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Individual and Socio-Environmental Factors Associated with Unsafe Injection Practices Among Young Adult Injection Drug Users in San Diego

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Abstract

Unsafe injection practices significantly increase the risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection among injection drug users (IDUs). We examined individual and socio-environmental factors associated with unsafe injection practices in young adult IDUs in San Diego, California. Of 494 IDUs, 46.9 % reported receptive syringe sharing and 68.8 % sharing drug preparation paraphernalia in the last 3 months. Unsafe injection practices were associated with increased odds of having friends who injected drugs with used syringes, injecting with friends or sexual partners, and injecting heroin. Perceived high susceptibility to HIV and perceived barriers to obtaining sterile syringes were associated with increased odds of receptive syringe sharing, but not with sharing injection paraphernalia. Over half the IDUs reported unsafe injection practices. Our results suggest that personal relationships might influence IDUs’ perceptions that dictate behavior. Integrated interventions addressing individual and socio-environmental factors are needed to promote safe injection practices in this population.

Resumen

Las prácticas inseguras de inyección aumentan significativamente el riesgo de infección para el virus de la hepatitis C (VHC) y el virus de la inmunodeficiencia humana (VIH) entre usuarios de drogas inyectables (UDI). Se examinó la asociación de los factores individuales y socio-ambientales con las prácticas inseguras de inyección entre los adultos jóvenes UDIs en San Diego, California. De los 494 UDIs, el 46.9 % reportaron que se han inyectado con jeringas usadas y el 68.8 % que han compartido el equipo de preparación de drogas en los últimos 3 meses. Las prácticas inseguras de inyección se asociaron con mayor probabilidad de: tener amigos que se inyectaban drogas con jeringas usadas, inyectarse heroína, y de inyectarse con amigos o con su pareja sexual. La percepción de una alta susceptibilidad para la infección del VIH y la percepción de barreras para la obtención de jeringas estériles se asociaron con una mayor probabilidad de inyectarse con jeringas usadas, pero no se asociaron con el uso compartido del equipo para preparación de drogas. Más de la mitad de los UDIs reportaron prácticas inseguras de inyección. Nuestros resultados sugieren que las relaciones personales pueden influir en las percepciones de los UDIs que dictan su comportamiento. Se necesitan intervenciones integradas que aborden los factores individuales y socio-ambientales para promover prácticas seguras de inyección en esta población.

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Acknowledgments

We are grateful to all the participants in our study. Funding for the Study to Assess Hepatitis C Risk (STAHR), which yielded the data, was provided by a contract (#200-2007-21016) from the Centers for Disease Control and Prevention (PI: Garfein). Dr. Muñoz was supported by an NIH/NIAID T32 Training Grant (2T32A1007384-21A1). Support for additional HIV and HCV testing was provided by grants from the National Institutes of Health (AI36214, AI074621, and AI007384) and the California HIV/AIDS Research Program (RN07-SD-702).

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

    Fátima Muñoz, José Luis Burgos, Jazmine Cuevas-Mota & Richard S. Garfein

  2. National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA

    Eyasu Teshale

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  1. Fátima Muñoz
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Correspondence to Richard S. Garfein.

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Muñoz, F., Burgos, J.L., Cuevas-Mota, J. et al. Individual and Socio-Environmental Factors Associated with Unsafe Injection Practices Among Young Adult Injection Drug Users in San Diego. AIDS Behav 19, 199–210 (2015). https://doi.org/10.1007/s10461-014-0815-y

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