Skip to main content

Advertisement

SpringerLink
Log in

Prevalence and Correlates of the Use of Prefilled Syringes Among Persons Who Inject Drugs in San Diego, CA

  • Published:
Journal of Urban Health Aims and scope Submit manuscript

Abstract

Persons who inject drugs (PWID) are at increased risk for blood-borne virus (BBV) infections and overdose resulting from high-risk injecting practices. Studies of prefilled syringe use ([PFSU] using a syringe that already contained drug solution when it was obtained by the user), an injection practice previously described in Eastern Europe, suggest that it increases susceptibility to BBV. However, little is known about this practice in the USA. Data were obtained from an ongoing cohort study of PWID to determine the prevalence and assess correlates of PFSU in San Diego, CA. Baseline interviews assessed socio-demographics and drug use behaviors. Logistic regression was used to identify factors independently associated with ever using a prefilled syringe (yes/no). Participants (n = 574) were predominately males (73.9 %) and white (50.9 %) with a mean age of 43.4 years (range 18–80); 33.3 % reported ever using prefilled syringes, although only 4.9 % reported use in the past 6 months. In multivariable analyses, PFSU was independently associated with ever having a rushed injection due to police presence [adjusted odds ratio (AOR) = 2.51, 95 % CI 1.66, 3.79], ever being in prison (AOR = 1.80, 95 % CI 1.23, 2.63), injecting most often in public versus private places in the past 6 months (AOR = 1.66, 95 % CI 1.11, 2.48), and injecting drugs in Mexico (AOR = 1.70, 95 % CI 1.16, 2.49). Results indicate that a history of PFSU is common and associated with environmental factors that may also increase risk for adverse health outcomes. Studies are needed to better understand PFSU in order to develop interventions to prevent adverse outcomes associated with their use.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Nelson PK, Mathers BM, Cowie B, et al. Global epidemiology of hepatitis B and hepatitis C in people who inject drugs: results of systematic reviews. Lancet. 2011; 378(9791): 571–583.

    Article  PubMed Central  PubMed  Google Scholar 

  2. Strathdee SA, Hallett TB, Bobrova N, et al. HIV and risk environment for injecting drug users: the past, present, and future. Lancet. 2010; 376(9737): 268–284.

    Article  PubMed  Google Scholar 

  3. Strathdee SA, Lozada R, Pollini RA, et al. Individual, social, and environmental influences associated with HIV infection among injection drug users in Tijuana, Mexico. Jaids J Acquir Immune Defic Syndr. 2008; 47(3): 369–376.

    Article  PubMed  Google Scholar 

  4. Hammett TM, Johnston P, Kling R, et al. Correlates of HIV status among injection drug users in a border region of southern China and northern Vietnam. J Acquir Immune Defic Syndr. 2005; 38(2): 228–235.

    Article  PubMed  Google Scholar 

  5. Mathers BM, Degenhardt L, Phillips B, et al. Global epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. Lancet. 2008; 372(9651): 1733–1745.

    Article  PubMed  Google Scholar 

  6. Thomas DL, Vlahov D, Solomon L, et al. Correlates of hepatitis C virus infections among injection drug users. Medicine (Baltimore). 1995; 74(4): 212–220.

    Article  CAS  Google Scholar 

  7. Garfein RS, Golub ET, Greenberg AE, et al. A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users. AIDS. 2007; 21(14): 1923–1932.

    Article  PubMed  Google Scholar 

  8. Clatts MC, Giang LM, Goldsamt LA, Yi H. Novel heroin injection practices: implications for transmission of HIV and other bloodborne pathogens. Am J Prev Med. 2007; 32(6 Suppl): S226–S233.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Dehne KL. The emerging AIDS crisis in Russia: review of enabling factors and prevention needs. Int J STD AIDS. 2001; 12(4): 277–278.

    Article  CAS  PubMed  Google Scholar 

  10. Rhodes T, Singer M, Bourgois P, Friedman SR, Strathdee SA. The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005; 61(5): 1026–1044.

    Article  PubMed  Google Scholar 

  11. Heimer R, Kinzly ML, He H, Abdala N. The effect of acids on the survival of HIV during drug injection. J Acquir Immune Defic Syndr. 2007; 45(2): 144–150.

    Article  PubMed  Google Scholar 

  12. Bobkov AF, Selimova LM, Khanina TA, et al. Human immunodeficiency virus type 1 in illicit-drug solutions used intravenously retains infectivity. J Clin Microbiol. 2005; 43(4): 1937–1939.

    Article  PubMed Central  PubMed  Google Scholar 

  13. Rhodes T, Platt L, Maximova S, et al. Prevalence of HIV, hepatitis C and syphilis among injecting drug users in Russia: a multi-city study. Addiction. 2006; 101(2): 252–266.

