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Journal of Urban Health

, Volume 77, Issue 3, pp 396–414 | Cite as

Gender differences in the initiation of injection drug use among young adults

  • Meg C. Doherty
  • Richard S. Garfein
  • Edgar Monterroso
  • Carl Latkin
  • David Vlahov
Original Articles: Substance Use and HIV Prevention

Abstract

To characterize the circumstances surrounding initiation of injecting drug use, data were collected from 229 young, recently initiated injection drug users enrolled through community-based recruitment in Baltimore, Maryland. Gender differences in the pattern of initiation, the number of persons present at initiation, risky injection, and sexual behaviors at initiation, as well as behaviors after initiation, were examined. Overall, men and women were similar statistically with respect to age at initiation (19.5 years) and risk behaviors at initiation. While men were initiated by men (77%), women were more often initiated by women (65%), most of whom were friends (75%) or relatives (23%). The percentage of women infected with human immunodeficiency virus (HIV) was slightly greater than that of men, 17% versus 11% (P<.2), whether initiated by a man or a woman. Persons who self-initiated had a lower HIV prevalence and fewer HIV-related risk behaviors. Analysis of variance assessed differences in the HIV risk profiles of female and male IDUs who were intiated by someone of the same sex, of the opposite sex, or who self-initiated. These results indicated that (1) young women and men had similar patterns of injection initiation; (2) most women were initiated by female friends, runing counter to earlier literature claims that women were initated to injection drug use by male sex partners; and (3) women initiated by men had a marginally greater mean score on the HIV risk profile.

Key Words

Gender Differences Human Immunodeficiency Virus Initiation Injection Drug Use Intravenous Substance Abuse 

