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Injecting Risk Behavior among Traveling Young Injection Drug Users: Travel Partner and City Characteristics

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Abstract

Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004–2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000–1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56–8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25–22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11–27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46–5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42–7.68; AOR = 3.03; 95 % CI, 1.32–6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.

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Acknowledgments

The authors would like to acknowledge the important contributions of the participants and field staff, past and present, of the UFO Study, and David Purchase, Chair of the North American Syringe Exchange Network (NASEN). This study was funded by NIDA 5T32DA02335603 (Davidson), NIDA 5R01 DA016017-08 (Evans, Page), the University wide AIDS Research Program ID03-SF-006 (Hahn), and by NIH/NIDA K01 DA023365 (Hahn).

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Authors and Affiliations

  1. University of California, Berkeley and University of California, San Francisco Joint Medical Program, Berkeley and San Francisco, CA, USA

    Martha E. Montgomery

  2. Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

    Robin S. Fatch & Judith A. Hahn

  3. Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA

    Jennifer L. Evans, Michelle Yu, Kimberly Page & Judith A. Hahn

  4. School of Medicine, Division of Global Public Health, University of California, San Diego, CA, USA

    Peter J. Davidson

Authors
  1. Martha E. Montgomery
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  2. Robin S. Fatch
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  3. Jennifer L. Evans
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  4. Michelle Yu
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  5. Peter J. Davidson
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  6. Kimberly Page
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  7. Judith A. Hahn
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Correspondence to Judith A. Hahn.

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Montgomery, M.E., Fatch, R.S., Evans, J.L. et al. Injecting Risk Behavior among Traveling Young Injection Drug Users: Travel Partner and City Characteristics. J Urban Health 90, 500–515 (2013). https://doi.org/10.1007/s11524-012-9718-2

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  • DOI: https://doi.org/10.1007/s11524-012-9718-2

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