    Article  PubMed  Google Scholar 

  14. Koester S, Booth R, Wiebel W. The risk of HIV transmission from sharing water, drug mixing containers and cotton filters among intravenous drug users. Int J Drug Policy. 1990; 1(6): 28–30.

    Google Scholar 

  15. Booth RE, Mikulich-Gilbertson SK, Brewster JT, Salomonsen-Sautel S, Semerik O. Predictors of self-reported HIV infection among drug injectors in Ukraine. J Acquir Immune Defic Syndr. 2004; 35(1): 82–88.

    Article  PubMed  Google Scholar 

  16. Gyarmathy VA, Neaigus A, Li N, et al. Liquid drugs and high dead space syringes may keep HIV and HCV prevalence high—a comparison of Hungary and Lithuania. Eur Addict Res. 2010; 16(4): 220–228.

    Article  PubMed Central  PubMed  Google Scholar 

  17. Rhodes T, Ball A, Stimson GV, et al. HIV infection associated with drug injecting in the newly independent states, Eastern Europe: the social and economic context of epidemics. Addiction. 1999; 94(9): 1323–1336.

    Article  CAS  PubMed  Google Scholar 

  18. Taran YS, Johnston LG, Pohorila NB, Saliuk TO. Correlates of HIV risk among injecting drug users in sixteen Ukrainian cities. AIDS Behav. 2011; 15(1): 65–74.

    Article  PubMed  Google Scholar 

  19. Booth RE, Kennedy J, Brewster T, Semerik O. Drug injectors and dealers in Odessa, Ukraine. J Psychoactive Drugs. 2003; 35(4): 419–426.

    Article  PubMed  Google Scholar 

  20. Burrows D, Rhodes T, Trautmann F, et al. Responding to HIV infection associated with drug injecting in Eastern Europe. Drug Alcohol Rev. 1998; 17(4): 453–463.

    Article  CAS  PubMed  Google Scholar 

  21. Rhodes T, Mikhailova L, Sarang A, et al. Situational factors influencing drug injecting, risk reduction and syringe exchange in Togliatti City, Russian Federation: a qualitative study of micro risk environment. Soc Sci Med. 2003; 57(1): 39–54.

    Article  PubMed  Google Scholar 

  22. Wagner KD, Bloom JJ, Hathazi SD, Sanders B, Lankenau SE. Control over drug acquisition, preparation and injection: implications for HIV and HCV risk among young female injection drug users. ISRN Addict. 2013; 2013:9

  23. Rhodes T. The ‘risk environment’: a framework for understanding and reducing drug-related harm. Int J Drug Policy. 2002; 13(2): 85–94.

    Article  Google Scholar 

  24. Rhodes T, Lowndes C, Judd A, et al. Explosive spread and high prevalence of HIV infection among injecting drug users in Togliatti City, Russia. AIDS. 2002; 16(13): F25–F31.

    Article  PubMed  Google Scholar 

  25. McCurdy S, Kilonzo GP, Williams M, Kaaya S. Harm reduction in Tanzania: an urgent need for multisectoral intervention. Int J Drug Policy. 2007; 18(3): 155–159.

    Article  PubMed  Google Scholar 

  26. Cooper H, Moore L, Gruskin S, Krieger N. The impact of a police drug crackdown on drug injectors’ ability to practice harm reduction: a qualitative study. Soc Sci Med. 2005; 61(3): 673–684.

    Article  PubMed  Google Scholar 

  27. Philbin M, Pollini RA, Ramos R, et al. Shooting gallery attendance among IDUs in Tijuana and Ciudad Juarez, Mexico: correlates, prevention opportunities, and the role of the environment. Aids Behav. 2008; 12(4): 552–560.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Brouwer KC, Case P, Ramos R, et al. Trends in production, trafficking, and consumption of methamphetamine and cocaine in Mexico. Subst Use Misuse. 2006; 41(5): 707–727.

    Article  PubMed Central  PubMed  Google Scholar 

  29. Volkmann T, Shin SS, Garfein RS, et al. Border crossing to inject drugs in Mexico among injection drug users in San Diego, California. J Immigr Minor Health. 2012; 14(2): 281–286.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Wagner KD, Pollini RA, Patterson TL, et al. Cross-border drug injection relationships among injection drug users in Tijuana, Mexico. Drug Alcohol Depend. 2011; 113(2–3): 236–241.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Robertson AM, Garfein RS, Wagner KD, et al. Evaluating the impact of Mexico’s drug policy reforms on people who inject drugs in Tijuana, B.C., Mexico, and San Diego, CA, United States: a binational mixed methods research agenda. Harm Reduct J. 2014; 11: 4.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Dormann CF, Elith J, Bacher S, et al. Collinearity: a review of methods to deal with it and a simulation study evaluating their performance. Ecography. 2013; 36(1): 27–46.

