Severe Anxiety Symptomatology and HIV Risk Behavior Among Hispanic Injection Drug Users in Puerto Rico

Reyes, Juan C.; Robles, Rafaela R.; Colón, Héctor M.; Marrero, C A; Matos, Tomás D.; Calderón, José Meneses; Shepard, Elizabeth

doi:10.1007/s10461-006-9090-x

Cited by 24 publications

(20 citation statements)

References 30 publications

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“…Several studies have shown that symptoms of anxiety or depression were associated with drug-equipment sharing behaviours among drug users (Lundgren et al, 2005;Golub et al, 2007;Reyes et al, 2007;Lemstra et al, 2011;German et al, 2012;Armstrong et al, 2013). The mechanisms underlying these relationships are not well understood.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of prescription opioid residue injection

Roy

Arruda

Bertrand

et al. 2016

Drug and Alcohol Dependence

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Background: There is growing evidence of intravenous administration of prescription opioids (POs) in several countries. Preparation of POs for injection may leave residues in containers and filters used by people who inject drugs and may lead to adverse health outcomes if they are injected.Methods: This exploratory study used cross-sectional data from the COSMO study, a prospective cohort of out-of-treatment cocaine users carried out in Montréal (Canada) between October 2010 and August 2015. For this analysis, only one visit per participant was selected, that is, the first time the participant reported PO injection during the study.The outcome of interest, "injection of PO residues", was defined as having injected PO residues from a filter and/or a container in the last month. Correlates of this outcome were identified using logistic regression analyses.Results: Of the 122 participants who reported PO injection during the study period, 41.8% had injected PO residues. Reporting an unstable source of income (AOR=4.26; 95% CI: 1.03-17.69), a recent overdose (AOR=5.45; 95% CI: 1.50-19.88) and a preponderant use of opiates (mostly opiate use versus other drugs excluding alcohol and cannabis) (AOR=2.46; 95% CI: 1.08-5.63) increased the risk of PO residue injection. The odds of reporting PO residue injection rose by 7% per unit increase in the score of psychological distress (AOR=1.07 per unit increase; 95% CI: 1.01-1.12). Conclusions:The findings of this study suggest that PO residue injection is associated with markers of vulnerability. Further investigation is needed in order to better understand this understudied drug injection practice.

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Section: Discussionmentioning

confidence: 99%

Prevalence and correlates of prescription opioid residue injection

Roy

Arruda

Bertrand

et al. 2016

Drug and Alcohol Dependence

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“…It has been hypothesised that frequent consequences of anxiety disorders, such as insomnia, impulsivity, and difficulty concentrating, may compromise the ability of users to plan ahead and successfully adopt safe injection practices (Reyes et al, 2007). It is also possible that certain primary anxiety disorders, such as panic disorder, have more profound effects on specific cognitive functions involved in sharing behaviors compared to symptoms that are assessed by the K10 scale or associated with depressive disorders.…”

Section: Discussionmentioning

confidence: 99%

“…A positive association was found between depressive symptoms and injection material sharing in PWID samples in India and Canada (Armstrong et al, 2013;Lemstra, Rogers, Thompson, Moraros, & Buckingham, 2011), but not among a sample of PWID in Massachusetts, United States (Lundgren, Amodeo, & Chassler, 2005) nor among street-based female injectors in the city of Danzhou, China (Gu et al, 2010). Likewise, symptoms of anxiety were associated with sharing of injection material in Puerto Rico and in Massachusetts, USA (Lundgren et al, 2005;Reyes et al, 2007), while a negative association was found among PWID in Delhi, India (Armstrong et al, 2013).…”

Section: Introductionmentioning

confidence: 91%

Examining the link between psychological distress, mental health disorders and sharing behaviors among cocaine users

Lévesque

Roy

Jutras‐Aswad

et al. 2016

Addictive Behaviors

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“…Our data are also consistent with an emerging literature suggesting that specific dimensions of mental health disorders may come into play in the manifestation of risk behaviors. Previous studies have suggested that severe anxiety symptoms may cause difficulty concentrating and impulsive behaviors which may in turn lead to impaired decision making and increased risk taking [50,51]. Likewise, it has been argued that depressive symptoms increase risky behaviors through a feeling of hopelessness and despair, leading individuals to care less about deleterious health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Psychological Distress Increases Needle Sharing among Cocaine users: Results from the COSMO Study

Lévesque¹,

Bruneau²,

Jutras‐Aswad³

et al. 2014

J Addict Res Ther

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Objective: Cocaine use and mental health disorders have both been separately identified as risk factors for blood borne virus infection. However, the contribution of specific underlying aspects of mental health to risks is not well documented. The aim of this study was to examine the association between psychological distress and risk behaviors for HIV and Hepatitis C infection among cocaine users.Methods: Individuals who either smoked or injected cocaine were recruited in community-based and addiction treatment programs located in downtown Montreal. Participants were asked to complete an interviewer-administered questionnaire assessing psychological distress based on the Kessler scale (K10). Three-month risk behaviors outcomes included drug injection material sharing (needle, dilution water, cooker, filters, backloading, frontloading or wash), and smoking equipment sharing. Socio-demographic data, severity of cocaine dependence and other substances use information were also collected. Statistical analyses were conducted using logistic regression.Results: Severe psychological distress was reported by 202 (34.3%) out of 589 participants (86.2% male; 76.6% ≥ 30y.o.). The prevalence of sharing was: 14.8% for needles, 24.9% for other injection equipment (378 injectors) and 68.3% for smoking material (508 smokers). Multivariate analysis showed that injectors with severe psychological distress were more likely to report needle sharing (Adjusted Odds Ratio (AOR): 2.1, 95% CI: 1.1-3.8). No significant association was found between K10 score and sharing of other paraphernalia. Conclusion:Severe psychological distress increases the risk of needle sharing, a major risk factor for HIV and HCV infection, but not sharing of other paraphernalia. These results suggest differential psychological mechanisms according to sharing practices. They also support the importance of screening for psychological distress in order to implement adequate preventive interventions aimed at cocaine users.

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Severe Anxiety Symptomatology and HIV Risk Behavior Among Hispanic Injection Drug Users in Puerto Rico

Cited by 24 publications

References 30 publications

Prevalence and correlates of prescription opioid residue injection

Prevalence and correlates of prescription opioid residue injection

Examining the link between psychological distress, mental health disorders and sharing behaviors among cocaine users

Psychological Distress Increases Needle Sharing among Cocaine users: Results from the COSMO Study

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