Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war

Strathdee, Steffanie A.; Zafar, Tariq; Brahmbhatt, Heena; Baksh, Ahmed; Hassan, Salman ul

doi:10.1016/s0376-8716(03)00072-3

Cited by 67 publications

(54 citation statements)

References 14 publications

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“…For example, police can have a direct effect on where, with whom, when and how IDUs administer their dose. Studies from the United States and elsewhere show that police pressure is associated with use of shooting galleries, where drugs can be injected beyond view of police but syringe sharing is commonplace [13,16,30]. Similarly, in earlier qualitative interviews [14,17] in Tijuana and Ciudad Juarez, IDUs described attempting to reduce their risk of arrest by obtaining syringes at the location where they purchase and inject their drugs.…”

Section: Discussionmentioning

confidence: 99%

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Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Pollini

Brouwer

Lozada³

et al. 2007

Addiction

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Aims To identify factors associated with receptive syringe sharing among injection drug users (IDUs) and elucidate the association between syringe possession arrests and syringe sharing.Design Cross‐sectional study.Setting Mexican border cities of Tijuana, Baja California and Ciudad Juarez, Chihuahua.Participants IDUs in Tijuana (n = 222) and Ciudad Juarez (n = 206) were recruited using respondent‐driven sampling (RDS). IDUs were ≥ 18 years and had injected illicit drugs in the past month.Measurements An interviewer‐administered survey was used to collect quantitative data on socio‐demographic, behavioral and contextual characteristics, including self‐reported syringe sharing and arrests for syringe possession. Associations with receptive syringe sharing were investigated using logistic regression with RDS adjustment.Findings Overall, 48% of participants reported ever being arrested for carrying an unused/sterile syringe, even though syringe purchase and possession is legal in Mexico. Arrest for possessing unused/sterile syringes was associated independently with receptive syringe sharing [adjusted odds ratio (AOR) = 2.05; 95% confidence interval (CI): 1.26, 3.35], as was injecting in a shooting gallery (AOR = 3.60; 95% CI: 2.21, 5.87), injecting in the street (AOR = 2.05; 95% CI: 1.18, 3.54) and injecting methamphetamine (AOR = 2.77; 95% CI: 1.41, 5.47) or cocaine (AOR = 1.96; 95% CI: 1.15, 3.36). More than half of participants (57%) had been arrested for possessing a used syringe; in a second model, arrest for used syringe possession was also associated independently with receptive sharing (AOR = 2.87; 95% CI: 1.76, 4.69).Conclusions We documented high levels of syringe‐related arrests in two Mexican–US border cities and an independent association between these arrests and risky injection practices. Public health collaborations with law enforcement to modify the risk environment in which drug use occurs are essential to facilitate safer injection practices.

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Section: Discussionmentioning

confidence: 99%

“…Overall, 92% were male and 99% considered themselves Hispanic or Latino. Median age was 34 years [interquartile range (IQR): [28][29][30][31][32][33][34][35][36][37][38][39][40] and median time since first injection was 12.5 years (IQR: [8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: Study Populationmentioning

confidence: 99%

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Pollini

Brouwer

Lozada³

et al. 2007

Addiction

Self Cite

121

113

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“…Further, the efficiency afforded by injection vs. non-injection of drugs has been identified as a key motivator for transitions into initiation, particularly among individuals experiencing endemic poverty and during periods when the price of illegal drugs increases [26][27][28][29][30][31].…”

Section: Risk Factors For Injection Initiatesmentioning

confidence: 99%

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

et al. 2017

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“…However, fluctuations in heroin availability, purity, and price have led many to switch to injection of liquid pharmaceuticals that are readily available at pharmacies without a prescription. 2,3 As a result, injection drug use may become increasingly common in Pakistan, increasing the probability of a widespread HIV/AIDS (acquired immuno-deficiency syndrome) epidemic associated with needle-sharing practices, as documented elsewhere in Asia. 4,5 There is a pressing need to identify factors associated with injection drug use in this setting.…”

Section: Introductionmentioning

confidence: 99%

HIV/AIDS Risk Behaviors and Correlates of Injection Drug Use Among Drug Users in Pakistan

Ahmed

Zafar²,

Brahmbhatt

et al. 2003

Journal of Urban Health: Bulletin of the New York Academy of Me

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Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war

Cited by 67 publications

References 14 publications

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Syringe possession arrests are associated with receptive syringe sharing in two Mexico–US border cities

Preventing Injection Drug use Initiation: State of the Evidence and Opportunities for the Future

HIV/AIDS Risk Behaviors and Correlates of Injection Drug Use Among Drug Users in Pakistan

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