Transitions to Injecting Drug Use Among Noninjecting Heroin Users

• DOI: 10.1097/01.qai.0000186391.49205.3b
• Publication Date: 2006-05-01T12:05:17Z
• Authors: Alan Neaigus; V. Anna Gyarmathy; Maureen Miller; Veronica M. Frajz...; Samuel R. Friedman; Don C. Des Jarlais
• Keywords: Social network (sociolinguistics); Needle sharing; harm reduction

Objectives: To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Methods: Street-recruited NIUs in New York City, March/1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure injectors) and individual susceptibility. A transition was first drug injection following baseline. Hazards ratios (HRs) (P < 0.05) estimated by Cox proportional hazards regression, stratified baseline history. Results: Of 369 (64% 579) followed, former-injectors more likely (33% or 53/160 vs. 12% 25/209; 16.0/100 person-years-at-risk [pyar] 4.6/100 pyar; HR = 3.25). Independent predictors never-injectors included using ≥2 bags daily (HR 7.0); (communication) homelessness 6.3); shorter-term use 5.3); (exposure) physically abused 4.7); friends approve/condone 3.5); lower perceived distance from injectors 2.9); younger age at 1.2). 3.4); white race/ethnicity 2.0); not very afraid needles 1.8); 1.1). Conclusions: The risk initiating than resuming injecting. Social facilitates transitioning those susceptible. Interventions prevent should address both