    Article  Google Scholar 

  33. Kleinbaum DG, Sullivan KM, Barker ND. Other factors accounted for? Confounding and interaction. A pocket guide to epidemiology. New York, NY: Springer New York; 2007:161–178.

  34. City of San Diego. Clean syringe exchange pilot program. Available at: http://www.sandiego.gov/communityservices/programs/cleansyringe/index.shtml. Accessed February 10, 2015.

  35. Gaines TL, Beletsky L, Arredondo J, et al. Examining the spatial distribution of law enforcement encounters among people who inject drugs after implementation of Mexico’s drug policy reform. J Urban Health. 2015; 92(2): 338–351.

  36. Koester SK, Hoffer L. “Indirect sharing”: additional HIV risks associated with drug injection. AIDS Public Policy J. 1994; 9: 100–100.

    Google Scholar 

  37. Grund JPC, Stern LS, Kaplan CD, Adriaans NFP, Drucker E. Drug use contexts and HIV-consequences: the effect of drug policy on patterns of everyday drug use in Rotterdam and the Bronx. Br J Addict. 1992; 87(3): 381–392.

    Article  CAS  PubMed  Google Scholar 

  38. Latkin C, Srikrishnan AK, Yang C, et al. The relationship between drug use stigma and HIV injection risk behaviors among injection drug users in Chennai, India. Drug Alcohol Depend. 2010; 110(3): 221–227.

    Article  PubMed Central  PubMed  Google Scholar 

  39. Neblett RC, Davey-Rothwell M, Chander G, Latkin CA. Social network characteristics and HIV sexual risk behavior among urban African American women. J Urban Health. 2011; 88(1): 54–65.

    Article  PubMed Central  PubMed  Google Scholar 

  40. Davey-Rothwell MA, Latkin CA. HIV-related communication and perceived norms: an analysis of the connection among injection drug users. AIDS Educ Prev. 2007; 19(4): 298–309.

    Article  PubMed  Google Scholar 

  41. Bluthenthal R, Lorvick J, Kral A, Erringer E, Kahn J. Collateral damage in the war on drugs: HIV risk behaviors among injection drug users. Int J Drug Policy. 1999; 10(1):25–38.

  42. Beletsky L, Lozada R, Gaines T, et al. Syringe confiscation as an HIV risk factor: the public health implications of arbitrary policing in Tijuana and Ciudad Juarez, Mexico. J Urban Health. 2013; 90(2): 284–298.

    Article  PubMed Central  PubMed  Google Scholar 

  43. Rhodes T, Simic M. Transition and the HIV risk environment. BMJ. 2005; 331(7510): 220–223.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Volkmann T, Lozada R, Anderson CM, Patterson TL, Vera A, Strathdee SA. Factors associated with drug-related harms related to policing in Tijuana, Mexico. Harm Reduct J. 2011; 8(1): 7.

    Article  PubMed Central  PubMed  Google Scholar 

  45. Syme SL. Social determinants of health: the community as an empowered partner. Prev Chronic Dis. 2004; 1(1): A02.

    PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This study was funded by the National Institutes of Drug Abuse (NIDA): R01 DA031074 (PI: Garfein). RFA received support from NIDA diversity supplement R01 DA031074-01S1 and NIDA T32 DA 023356. AMR received funding from NIDA T32 DA 023356, KDW received support from NIDA K01DA031031, FAM received support from NIDA R01 DA031074-03S1, and SAS received support from NIDA R37 DA019829. NIDA had no role in the study design, data collection, data analysis, or interpretation of the results.

Author information

Authors and Affiliations

  1. Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA

    Richard F. Armenta, Steffanie A. Strathdee, Jazmine Cuevas-Mota, Fatima A. Munoz & Richard S. Garfein

  2. Division of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, CA, USA

    Richard F. Armenta & Stephanie K. Brodine

  3. Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA

    Alexis M. Roth

  4. School of Community Health Sciences, University of Nevada, Reno, NV, USA

    Karla D. Wagner

Authors
  1. Richard F. Armenta
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Alexis M. Roth
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Karla D. Wagner
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Steffanie A. Strathdee
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Stephanie K. Brodine
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jazmine Cuevas-Mota
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Fatima A. Munoz
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Richard S. Garfein
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Richard S. Garfein.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Armenta, R.F., Roth, A.M., Wagner, K.D. et al. Prevalence and Correlates of the Use of Prefilled Syringes Among Persons Who Inject Drugs in San Diego, CA. J Urban Health 92, 1081–1091 (2015). https://doi.org/10.1007/s11524-015-9988-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11524-015-9988-6

Keywords

Search

Navigation