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References

  1. 1.
    UNAIDS, WHO.Report on the Global HIV/AIDS Epidemic: June 1998. Geneva, Switzerland; UNAIDS, WHO,Global HIV/AIDS and STD Surveillance; 1998.Google Scholar
  2. 2.
    Fennema JSA, van Ameijden EJC, van den Hoek A, Coutinho RA. Young and recentonset injecting drug users are at hihger risk for HIV.Addiction. 1997;92(11):1457–1465.CrossRefPubMedGoogle Scholar
  3. 3.
    Battjes RJ, Leukefeld CG, Pickens RW. Age at first injection and HIV risk among intravenous drug users.Am J Drug Alcohol Abuse. 1992;18(3):263–273.PubMedGoogle Scholar
  4. 4.
    Hser YI, Anglin MD, McGlothlin W. Sex differences in addict careers. 1. Initiation of use.Am J Drug Alcohol Abuse. 1987;13(1&2):33–57.PubMedGoogle Scholar
  5. 5.
    Zinberg NE.Drug, Set, and Setting: the Basis for Controlled Intoxicant Use. New Haven CT: Yale University Press; 1984.Google Scholar
  6. 6.
    Chein I, Gerard DL, Lee RS, Rosenfeld E.The Road to H: Narcotics, Delinquency, and social Policy. New York: Basic Books; 1964.Google Scholar
  7. 7.
    Fiedman SR, Des Jarlais DC, Neaigus A, et al. AIDS and the new drug injector.Nature. 1989;339:333–339.Google Scholar
  8. 8.
    Stenbecka M. Initiation into intravenous drug abuse.Acta Psychiatr Scand. 1990;81:459–462.Google Scholar
  9. 9.
    Hughes PH, Barker NW, Crawford GA, Jaffe JH. The natural history of a heroin epidemic.Am J Public Health. 1972;62:995–1001.PubMedGoogle Scholar
  10. 10.
    de Alarcón R. The spread of heroin abuse in a community.Community Health. 1969; 1(3):155–161.PubMedGoogle Scholar
  11. 11.
    Kral AH, Bluthenthal RN, Erringer EA, Lorvick J, Edlin BR. Risk factors among IDUs who give injections to or receive injections from other drug users.Addiction. 1999;94(5):675–683.CrossRefPubMedGoogle Scholar
  12. 12.
    Crofts N, Louie R, Rosenthal D, Jolley D. The first hit; circumstances surrounding initiation into injection.Addiction 1996;91(8):1187–1196.CrossRefPubMedGoogle Scholar
  13. 13.
    Latkin CA, Mandell W, Knowlton AR, et al. Gender differences in injection-related behaviors among injection drug users in Baltimore, Maryland.AIDS Educ Prev. 1998;10(3):257.PubMedGoogle Scholar
  14. 14.
    Friedman SR, Neaigus A, Jose B, Goldstein M, Curtis R, Des Jarlais DC. Gender differences in HIV seroprevalence among new drug injectors vary by city and by social network. Paper presented at:HIV Injection in Women Conference; February 22–25, 1995; Washington, DC. Abstract 82.Google Scholar
  15. 15.
    Gamella JF. The spread of intravenous drug use and AIDS in a neighborhood in Spain.Med Anthropol Q. 1994;8:131–160.CrossRefGoogle Scholar
  16. 16.
    Anglin MD, Hser YI, McGlothlin WH. Sex differences in addict careers. 2. Becoming addicted.Am J Drug Alcohol Abuse. 1987;13(1&2):59–71.PubMedGoogle Scholar
  17. 17.
    Hser YI, Anglin MD, Booth MW. Sex differences in addict careers. 3. Addiction.Am J Drug Alcohol Abuse. 1987;13(3):231–251.PubMedGoogle Scholar
  18. 18.
    Almog YJ, Anglin MD, Fisher DG, Alcohol and heroin use patterns of narcotics addicts: gender and ethnic differences.Am J Drug Alcohol Abuse. 1993;19(2):219–238.PubMedGoogle Scholar
  19. 19.
    Hartel D. Context of HIV risk behavior among female injecting drug users and female sexual partners of injecting drug users. In: Battjes RJ, Sloboda Z, Grace WC, eds.The Context of HIV Risk Among Drug Users and Their Sexual Partners. Rockville, MD: US Department of Health and Human Services; 1994:41–47.Google Scholar
  20. 20.
    Powis B, Griffiths P, Gossop M, Strang J. The differences between male and female drug users: community samples of heroin and cocaine users compared.Subst Use Misuse. 1996;31:529–543.PubMedGoogle Scholar
  21. 21.
    Gerstein DR, Judd LL, Roviner SA. Carrer dynamics of female heroin addicts.Am J Drug Alcohol Abuse. 1979;6:1–23.PubMedGoogle Scholar
  22. 22.
    Helzer JE, Robins LN, Davis DH. Antecedents of narcotic use and addiction. A study of 898 Vietmam Veterans.Drug Alcohol Depend. 1975;1:183–190.Google Scholar
  23. 23.
    Ronald PJM, Robertson JR. Initial and current drug use: how are they related?Addiction. 1993;88:1225–1231.CrossRefPubMedGoogle Scholar
  24. 24.
    Friedman SR, Neaigus A, Jose B, et al. Female injecting drug users get infected sooner than males. Paper presented at:Ninth Intenational Conference on AIDS; June 7–11, 1993; Berlin. Abstract PO-DO3-35122.Google Scholar
  25. 25.
