The impact of recent homelessness on the provision of injection drug use initiation assistance among persons who inject drugs in Tijuana, Mexico and Vancouver, Canada

Marks, Charles; Bouck, Zachary; Jain, Sonia; Sun, Xiaoying; Strathdee, Steffanie A.; Vickerman, Peter; DeBeck, Kora; Milloy, M‐J; Hayashi, Kanna; Werb, Dan

doi:10.1016/j.drugalcdep.2021.108829

Cited by 4 publications

(7 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The extent of influence of these contextual factors differ across each setting and was selected accordingly [34]. In the Vancouver model, this included age, gender, housing status, public injecting, duration of injecting career and recent law enforcement interaction [17,19,[33][34][35][36][37]. The Tijuana model included age, gender, housing status, duration of injection career and recent law enforcement interaction [17,19,[33][34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings

Rammohan

Jain

Sun

et al. 2023

Drug and Alcohol Review

Self Cite

View full text Add to dashboard Cite

IntroductionWe sought to identify latent profiles of polysubstance use patterns among people who inject drugs in three distinct North American settings, and then determine whether profile membership was associated with providing injection initiation assistance to injection‐naïve persons.MethodsCross‐sectional data from three linked cohorts in Vancouver, Canada; Tijuana, Mexico; and San Diego, USA were used to conduct separate latent profile analyses based on recent (i.e., past 6 months) injection and non‐injection drug use frequency. We then assessed the association between polysubstance use patterns and recent injection initiation assistance provision using logistic regression analyses.ResultsA 6‐class model for Vancouver participants, a 4‐class model for Tijuana participants and a 4‐class model for San Diego participants were selected based on statistical indices of fit and interpretability. In all settings, at least one profile included high‐frequency polysubstance use of crystal methamphetamine and heroin. In Vancouver, several profiles were associated with a greater likelihood of providing recent injection initiation assistance compared to the referent profile (low‐frequency use of all drugs) in unadjusted and adjusted analyses, however, the inclusion of latent profile membership in the multivariable model did not significantly improve model fit.Discussion and ConclusionsWe identified commonalities and differences in polysubstance use patterns among people who inject drugs in three settings disproportionately impacted by injection drug use. Our results also suggest that other factors may be of greater priority when tailoring interventions to reduce the incidence of injection initiation. These findings can aid in efforts to identify and support specific higher‐risk subpopulations of people who inject drugs.

show abstract

Section: Discussionmentioning

confidence: 99%

Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings

Rammohan

Jain

Sun

et al. 2023

Drug and Alcohol Review

Self Cite

View full text Add to dashboard Cite

show abstract

“…In Tijuana, these included: gender, age, years spent injecting, housing status, recent injection heroin and methamphetamine use, and recent sex work [18,27,32]. In Vancouver, these included: gender, age, years spent injecting, housing status, recent injection heroin, cocaine, methamphetamine and speedball use, and recent sex work [18,28,32]. All descriptive and survival analyses were conducted in SAS On Demand for Academics (SAS Institute Inc., Cary, North Carolina, USA).…”

Section: Discussionmentioning

confidence: 99%

“…We employed a multivariable discrete-time survival analysis approach, for each cohort, in which all variables of interest were entered simultaneously, consistent with recommendations from Tabachnick, Fidell and colleagues [30,31]. As such, gender and other variables previously found to be associated with gender, ever providing injection initiation assistance, or both in the literature were included [18,27,28,32]. In Tijuana, these included: gender, age, years spent injecting, housing status, recent injection heroin and methamphetamine use, and recent sex work [18,27,32].…”

Section: Discussionmentioning

confidence: 99%

“…As such, gender and other variables previously found to be associated with gender, ever providing injection initiation assistance, or both in the literature were included [18,27,28,32]. In Tijuana, these included: gender, age, years spent injecting, housing status, recent injection heroin and methamphetamine use, and recent sex work [18,27,32]. In Vancouver, these included: gender, age, years spent injecting, housing status, recent injection heroin, cocaine, methamphetamine and speedball use, and recent sex work [18,28,32].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Gender and the first‐time provision of injection initiation assistance among people who inject drugs across two distinct North American contexts: Tijuana, Mexico and Vancouver, Canada

