The role of social networks and geography on risky injection behaviors of young persons who inject drugs

Abstract

Background Little is known about young persons who inject drugs (PWID), who are increasingly from suburban communities and predominantly non-Hispanic white. Methods We conducted a cross-sectional personal network (egocentric) and geographic study of young PWID and their drug-using, sexual, and support network members in 2012-13 in metropolitan Chicago, Illinois, U.S. Results We enrolled 164 young (median age=26), mostly male (65%), non-Hispanic white PWID (71%), with a self-reported HCV prevalence of 13%. Many (59%) reported multiple residences (i.e., were transient) in the past year, 45% of whom reported living in both urban and suburban places (i.e., were cross-over transients). In multivariable analyses that adjusted for participant and network member characteristics, (1) large injection networks were more common among homeless participants; and (2) syringe sharing was (a) highest among cross-over transients compared to suburban (OR = 4.19 95% CI 1.69 – 10.35) and urban only residents (OR = 2.91 95% CI 1.06 – 8.03), (b) higher among HCV-unknown compared HCV-negative participants (OR = 4.62 95% CI 1.69-10.35), (c) more likely with network members who were cross-over transients compared to urban (OR = 4.94, 95% CI 2.17 – 11.23) and (d) less likely with network members with HCV-unknown compared to HCV-negative status (OR = 0.4 95% CI 0.19 – 0.84). Conclusions We identified homelessness as a significant risk factor for large networks and cross-over transience as a significant risk factor for syringe sharing. Further research is needed to understand the role of geographic factors promoting higher risk among these crossover transient PWID.

Gender, Transience, Network Partnerships and Risky Sexual Practices Among Young Persons who Inject Drugs

“…Characteristics such as network size and density (i.e., connectedness among members) and multiplexity (i.e., overlapping membership in multiple networks), have been associated with risky injection practices among PWID in several studies (23-27). More recently, social network characteristics have been shown to impact sexual risk behaviors among urban African-American women (28, 29) and men who have sex with men (30).…”

“…Studies have consistently linked residential instability (i.e., having multiple residences over a short period) with high risk behaviors, including syringe sharing and sex exchange (27, 31-33), and HIV infection (34, 35). However, the impact of geographic mobility on sexual risk behaviors and networks of young PWID has not been well studied.…”

A rede de apoio social de usuários de crack acompanhados por um equipe de consultório na rua de uma cidade no interior de Minas Gerais

“…A partir da leitura desses artigos, identificou-se que, nos estudos recentes sobre a temática, têm-se focado principalmente as características da rede social dos usuários (GRIFFIN; RODRIGUEZ, 2011;RUDOLPH et al, 2011;JONAS et al, 2012;LATKIN et al, 2012;NYAMATHI et al, 2012;WENZEL et al, 2012;BUTTRAM;KURTZ;SURRAT, 2013;RUDOLPH et al, 2013;BOODRAM;MACKESY-AMITIA, LATKIN, 2015;KING;LATKIN, DAVEY-ROTHWWLL, 2015;SONG;WENZEL, 2015;SCHERER et al, 2016;SMITH et al, 2016), os fatores de risco, da rede social, em relação ao uso de drogas (DOHERTY et al, 2011;RHOADES et al, 2011;TOBIN et al, 2011;CRAWFORD et al, 2013;KELLY et al, 2013;MAUSLBY et al, 2014;GUNN;CANADA, 2015;FUJIMOTO et al, 2016) e os fatores de proteção, da rede social, em relação ao uso de drogas (BOOTH et al, 2011;TRENZ et al, 2012;CHARLEBOIS et al, 2012;OSER, LEUKERFELD, 2012;RAMASWAMY et al, 2013;SAPRA et al, 2013;HUDSON;NANDY, 2014;JORGE, 2014;HEARN et al, 2015;CUCCIARE et al, 2016;HORTA et al, 2016;MCNEIL et al, 2015).…”

“…No que diz respeito às populações estudadas, em tais estudos trabalhou-se com indivíduos com privação da liberdade (GRIFFIN E RODRIGUEZ, 2011;LEUKEFELD, 2012), população rural (DOHERTY et al, 2011;JONAS et al, 2012;CUCCIARE et al, 2016;SMITH et al, 2016), homossexuais (Tobin et al, 2011;KELLY et al, 2013;BUTTRAM;KURTZ;SURRAT, 2013;MAULSBY et al, 2014;FUJIMOTO et al, 2016), pessoas com baixa renda (KING; LATKIN, DAVEY-ROTHWWLL, et al, 2015;, sujeitos em situação de rua (RHOADES et al, 2011;NYAMATHI et al, 2012;WENZEL et al, 2012;HUDSON;NANDY, 2014;SONG;WENZEL, 2015), usuários de crack e outras drogas (BOOTH et al, 2011;RUDOLPH et al, 2011;TRENZ et al, 2012;LATKIN et al, 2012;CRAWFORD et al, 2013;RAMASWAMY et al, 2013;RUDOLPH et al, 2013;SAPRA et al, 2013;BOODRAM;MACKESY-AMITIA;GUNN;CANADA, 2015;HEARN et al, 2015). Destaca-se que apenas em alguns desses estudos trabalhou-se exclusivamente com os usuários de crack (CHARLEBOIS et al, 2012;HORTA et al, 2016;SCHERER et al, 2016;JORGE, 2014;MCNeil et al, 2015)…”

“…Em relação à caracterização da rede social dos usuários de drogas, diversos autores (GRIFFIN; RODRIGUEZ, 2011;RUDOLPH et al, 2011;JONAS et al, 2012;LATKIN et al, 2012;NYAMATHI et al, 2012;WENZEL et al, 2012;BUTTRAM;KURTZ, 2013;RUDOLPH et al, 2013;BOODRAM;MACKESY-AMITIA;KING;DAVEY-ROTHWWLL, 2015;SONG;WENZEL, 2015;SCHERER et al, 2016;SMITH et al, 2016) (DOHERTY et al, 2011;TOBIN et al, 2011;KELLY et al, 2013;MAULSBY et al, 2014;FUJIMOTO et al, 2016), estigma e discriminação (CRAWFORD et al, 2013;GUNN;CANADA, 2015) e viver em situação de rua (RHOADES et al, 2011;TRENZ et al, 2012;HUDSON;NANDY, 2014 No tocante ao estigma e discriminação, em um estudo conduzido por Crawford et al (2013), em Nova York, teve-se como objetivo analisar a associação entre preconceito por raça, uso de drogas ou histórico carcerário e a rede social de usuários de drogas ilícitas. Foi apresentado em seus achados, que os participantes que relataram ter sofrido discriminação devido à raça e ao uso de drogas tinham em suas redes sociais mais vínculos que apresentavam risco tanto para uso de drogas quanto para comportamento sexual de risco.…”