Age and sharing of needle injection equipment in a cohort of Massachusetts injection drug users: an observational study

Katherine Tassiopoulos, Judith Bernstein, Edward Bernstein, Katherine Tassiopoulos, Judith Bernstein, Edward Bernstein

Abstract

Background: Hepatitis C infection (HCV) among individuals aged 15-24 years has increased in Massachusetts, likely due to injection drug use. The prevalence of injection equipment sharing (sharing) and its association with age was examined in a cohort of out-of-treatment Massachusetts substance users.

Methods: This analysis included baseline data from a behavioral intervention with substance users. Younger and older (<25 versus ≥ 25 years) injection drug users were compared on demographic characteristics, substance use practices, including factors present during the most recent sharing event ("event-level factors"), and HCV testing history.

Results: Sharing was reported by 41% of the 484 individuals who reported injection drug use in the past 30 days. Prevalence of sharing varied by age (50% <25 years old versus 38% ≥ 25 years, p=0.02). In a multivariable logistic regression model younger versus older individuals had twice the odds of sharing (95% CI=1.26, 3.19). During their most recent sharing event, fewer younger individuals than older had their own drugs available (50% versus 75%, p<0.001); other injection event-level factors did not vary by age. In the presence of PTSD, history of exchanging sex for money, or not being US born, prevalence of sharing by older users was higher and was similar to that of younger users, such that there was no association between age and sharing.

Conclusions: In this cohort of injection drug users, younger age was associated with higher prevalence of sharing, but only in the absence of certain stressors. Harm reduction efforts might benefit from intervening on mental health and other stressors in addition to substance use. Study findings suggest a particular need to address the dangers of sharing with young individuals initiating injection drug use.

