Journal of Community Health

, Volume 35, Issue 3, pp 258–267 | Cite as

Circumstances, Pedagogy and Rationales for Injection Initiation Among New Drug Injectors

  • Lloyd A. Goldsamt
  • Alex Harocopos
  • Paul Kobrak
  • John J. Jost
  • Michael C. Clatts
Original Paper


Injection drug use is especially risky for new injectors. To understand the social and environmental contexts in which risks occur, we interviewed individuals who had initiated injection within the past 3 years (n = 146, 69.2% male) about the circumstances and rationales for their initial injection events. Respondents typically initiated injection due to tolerance (49.3%) and/or for experimentation (61.1%). Most (86.2%) did not possess the technical skills required to self-inject, and relied on the assistance of someone older (58.5%). While low levels of syringe sharing (5.8%) were reported, a majority of respondents (60.5%) engaged in at least one type of behavioral risk. Female injectors were more likely than male injectors to rely on another individual (95.5 vs. 82.2%), often a sex partner (40.5 vs. 7.2%), for assistance. The diversity seen in early injection practices highlights the need for tailored prevention messages to reach this population prior to the onset of injection risk.


Injection initiation Drug injectors Heroin HIV HCV 



The authors wish to acknowledge Christopher Alley for his work on recruiting and interviewing subjects and Julie O’Brien for her work on study data, as well as all of the new injectors who shared their stories and experiences with us.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Lloyd A. Goldsamt
    • 1
  • Alex Harocopos
    • 1
  • Paul Kobrak
    • 2
  • John J. Jost
    • 3
  • Michael C. Clatts
    • 4
  1. 1.Institute for International Research on Youth at RiskNational Development and Research Institutes, Inc.New YorkUSA
  2. 2.Bureau of HIV/AIDS Prevention and ControlNew York City Department of Health and Mental HygieneNew YorkUSA
  3. 3.Center for Urban Community ServicesNew YorkUSA
  4. 4.School of Public HealthUniversity of Puerto RicoSan JuanUSA

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