    Des Jarlais DC, Friedman SR, Perlis T, et al. Risk behavior and HIV infection among new drug injectors in the era of AIDS in New York City.J. Acquir Immune Defic Syndr Human Retrovirol. 1999;20(1):67–72.Google Scholar
  26. 26.
    Sotheran JL, Wenston JA, Rockwell R, Des Jarlais DC, Friedman SR. Injecting drug users: why do women share syringes more often than men? Paper presented at:American Public Health Association Annual Meeting; November 8–12, 1992; Washington, DC.Google Scholar
  27. 27.
    Dwyer R, Richardson D, Ross MW, Wodak A, Miller ME, Gold J. A comparison of HIV risk between women and men who inject drugs.AIDS Educt Prev. 1994;6:379–389.Google Scholar
  28. 28.
    Barnard MA. Needle sharing in context: patterns of sharing among men and women injectors and HIV risks.Addiction. 1993;88:805–812.CrossRefPubMedGoogle Scholar
  29. 29.
    Hindin R, Bigelow C, Vickers-Lahti M, Lewis B, McCusker J. Gender differences in sharing behavior among intravenous drug users (IVDUs). Paper presented at:Eighth International AIDS Conference; July 19–24, 1992; Amsterdam. Abstract 8:C287.Google Scholar
  30. 30.
    Wells EA, Clark LL, Caslyn DA, Saxon AJ, Jackson TR, Wrede AF. Reporting of HIV risk behaviors by injection drug using heterosexual couples in methadone maintenance.Drug Alcohol Depend. 1994;36:33–38.PubMedGoogle Scholar
  31. 31.
    Davies AG, Dominy NJ, Peters AD, Richardson AM. Gender differences in HIV risk behaviour of injecting drug users in Edinburgh.AIDS Care. 1996;8:517–527.CrossRefPubMedGoogle Scholar
  32. 32.
    Neaigus A, Friedman SR, Jose B, et al. High-risk personal networks and syringe sharing as risk factors for HIV infection among new drug injectors.J Acquir Immune Defic Syndr Human Retrovirol. 1996;11:499–509.Google Scholar
  33. 33.
    Murphy S, Waldorf D. Kickin' down to the street doc: shooting galleries in the San Francisco Bay area.Comtemp Drug Probl. 1991;18:9–29.Google Scholar
  34. 34.
    Doherty MC, Garfein RS, Monterroso EM, Brown D, Vlahov D. Correlates of HIV infection among young adult short-term injection drug users.AIDS. 2000;14:717–726.CrossRefPubMedGoogle Scholar
  35. 35.
    Page B. Aggregation of in-depth interviews: Cultural patterns among intravenous durg users. Paper presented at:Annual Meeting of the Society for Applied Anthropology; March 29–April 2, 1995; Albuquerque, NM.Google Scholar
  36. 36.
    Edlin BR, Irwin KL, Faruque S, et al. Intersecting epidemics—crack cocaine use and HIV infection among inner-city young adults.N Engl J Med. 1994;331:1422–1427.CrossRefPubMedGoogle Scholar
  37. 37.
    Edlin BR, Irwin KL, Ludwig DD, et al. High-risk sex behavior among young streetrecruited crack cocaine smokers in three American cities: an interim report.J Psychoactive Drugs. 1992;24:363–371.PubMedGoogle Scholar
  38. 38.
    Chiasson MA, Stoneburner RL, Hildebrandt DS, Ewing WE, Telzak EE, Jaffe HW. Heterosexual transmission of HIV-1 associated with the use of smokable freebase cocaine (crack).AIDS 1991;5:1121–1126.PubMedGoogle Scholar
  39. 39.
    Des Jarlais DC, Casriel C, Friedman SR, Rosenblum A. AIDS and the transition to illicit drug injection—results of a randomized trial prevention program.Br J Addict. 1992; 87:493–498.PubMedGoogle Scholar
  40. 40.
    Griffiths P, Gossop M, Powis B, Strang J. Extent and nature of transitions of route among heroin addicts in treatment—preliminary data from the Drug Transitions Study.Br J Addict. 1992;87:485–491.CrossRefPubMedGoogle Scholar
  41. 41.
    Yamaguchi K, Kandel DB. Patterns of drug users from adolescence to young adulthood: III. Predictors of progression.Am J Public Health. 1984;74(7):673–681.PubMedGoogle Scholar
  42. 42.
    Chen K, Kandel DB The natural history of drug use from adolescence to the midthirties in a general population sample.Am J Public Health. 1995;85(1):41–47.PubMedGoogle Scholar

Copyright information

© The New York Academy of Medicine 2000

Authors and Affiliations

  • Meg C. Doherty
    • 3
  • Richard S. Garfein
    • 3
  • Edgar Monterroso
    • 1
  • Carl Latkin
    • 2
  • David Vlahov
    • 3
  1. 1.Division of HIV/AIDSCenters for Disease Control and PreventionAtlanta
  2. 2.Department of Health PolicyThe Johns Hopkins School of Hygiene and Public HealthBaltimore
  3. 3.Room E-6008, Infections Disease Program, Department of EpidemiologyJohns Hopkins School of Hygiene and Public HealthBaltimore

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