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

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Abstract

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.

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References

  1. Day, C., Conroy, E., Lowe, J., Page, J., & Dolan, K. (2006). Patterns of drug use and associated harms among rural injecting drug users: Comparisons with metropolitan injecting drug users. Australian Journal of Rural Health, 14, 120–125.

    Article  PubMed  Google Scholar 

  2. Garfield, J., & Drucker, E. (2001). Fatal overdose trends in major US cities: 1990–1997. Addiction Research and Theory, 9, 425–436.

    Article  Google Scholar 

  3. Wood, E., Tyndall, M. W., Li, K., Lloyd-Smith, E., Small, W., Montaner, J. S. G., et al. (2005). Do supervised injecting facilities attract higher-risk injection drug users? American Journal of Preventive Medicine, 29, 126–130.

    Article  PubMed  Google Scholar 

  4. Doherty, M. C., Garfein, R. S., Monterroso, E., Brown, D., & Vlahov, D. (2000). Correlates of HIV infection among young adult short-term injection drug users. AIDS, 14, 717–726.

    Article  CAS  PubMed  Google Scholar 

  5. Garfein, R. S., Vlahov, D., Galai, N., Doherty, M. C., & Nelson, K. E. (1996). Viral infections in short-term injection drug users: The prevalence of the Hepatitis C, Hepatitis B, human immunodeficiency, and human T-lymphotrophic viruses. American Journal of Public Health, 86, 655–661.

    Article  CAS  PubMed  Google Scholar 

  6. Hagan, H., Thiede, H., & Des Jarlais, D. C. (2004). Hepatitis C virus infection among injection drug users: Survival analysis of time to seroconversion. Epidemiology, 15, 543–549.

    Article  PubMed  Google Scholar 

  7. Spunt, B. (2003). The current New York City heroin scene. Substance Use and Misuse, 38, 1539–1549.

    Article  PubMed  Google Scholar 

  8. Des Jarlais, D. C., Friedman, S. R., Perlis, T., Chapman, T. F., Sotheran, J. L., Paone, D., et al. (1999). Risk behavior and HIV infection among new drug injectors in the era of AIDS in New York City. Journal of Acquired Immune Deficiency Syndrome, 20, 67–72.

    CAS  Google Scholar 

  9. Neaigus, A., Gyarmathy, V. A., Miller, M., Frajzyngier, V., Zhao, M., Friedman, S. R., et al. (2007). Injecting and sexual risk correlates of HBV and HCV seroprevalence among new drug injectors. Drug and Alcohol Dependence, 89, 234–243.

    Article  PubMed  Google Scholar 

  10. Crofts, N., Louie, R., Rosenthal, D., & Jolley, D. (1996). The first hit: Circumstances surrounding initiation into injecting. Addiction, 91, 1187–1196.

    Article  CAS  PubMed  Google Scholar 

  11. Diaz, T., Vlahov, D., Edwards, V., Conover, S., & Monterroso, E. (2002). Sex-specific differences in circumstances of initiation into injecting-drug use among young adult Latinos in Harlem, New York City. AIDS and Behavior, 6, 117–122.

    Article  Google Scholar 

  12. Doherty, M. C., Garfein, R. S., Monterroso, E., Latkin, C., & Vlahov, D. (2000). Gender differences in the initiation of injection drug use among young adults. Journal of Urban Health, 77, 396–414.

    Article  CAS  PubMed  Google Scholar 

  13. Bryant, J., & Treloar, C. (2007). The gendered context of initiation to injecting drug use: Evidence for women as active initiates. Drug and Alcohol Review, 26, 287–293.

    Article  PubMed  Google Scholar 

  14. Frajzyngier, V., Neaigus, A., Gyarmathy, V. A., Miller, M., & Friedman, S. R. (2007). Gender differences in injection risk behaviors at the first injection episode. Drug and Alcohol Dependence, 89, 145–152.

    Article  PubMed  Google Scholar 

  15. Roy, E., Haley, N., Leclerc, P., Cedras, L., & Boivin, J. F. (2002). Drug injection among street youth: The first time. Addiction, 97, 1003–1009.

    Article  PubMed  Google Scholar 

  16. Van Ameijden, E. J. C., van den Hoek, J. A. R., Hartgers, C., & Coutinho, R. A. (1994). Risk factors for the transition from noninjection to injection drug use and accompanying AIDS risk behavior in a cohort of drug users. American Journal of Epidemiology, 139, 1153–1163.

    PubMed  Google Scholar 

  17. Kobrak, P., Goldsamt, L. A., Harocopos, A., Jost, J., & Clatts, M. C. (2009). Homegrown methods of risk reduction among new injection drug users. Manuscript under review.

  18. MacRae, R., & Aalto, E. (2000). Gendered power dynamics and HIV risk in drug-using sexual relationships. AIDS Care, 12, 505–515.

    Article  CAS  PubMed  Google Scholar 

  19. Sherman, S. G., Smith, L., Laney, G., & Strathdee, S. A. (2002). Social influences on the transition to injection drug use among young heroin sniffers: A qualitative analysis. International Journal of Drug Policy, 13, 113–120.

    Article  Google Scholar 

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Acknowledgments

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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Correspondence to Lloyd A. Goldsamt.

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The research reported here was supported by a grant from the National Institute on Drug Abuse (R01-DA14234).

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Goldsamt, L.A., Harocopos, A., Kobrak, P. et al. Circumstances, Pedagogy and Rationales for Injection Initiation Among New Drug Injectors. J Community Health 35, 258–267 (2010). https://doi.org/10.1007/s10900-010-9231-z

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  • DOI: https://doi.org/10.1007/s10900-010-9231-z

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