AIDS and Behavior

, Volume 15, Issue 7, pp 1579–1588 | Cite as

Role of Social Network Dimensions in the Transition to Injection Drug Use: Actions Speak Louder than Words

  • Nana Koram
  • Hongjie Liu
  • Jianhua Li
  • Jian Li
  • Jian Luo
  • Jennifer Nield
Original Paper


The objective of this study was to examine the influences of social network factors, particularly social support and norms, in the transition from non-injection heroin and/or opiate use to heroin-injection, which is one of the leading causes of the spread of HIV/AIDS in China. Respondent-driven sampling was used to recruit young heroin and/or opiate users in an egocentric network study in Yunnan, China. Multivariate logistic regression using hierarchical combinations of candidate variables was used to analyze network factors for the injection transition. A total of 3,121 social network alters were reported by 403 egos with an average network size of eight. Fifty-eight percent of egos transitioned to heroin-injection from non-injection. This transition was associated with having a larger sex network size, a larger number of heroin injectors in one’s network, and a higher network density. The findings enhance our understanding of the influence of social network dimensions on the transition to injection drug use. Accordingly, the development of interventions for heroin and/or opiate users in China should consider social network characteristics.


Social networks Heroin Transition HIV/AIDS China 



This work was supported by a research grant (R21 DA023893-01A1) from NIH-NIDA. It was awarded to Hongjie Liu and Jianhua Li. We are grateful to the staff from Yunnan Institute of Drug Abuse for their participation in the study, and to all the participants who gave so willingly of their time to provide the study data.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Nana Koram
    • 1
  • Hongjie Liu
    • 1
  • Jianhua Li
    • 2
  • Jian Li
    • 1
  • Jian Luo
    • 2
  • Jennifer Nield
    • 1
  1. 1.Department of Epidemiology and Community HealthVirginia Commonwealth UniversityRichmondUSA
  2. 2.Yunnan Institute for Drug AbuseKunmingChina

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