Social Networks, Drug Injectors’ Lives, and HIV/AIDS

Friedman, Samuel R.; Curtis, Richard; Neaigus, Alan; Jose, Benny; Jarlais, Don C. Des

doi:10.1007/b112219

Cited by 123 publications

(172 citation statements)

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“…First, as Williams, Rockwell, and others have found, [24][25][26] individuals who live closer to an SEP site are more likely than other injectors to go to an SEP and to inject with a sterile syringe. Second, injectors' drug use networks may be relatively contained within their residential neighborhood, 27 and thus many syringes distributed through secondary exchange efforts may not travel far from the original SEP source. By their very nature, satellite exchange efforts should counter this spatial concentration.…”

Section: Discussionmentioning

confidence: 99%

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Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

et al. 2012

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Despite the 2010 repeal of the ban on spending federal monies to fund syringe exchange programs (SEPs) in the USA, these interventions-and specifically SEP site locations-remain controversial. To further inform discussions about the location of SEP sites, this longitudinal multilevel study investigates the relationship between spatial access to sterile syringes distributed by SEPs in New York City (NYC) United Hospital Fund (UHF) districts and injecting with an unsterile syringe among injectors over time (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006). Annual measures of spatial access to syringes in each UHF district (N = 42) were created using data on SEP site locations and site-specific syringe distribution data. Individual-level data on unsterile injecting among injectors (N = 4,067) living in these districts, and on individual-level covariates, were drawn from the Risk Factors study, an ongoing cross-sectional study of NYC drug users. We used multilevel models to explore the relationship of district-level access to syringes to the odds of injecting with an unsterile syringe in 975% of injection events in the past 6 months, and to test whether this relationship varied by district-level arrest rates (per 1,000 residents) for drug and drug paraphernalia possession. The relationship between district-level access to syringes and the odds of injecting with an unsterile syringe depended on district-level arrest rates. In districts with low baseline arrest rates, better syringe access was associated with a decline in the odds of frequently injecting with an unsterile syringe (AOR, 0.95). In districts with no baseline syringe access, higher arrest rates were associated with increased odds of frequently injecting with an unsterile syringe (AOR, 1.02) When both interventions were present, arrest rates eroded the protective effects of spatial access to syringes. Spatial access to syringes in small geographic areas appears to reduce the odds of injecting with an unsterile syringe among local injectors, and arrest rates elevate these odds. Policies and practices that curtail syringe flow in geographic areas (e.g., restrictions on SEP locations or syringe distribution) or that make it difficult for injectors to use the sterile syringes they have acquired may damage local injectors' efforts to reduce HIV transmission and other injection-related harms.

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Section: Discussionmentioning

confidence: 99%

“…25,26 Individuals who live near SEPs thus appear to be more likely to use these programs regularly. Given that SEP participants may be more likely to form relationships with injectors living near them, 27 non-participants who live near SEPs may also be likely to reap the benefits of secondary exchange.…”

Section: Conceptualizing Seps As Spatial Interventionsmentioning

confidence: 99%

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

et al. 2012

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“…Previous research suggests HIV prevalence or incidence among IDUs in a locality is a function of policies about purchasing syringes (Friedman et al, 2001;, syringe exchange (Des Jarlais et al, 1996;Hurley, 1997;MacDonald et al, 2003) urban development (Friedman et al, 1999) or urban "desertification" (Wallace and Wallace, 1998), and indicate that these policies might be altered to reduce HIV transmission. Structural constraints relating to syringe acquisition, which differ by state and locality, can significantly reduce the ability of IDUs to purchase and possess sterile syringes.…”

Section: The Relevance Of Structural Constraints In Idu-related Hiv Vmentioning

confidence: 99%

Placing the dynamics of syringe exchange programs in the United States

Tempalski

2007

Health & Place

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Drawing upon the broader health, social, and political geography literature this paper outlines a framework for considering place-based processes through which syringe exchange availability may be understood. It is argued that the geographic distribution of syringe exchange programs (SEPs) in the United States is linked to the social and political conditions of particular localities through three place characteristics: (1) structural constraints; (2) social and spatial distancing of injection drug users; and (3) localized action. Although SEPs remain a controversial issue and face ongoing obstacles from the government, law enforcement and local communities, they continue to operate through the efforts of grassroots organizations and local activists. Action on this issue occurs locally, and the characteristics of place-based factors will affect whether particular areas adopt SEPs.

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“…Because New York City has been the epicenter for the HIV/intravenous drug use epidemic in the United States, [11][12][13][14] distance from New York City was controlled in multivariate analyses of HIV prevalence and incidence.…”

Section: Discussionmentioning

confidence: 99%

Laws prohibiting over-the-counter syringe sales to injection drug users: relations to population density, HIV prevalence, and HIV incidence

Friedman

Perlis

Jarlais³

2001

Am J Public Health

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OBJECTIVES: This study sought to assess relations of laws prohibiting over-the-counter syringe sales (anti-OTC laws) to population prevalence of injection drug users and HIV prevalence or incidence among 96 US metropolitan areas. METHODS: A cross-sectional analysis was used. RESULTS: Metropolitan areas with anti-OTC laws had a higher mean HIV prevalence (13.8% vs 6.7%) than other metropolitan areas (pseudo-P < .001). In 83 metropolitan areas with HIV prevalence of less than 20%, anti-OTC laws were associated with HIV incidence rates of 1% or greater (pseudo-P < .001). Population proportions of injection drug users did not vary by presence of anti-OTC laws. CONCLUSIONS: Anti-OTC laws are not associated with lower population proportions of injection drug users. Laws restricting syringe access are associated with HIV transmission and should be repealed.

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Social Networks, Drug Injectors’ Lives, and HIV/AIDS

Cited by 123 publications

References 0 publications

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

Spatial Access to Sterile Syringes and the Odds of Injecting with an Unsterile Syringe among Injectors: A Longitudinal Multilevel Study

Placing the dynamics of syringe exchange programs in the United States

Laws prohibiting over-the-counter syringe sales to injection drug users: relations to population density, HIV prevalence, and HIV incidence

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