Social network characteristics and injecting HIV-risk behaviors among street injection drug users

Suh, Tongwoo; Mandell, Wallace; Latkin, Carl A.; Kim, Joohyung

doi:10.1016/s0376-8716(97)00082-3

Cited by 79 publications

(64 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…107,108 Studies in various US cities have identified large social networks of injection drug users. [109][110][111][112][113][114][115][116][117][118] A key conclusion of these studies is that prevention efforts are more effective when they are targeted to individuals who are centrally located in high-risk networks than when they reach individuals on the periphery of such networks. If incremental methadone capacity were targeted to injection drug users who are centrally located in networks, then such expansion would likely be more costeffective than we have estimated; and if incremental capacity reached injection drug users located on the periphery of networks, then such expansion would likely be less cost-effective than we have estimated.…”

Section: Discussionmentioning

confidence: 99%

HIV transmission and the cost-effectiveness of methadone maintenance

Zaric¹,

Barnett²,

Brandeau³

2000

Am J Public Health

196

View full text Add to dashboard Cite

OBJECTIVES: This study determined the cost-effectiveness of expanding methadone maintenance treatment for heroin addiction, particularly its effect on the HIV epidemic. METHODS: We developed a dynamic epidemic model to study the effects of increased methadone maintenance capacity on health care costs and survival, measured as quality-adjusted life-years (QALYs). We considered communities with HIV prevalence among injection drug users of 5% and 40%. RESULTS: Additional methadone maintenance capacity costs $8200 per QALY gained in the high-prevalence community and $10,900 per QALY gained in the low-prevalence community. More than half of the benefits are gained by individuals who do not inject drugs. Even if the benefits realized by treated and untreated injection drug users are ignored, methadone maintenance expansion costs between $14,100 and $15,200 per QALY gained. Additional capacity remains cost-effective even if it is twice as expensive and half as effective as current methadone maintenance slots. CONCLUSIONS: Expansion of methadone maintenance is cost-effective on the basis of commonly accepted criteria for medical interventions. Barriers to methadone maintenance deny injection drug users access to a cost-effective intervention that generates significant health benefits for the general population.

show abstract

Section: Discussionmentioning

confidence: 99%

HIV transmission and the cost-effectiveness of methadone maintenance

Zaric¹,

Barnett²,

Brandeau³

2000

Am J Public Health

196

View full text Add to dashboard Cite

show abstract

“…Given that PWID share syringes for a variety of reasons, only one of which is syringe availability, it seems reasonable that different levels of coverage are required in different locales, depending on the influence of other determinants of syringe sharing behaviour in those contexts. For example, areas where users have large social networks with strong ties may require higher targets of coverage since evidence shows that receptive syringe sharing is more likely between those who are close friends, family members or spouses [18,19]. Thus, in these settings, achieving a decline in sharing behaviour may require extra intervention, including better availability of syringes.…”

Section: Introductionmentioning

confidence: 93%

Syringe Coverage in an Australian Setting: Does a High Level of Syringe Coverage Moderate Syringe Sharing Behaviour?

Bryant¹,

Paquette²,

Wilson³

2011

AIDS Behav

View full text Add to dashboard Cite

We examined individual-level syringe coverage among 417 people who inject drugs who were recruited from pharmacies in New South Wales in 2009. There was a U-shaped distribution of syringe coverage with many people having very high (51%) or very low (23%) coverage. Overall, two-thirds of respondents (63%) reported adequate coverage (≥ 100%). Respondents who had not used a needle and syringe program in the previous month were more likely to report inadequate coverage (AOR 2.25, 95% CI 1.25-4.05) as were those who reported daily or more frequent injecting (AOR 3.69, 95% CI 2.00-6.81). Inadequate syringe coverage was not independently associated with receptive needle sharing. The level of syringe coverage was high among this sample, and met targets set out by UNAIDS and other organisations. We found that inadequate syringe coverage was not independently correlated with receptive needle sharing, possibly because coverage is sufficient to diminish the relationship between syringe availability and sharing behaviours.

show abstract

“…There has been increased interest in particular in how the micro physical settings of drug injection -such as 'shooting galleries', 'public injecting environments' and prisons -act as environmental determinants of health risk among injecting drug users (IDUs) 6,7,8,9,10,11 . Studies show the micro injecting environment to be a determinant of health risk, including regarding abscesses, vein damage, needle and syringe sharing, HCV infection and overdose 12,13,14,15,16 .…”

Section: Introductionmentioning

confidence: 99%

Injecting drug use and unstable housing: Scope for structural interventions in harm reduction

Briggs

Rhodes

Marks

et al. 2009

Drugs: Education, Prevention and Policy

View full text Add to dashboard Cite

Evidence links unstable housing, and especially homelessness, with elevated health harm among drug users, including riskier drug injecting practices. We undertook 45 in-depth qualitative interviews with injecting drug users (IDUs) in Bristol and London in 2006. IDUs were recruited through drug user networks and drug agencies. Temporary accommodation and hostels for the homeless may provide a 'safe haven' from street-based drug use and public injecting environments, and are characterised as a retreat from the 'chaos' of the street. But hostels may also constitute 'risk environments' in facilitating drug using and risk networks, transitions to new patterns of use, including increased frequency of injecting. For some, homelessness was positioned as 'safer' than temporary housing with regards to managing drug use. Stable housing emerges as a key structural factor in creating enabling environments for health. We emphasise that temporary accommodation hostels have potential for harm-reduction interventions, but may also be associated with the production of risk related to drug use and injecting.

show abstract

Social network characteristics and injecting HIV-risk behaviors among street injection drug users

Cited by 79 publications

References 34 publications

HIV transmission and the cost-effectiveness of methadone maintenance

HIV transmission and the cost-effectiveness of methadone maintenance

Syringe Coverage in an Australian Setting: Does a High Level of Syringe Coverage Moderate Syringe Sharing Behaviour?

Injecting drug use and unstable housing: Scope for structural interventions in harm reduction

Contact Info

Product

Resources

About