australia. Content analysis identified key domains related to the reasons for injecting with a primary injection partner and development of drug injection patterns. Main Findings Most partnerships (n=5) were also sexual; three were blood-relatives and one a friend dyad. The main drug injected was heroin (66%) with high rates of recent sharing behaviors (88%) reported within dyads. Injecting within a primary injection partnership provided perceived protection against overdose events, helped reduce stress, increased control over when, where, and how drugs were used, and promoted the development of an injecting pattern where responsibilities could be shared. Unique to injecting within primary injection partnerships was the social connection and companionship resulted in a feeling of fulfillment while also blinding one from recognizing risky behavior. Conclusions Findings illuminated the tension between protection and risks within primary injection partnerships. Primary injection partnerships provide a potential platform to expand risk reduction strategies.

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Section: Introductionmentioning

confidence: 99%

More than just someone to inject drugs with: Injecting within primary injection partnerships

Morris¹,

Bates²,

Andrew

et al. 2015

Drug and Alcohol Dependence

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“…We focused on individual and socio-environmental variables as these have been associated with a variety of drug use behaviours in this setting, including cross-border IDU (e.g. Munoz, Burgos, Cuevas-Mota, Teshale, & Garfein, 2015; Ramos et al, 2009; Volkmann et al, 2011; K. D. Wagner et al, 2012).…”

Section: Methodsmentioning

confidence: 99%

Cross-border injection drug use and HIV and hepatitis C virus seropositivity among people who inject drugs in San Diego, California

Horyniak

Wagner

Armenta

et al. 2017

International Journal of Drug Policy

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Background The prevalence of HIV and Hepatitis C Virus (HCV) are significantly lower among people who inject drugs (PWID) in San Diego, CA, USA compared with PWID in Tijuana, Mexico, located directly across the border. We investigated associations between cross-border injection drug use (IDU), HIV and HCV seroprevalence and engagement in injecting risk behaviours while on each side of the border. Methods Using baseline interviews and serologic testing data from STAHR II, a longitudinal cohort study of PWID in San Diego, bivariate and multivariable logistic regression analyses examined associations between recent (past six months) cross-border IDU and HIV and HCV antibody seropositivity, socio-demographics, drug use characteristics, and participants’ connections to, and perceptions about Mexico. Chi-squared tests and McNemar tests examined associations between cross-border IDU and injecting risk behaviours. Results Of the 567 participants (93% US-born, 73% male, median age 45 years), 86 (15%) reported recent cross-border IDU. Cross-border IDU was not associated with HIV (OR: 0.85, 95% CI: 0.37–1.95) or HCV seropositivity (OR: 1.01, 95% CI: 0.62–1.65). Age, identifying as Hispanic or Latino/a, and being concerned about risk of violence when travelling to Mexico were independently associated with decreased odds of recent cross-border IDU. Injecting cocaine at least weekly, having ever lived in Mexico and knowing PWID who reside in Mexico were associated with increased odds of recent cross-border IDU. PWID who reported cross-border IDU were significantly less likely to engage in receptive needle sharing, equipment sharing, and public injection while in Mexico compared with in San Diego (all p<0.001). Conclusion Prevalence of HIV and HCV infection was similar among PWID who had and had not injected in Mexico, possibly due to practicing safer injecting while in Mexico. Research is needed to elucidate contextual factors enabling U.S. PWID to inject safely while in Mexico.

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“…The most common SDOH influencing drug injecting equipment misuse was social context, wherein PWID see themselves as a community sharing common needs and practices. These behaviors appear to be similar to those who are not engaging in SEP services, including injecting with an intimate partner and having friends who inject (Munoz et al, 2015). Health and healthcare determinants were also identified, mainly in terms of low health literacy regarding disease transmission risk for misusing non-syringe equipment such as filters and cookers.…”

Section: Resultsmentioning

confidence: 95%

“…The literature supports this occurs outside of SEPs, where having limited access to sterile syringes and homelessness increases the likelihood of sharing used equipment Munoz et al, 2015). Sterile supply stability issues brought about by fear of arrest or strong police presence may lead to increased sharing of used equipment (Flath et al, 2017;Munoz et al, 2015). Despite the education PWID in SEP receive, high-risk behaviors and attitudes persist around saving drugs for later use (a wash).…”

Section: Resultsmentioning

confidence: 99%

“…Despite the use of SEP or other means of acquiring drug injecting supplies, significant numbers of PWID share or reuse equipment (Behrends et al, 2017;Des Jarlais et al, 2015;Flath, Tobin, King, Lee, & Latkin, 2017;Golub et al, 2007). Reasons for sterile supply interruptions and challenges are numerous, and may include difficulties with transportation (Canary et al, 2017;, seasonal changes (Allen, Ruiz, Roess, & Jones, 2015), police presence or fear of arrest (Beletsky et al, 2014;Davis et al, 2019;Flath et al, 2017;Munoz, Burgos, Cuevas-Mota, Teshale, & Garfein, 2015), and problems with SEP supply limits or operating hours (Bluthenthal et al, 2007;Davis et al, 2019). It is important to recognize there are a number of mechanisms that may help overcome such barriers, resulting in improved sterile injecting supply stability for PWID.…”

Section: Policy Alternatives: Increasing Access To a Consistent Supplmentioning

confidence: 99%

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Addressing the problem of sterile drug injecting supply acquisition for people who inject drugs.

Cave¹

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I would also like to express my appreciation and gratitude to my husband, Dr. Matt Cave. Without his love, devotion, compassion, respect, encouragement, willingness to pick up the slack at home, and patience, I would not have achieved the success I have to-date. Thank you to William and Sam Cave for eating my hastily cooked dinners, and respecting my need for quiet. Lastly, I wish to thank my son, Nikolai Goshko, for his kindness, respect, patience, and understanding, and recognize his personal sacrifices to help see me through the PhD journey.

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Individual and Socio-Environmental Factors Associated with Unsafe Injection Practices Among Young Adult Injection Drug Users in San Diego

Cited by 20 publications

References 54 publications

More than just someone to inject drugs with: Injecting within primary injection partnerships

More than just someone to inject drugs with: Injecting within primary injection partnerships

Cross-border injection drug use and HIV and hepatitis C virus seropositivity among people who inject drugs in San Diego, California

Addressing the problem of sterile drug injecting supply acquisition for people who inject drugs.

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