References

    1. Centers for Disease Control and Prevention (CDC) Hepatitis C virus infection among adolescents and young adults—Massachusetts, 2002–2009. MMWR Morb Mortal Wkly Rep. 2011;8:537–541.
    1. National Drug Intelligence Center, US Department of Justice. National Drug Threat Assessment 2010. 2010. [ ]
    1. Hagan H, Thiede H, Weiss NS, Hopkins SG, Duchin JS, Alexander ER. Sharing of drug preparation equipment as a risk factor for hepatitis C. Am J Public Health. 2001;8:42–46.
    1. Latkin C, Buchanan A, Metsch L, Knight K, Latka M, Mizuno Y, Knowlton A. for the Intervention for Seropositive Injectors-Research Evaluation Team. Predictors of sharing injection equipment by HIV-seropositive injection drug users. J Acquir Immune Defic Syndr. 2008;8:447–450. doi: 10.1097/QAI.0b013e31818a6546.
    1. Stein M, Solomon D, Herman D, Anderson B, Miller I. Depression severity and drug injection HIV risk behaviors. Am J Psychiatry. 2003;8:1659–1662. doi: 10.1176/appi.ajp.160.9.1659.
    1. Delgado M, Lundgren L, Deshpande A, Lonsdale J, Purington T. The association between acculturation and needle sharing among Puerto Rican injection drug users. Eval Program Plann. 2008;8:83–91. doi: 10.1016/j.evalprogplan.2007.05.010.
    1. Booth R, Kwiatkowski C, Mikulich-Gilbertson S, Brewster J, Salomonsen-Sautel S, Corski K, Sinitsyna L. Predictors of risky needle use following interventions with injection drug users in Ukraine. Drug Alcohol Depend. 2006;8(Suppl 1):49–55.
    1. Buxton M, Vlahov D, Strathdee C, Des Jarlais D, Morse E, Ouellet L, Kerndt P, Garfein R. Association between injection practices and duration of injection among recently initiated injection drug users. Drug Alcohol Depend. 2004;8:177. doi: 10.1016/j.drugalcdep.2004.01.014.
    1. De P, Cox J, Boivin J, Platt R, Jolly A, Alexander P. HIV and HCV discordant injecting partners and their association to drug equipment sharing. Scand J Infect Dis. 2009;8:206–214. doi: 10.1080/00365540902721376.
    1. Mandell W, Vlahov D, Latkin C, Oziemkowska M, Cohn S. Correlates of needle sharing among injection drug users. Am J Public Health. 1994;8:920–923. doi: 10.2105/AJPH.84.6.920.
    1. Metsch L, Pereyra M, Purcell D, Latkin C, Malow R, Gomez C, Latka M. for the INSPIRE Study Team. Correlates of lending needles/syringes among HIV-seropositive injection drug users. J Acquir Immune Defic Syndr. 2007;8(Suppl 2):72–79.
    1. Seal K, Edlin B, Ochoa K, Tulsky J, Moss A, Hahn J. Risk of hepatitis B infection among young injection drug users in San Francisco: opportunities for intervention. West J Med. 2000;8:16–20. doi: 10.1136/ewjm.172.1.16.
    1. Watters J, Estilo M, Clark G, Lorvick J. Syringe and needle exchange as HIV/AIDS prevention for injection drug users. JAMA. 1994;8:115–120. doi: 10.1001/jama.1994.03510260047027.
    1. Doherty M, Garfein R, Monterosso E, Brown D, Vlahov D. Correlates of HIV infection among young adult short-term injection drug users. AIDS. 2000;8:717–726. doi: 10.1097/00002030-200004140-00011.
    1. Garfein R, Doherty M, Monterroso E, Thomas D, Nelson K, Vlahov D. Prevalence and incidence of hepatitis C virus infection among young adult injection drug users. J Acquir Immune Defic Syndr Hum Retrovirol. 1998;8(Suppl 1):11–199.
    1. Miller CL, Johnston C, Spittal PM, Li K, LaLiberte N, Montaner J, Schechter M. Opportunities for prevention: hepatitis C prevalence and incidence in a cohort of young injection drug users. Hepatol. 2002;8:737–742. doi: 10.1053/jhep.2002.35065.
    1. Bernstein E, Bernstein J, Levenson S. Project ASSERT: an ED based intervention to increase access to primary care, preventive services, and the substance abuse treatment system. Ann Emerg Med. 1997;8:181–189. doi: 10.1016/S0196-0644(97)70140-9.
    1. Skinner HA. The Drug Abuse Screening Test (DAST-10): Guidelines for administration and scoring. Toronto: Addiction Research Foundation; 1995.
    1. Bernstein E, Ashong D, Heeren T, Winter M, Bliss C, Madico G, Bernstein J. The impact of a brief motivational intervention on unprotected sex and sex while high among drug-positive emergency department patients who receive STI/HIV VC/T and drug treatment referral as standard of care. AIDS Behav. 2012;8:1203–1216. doi: 10.1007/s10461-012-0134-0.
    1. Ruggiero KJ, DelBen K, Scotti JR, Rabalais AF. Psychometric properties of the PTSD checklist-civilian version. J Trauma Stress. 2003;8:495–502. doi: 10.1023/A:1025714729117.
    1. Lankenau S, Teti M, Silva K, Bloom J, Harocopos A, Treese M. Initiation into prescription opioid misuse among young injection drug users. Int J Drug Policy. 2012;8:37–44. doi: 10.1016/j.drugpo.2011.05.014.
    1. Page K, Morris M, Hahn J, Maher L, Prins M. Injection drug use and hepatitis C virus infection in young adult injectors: using evidence to inform comprehensive prevention. Clin Infect Dis. 2013;8(Suppl 2):32–38. doi: 10.1093/cid/cit300.
    1. Peters A, Davies T, Richardson A. Multi-site samples of injecting drug users in Edinburgh: prevalence and correlates of risky injecting practices. Addiction. 1998;8:253–267. doi: 10.1046/j.1360-0443.1998.9322539.x.
    1. Costenbader EC, Astone NM, Latkin CA. The dynamics of injection drug users’ personal networks and HIV risk behaviors. Addiction. 2006;8:1003–1013. doi: 10.1111/j.1360-0443.2006.01431.x.
    1. Hoffmann JP, Su SS, Pach A. Changes in network characteristics and HIV risk behavior among injection drug users. Drug Alcohol Depend. 1997;8:41–51. doi: 10.1016/S0376-8716(97)00038-0.
    1. Zerden L, López LM, Lundgren L. Needle sharing among Puerto Rican injection drug users in Puerto Rico and Massachusetts: place of birth and residence matter. Subst Use Misuse. 2010;8:1605–1622. doi: 10.3109/10826081003682842.
    1. Centers for Disease Control and Prevention (CDC) HIV-associated behaviors among injecting-drug users – 23 cities, United States, May 2005-February 2006. MMWR Morb Mortal Wkly Rep. 2009;8:329–332.
    1. Des Jarlais D, Diaz T, Perlis T, Vlahov D, Maslow C, Latka M, Rockwell R, Edwards V, Friedman S, Monterroso E, Williams I, Garfein R. Variability in the incidence of human immunodeficiency virus, hepatitis B virus, and hepatitis C virus infection among young injecting drug users in New York City. Am J Epidemiol. 2003;8:467–471. doi: 10.1093/aje/kwf222.
    1. Thorpe L, Ouellet L, Hershow R, Bailey S, Williams I, Williamson J, Monterroso E, Garfein R. Risk of hepatitis C virus infection among young adult injection drug users who share injection equipment. Am J Epidemiol. 2002;8:645–653. doi: 10.1093/aje/155.7.645.

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