Meyers-Pantele

Jain

Sun

et al. 2021

Drug and Alcohol Review

Self Cite

View full text Add to dashboard Cite

Introduction. Injection drug use initiation is commonly facilitated by other people who inject drugs (PWID). We investigated how the gender of PWID influences their risk of providing initiation assistance to others across two distinct geo-cultural settings. Methods. Data were drawn from two prospective cohorts in Tijuana, Mexico and Vancouver, Canada which conducted semi-annual interviews within the PReventing Injecting by Modifying Existing Responses (PRIMER) study. Participants consisted of PWID who had reported never providing injection initiation assistance at baseline. We then conducted site-specific discrete-time survival analyses assessing the relationship between gender and other relevant covariates (e.g. age and past 6-month sex work) on the risk of the first reported instance of providing initiation assistance. Results. Of 1988 PWID (Tijuana: n = 596; Vancouver: n = 1392), 256 (43%) and 511 (36.7%) participants were women, and 42 (1.7%) and 78 (1.6%) reported recent injection initiation assistance across a median of three and two follow-up visits, respectively. Women had a lower risk of providing injection initiation assistance for the first time in Tijuana (adjusted hazard ratio = 0.52, 95% confidence interval 0.27-0.99), but not in Vancouver. Gendered pathways, like sex work, were associated with providing initiation assistance for the first time in Vancouver (adjusted hazard ratio = 1.97, 95% confidence interval 1.08-3.61). Discussion and Conclusions. Women in Tijuana, but not Vancouver, were less likely to provide first-time initiation assistance among PWID. These results can inform gender-and site-specific prevention efforts aimed at reducing transitions into drug injecting across geographic contexts.

show abstract

“…10 The PReventing Injecting by Modifying Existing Responses (PRIMER) study has identified a range of factors placing PWID at increased likelihood of providing IDU initiation assistance to injection-naïve individuals across differing North American contexts (Vancouver, Canada; Tijuana, Mexico and San Diego, USA). 8 These include age, 11 gender, 11 injection frequency, the use of particular drug types (eg, opioids, crystal methamphetamine), non-injection drug use, 12 criminal justice system involvement, 13 14 homelessness 15 and access to opioid agonist treatment (OAT). [16][17][18] While these findings reveal important similarities and differences, no effort has yet been made to pool findings across settings to assess heterogeneity in risk factors for IDU initiation assistance provision.…”

Section: Open Accessmentioning

confidence: 99%

Involvement of people who inject drugs in injection initiation events: a cross-sectional analysis identifying similarities and differences across three North American settings

et al. 2021

Self Cite

View full text Add to dashboard Cite

ObjectivesPeople who inject drugs (PWID) play an integral role in facilitating the entry of others into injection drug use (IDU). We sought to assess factors influencing PWID in providing IDU initiation assistance across three distinct North American settings and to generate pooled measures of risk.DesignWe employed data from three PWID cohort studies participating in PReventing Injecting by Modifying Existing Responses (PRIMER), for this cross-sectional analysis.SettingTijuana, Mexico; San Diego, USA; Vancouver, Canada.ParticipantsA total of 2944 participants were included in this study (Tijuana: n=766, San Diego: n=353, Vancouver: n=1825).MeasurementsThe outcome was defined as recently (ie, past 6 months) assisting in an IDU initiation event. Independent variables of interest were identified from previous PRIMER analyses. Site-specific multiple modified Poisson regressions were fit. Pooled relative risks (pRR) were calculated and heterogeneity across sites was assessed via linear random effects models.ResultsEvidence across all three sites indicated that having a history of providing IDU initiation assistance (pRR: 4.83, 95% CI: 3.49 to 6.66) and recently being stopped by law enforcement (pRR: 1.49, 95% CI: 1.07 to 2.07) were associated with a higher risk of providing assistance with IDU initiation; while recent opioid agonist treatment (OAT) enrolment (pRR: 0.64, 95% CI: 0.43 to 0.96) and no recent IDU (pRR: 0.21, 95% CI: 0.07 to 0.64) were associated with a lower risk. We identified substantial differences across site in the association of age (I2: 52%), recent housing insecurity (I2: 39%) and recent non-injection heroin use (I2: 78%).ConclusionWe identified common and site-specific factors related to PWID’s risk of assisting in IDU initiation events. Individuals reporting a history of assisting IDU initiations, being recently stopped by law enforcement, and recently injecting methamphetamine/speedball were more likely to have recently assisted an IDU initiation. Whereas those who reported not recently engaging in IDU and those recently enrolled in OAT were less likely to have done so. Interventions and harm reduction strategies aimed at reducing the harms of IDU should incorporate context-specific approaches to reduce the initiation of IDU.

show abstract

The impact of recent homelessness on the provision of injection drug use initiation assistance among persons who inject drugs in Tijuana, Mexico and Vancouver, Canada

Cited by 4 publications

References 35 publications

Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings

Latent polydrug use patterns and the provision of injection initiation assistance among people who inject drugs in three North American settings

Gender and the first‐time provision of injection initiation assistance among people who inject drugs across two distinct North American contexts: Tijuana, Mexico and Vancouver, Canada

Involvement of people who inject drugs in injection initiation events: a cross-sectional analysis identifying similarities and differences across three North American settings

Contact Info

Product

Resources

About