First injection and current risk factors for HIV among new and long-term injection drug users

Chitwood, Dale D.; Sánchez, Jesús; Comerford, Mary; Page, Joanne; McBride, Duane C.; Kitner, Kathi R

doi:10.1080/09540120050042972

Cited by 43 publications

(8 citation statements)

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“…Existing research has documented the numerous social and health consequences associated with long-term heroin use including blood-borne pathogen infections, depression, and high frequency overdoses (Chitwood et al, 2000; Hser, 2007; Rajaratnam, Sivesind, Todman, Roane, & Seewald, 2008; Rosen, Hunsaker, Albert, Cornelius, & Reynolds, 2011; Rosen, Smith, & Reynolds, 2008). Although the public health implications have been consistently documented, the debate concerning the “natural history” or “drug career” of long-term heroin use is ongoing (Best, Ghufran, Day, & Ray, 2008; Genberg et al, 2011; Hser, Hoffman, Grella, & Anglin, 2001; Hser, Longshore, & Anglin, 2007; Weiss et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Trajectories of Aging Long-Term Mexican American Heroin Injectors

2015

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Objective To examine the applicability of the “maturing out” theory to a sample of aging Mexican American men who are long-term heroin injectors. Method Ethnographic data were collected as part of a cross-sectional study of aging Mexican American heroin users in Houston with 20 current heroin users. Results Findings indicate that dysfunctions that emerge in the heroin lifestyle lead not to cessation but rather to “maturing in,” a specific process of social readjustment that returns the heroin user to a stable maintenance pattern of use instead of a recovery phase. This process of paradoxical maturing out can be attributed to the unconditional social support provided to the heroin user by family, peers, and the tecato subculture embedded in Mexican American communities. Discussion Results highlight the implications for the intersection of heroin-related conditions, natural age-related impairments, and cognitive functioning that make this population increasingly susceptible to adverse health consequences.

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Section: Introductionmentioning

confidence: 99%

Trajectories of Aging Long-Term Mexican American Heroin Injectors

2015

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“…This focus reflects the persistent observation that most PWIDs initiate drug injection in their late teens and early twenties. Indeed, observational epidemiological studies have consistently found the mean age of first injection to range from 19 to 22 (Broz et al, 2013; Carneiro et al, 1999; Chitwood et al, 2000; Des Jarlais et al, 1999). Thus, the focus on younger PWID seems appropriate.…”

Section: Introductionmentioning

confidence: 99%

“…Three studies from the 1990s found that new injectors (having initiated injection drug use within the last 6 years) had a mean age of first injection in the range of 25 to 30 (Carneiro et al, 1999; Chitwood et al, 2000; Des Jarlais et al, 1999). Unpublished data from the National Institute for Drug Abuse’s (NIDA) 23-city Cooperative Agreement for AIDS Community-based Outreach/Intervention 1990s (Kral et al, 1998; Stephens et al, 2000), indicate that approximately 16% of PWIDs initiated drug injection at age 30 or later in this multi-site US study.…”

Section: Introductionmentioning

confidence: 99%

Characteristics of people who initiate injection drug use later in life

Arreola¹,

Bluthenthal

Wenger

et al. 2014

Drug and Alcohol Dependence

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BACKGROUND Studies report that among people who inject drugs (PWID), approximately 1 in 7 initiated injection during their thirties or later (referred to hereafter as “late initiates”). However, little is known about individuals who are late initiates. This study aims to describe characteristics of late initiates to drug injection and to examine how they differ from people who initiated drug injection prior to the age of 30 (“typical initiates”). METHODS We recruited 696 active PWID in Los Angeles and San Francisco, California between 2011 and 2013, using targeted sampling and street outreach methods. Participants completed personal interviews that covered items on demographics, drug use history and practices, injection initiation episode, HIV injection- and sex-related risk, health care utilization among others. We used bivariate and multivariate analyses to examine factors associated being a late initiate. RESULTS In our sample, 19% of participants who were 30 years or older were classified as late initiates. In multivariate analysis controlling for city, late initiates had higher odds of being female and African American, having been in treatment prior to initiation, initiating illicit drug use at an older age, and being assisted into injection by someone of the same age or younger. Late initiates had lower odds of frequent recent injection, and having a bipolar disorder diagnosis. CONCLUSION Late initiates comprise a significant proportion of active PWIDs. More study on the health consequences of late initiation are needed as are interventions to prevent transition to drug injection among at-risk populations.

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“…Of those infected with HIV, approximately 14% are IDUs and 2% are MSM who are also IDUs. Given an HIV seroprevalence rate of 19% (Chitwood et al, 2000) there are approximately 23,700 IDUs in Miami, i.e., approximately 1.4% of the total Miami metropolitan population aged 18 years or older. Gender differences are apparent in Miami.…”

Section: Introductionmentioning

confidence: 99%

Mental health in HIV seronegative and seropositive IDUs in South Florida

et al. 2009

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About one-third of HIV-infected people in the USA have a history of injection-drug use. Injecting drugs are a primary vector for HIV transmission. Drug and alcohol use are significant contributors to sexual transmission of the virus. In South Florida, urban injection-drug users (IDUs) represent a substantial population at risk for infection. Substance use management in this group is critical. As part of a larger study of at-risk populations in South Florida, we examined mental health differences among IDUs (n = 117), HIV seropositive IDUs (n = 130), and HIV seronegative non-IDUs (n = 169). We explored factors associated with depression and anxiety between groups, and found HIV seronegative and seropositive IDUs not receiving antiretroviral (ARV) treatment to have poorer overall mental health than both HIV seropositive participants on ARVs and non-IDU participants. Our data support systems enhancement to meet the various psychosocial and health care needs among IDUs and highlight the need for resource allocation to target community-based integrated mental health services in urban populations. In addition, our data underscore the need for primary and secondary HIV prevention interventions to address the drug-use risk behaviors among IDUs to reduce the likelihood of HIV infection and transmission in this population.

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First injection and current risk factors for HIV among new and long-term injection drug users

Cited by 43 publications

References 0 publications

Trajectories of Aging Long-Term Mexican American Heroin Injectors

Trajectories of Aging Long-Term Mexican American Heroin Injectors

Characteristics of people who initiate injection drug use later in life

Mental health in HIV seronegative and seropositive IDUs in South Florida

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