Social Networks of Substance-Using Populations: Key Issues and Promising New Approaches for HIV

West, Brooke S.

doi:10.1007/s11904-019-00425-w

Cited by 8 publications

(4 citation statements)

References 103 publications

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“…Social networks, which vary in size and composition, have long been recognized as central in shaping health behaviors and knowledge related to HIV transmission and prevention. In marginalized populations impacted by substance use like PWID, a large body of literature has documented the role of social networks and peer-based interventions in supporting engagement in HIV-prevention services [7]. More recently, peer-based interventions have also shown promise in preventing drug-related overdose [8].…”

Section: Introductionmentioning

confidence: 99%

PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report

et al. 2023

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Background In the context of increasing injection-related HIV outbreaks across the United States, particularly among people who inject drugs (PWID) experiencing homelessness, there is an urgent need to expand access to pre-exposure prophylaxis (PrEP) for HIV prevention. Peer-based interventions for PrEP could be helpful for promoting PrEP uptake, yet the social experiences of using PrEP among PWID experiencing homelessness have not been thoroughly explored. Methods To better understand social experiences surrounding PrEP use among PWID experiencing homelessness, we conducted qualitative interviews from March-December 2020 with current and former PrEP patients of an innovative, low-threshold program implemented by Boston Health Care for the Homeless Program (BHCHP) in Boston, MA. Thematic analysis of coded interview data explored participants’ perspectives and experiences with PrEP disclosure and discussions within their social networks. Results Among interviews with 21 participants, we identified the following four interrelated aspects of their social experiences using PrEP: (1) participants’ were aware of increasing HIV transmission within their social networks, which motivated their PrEP use and disclosure; (2) participants generally avoided disclosing their PrEP use within public spaces or casual conversations; (3) participants expressed greater willingness to discuss PrEP with their close social contacts; and (4) some participants self-identified as leaders or expressed interest in leading the dissemination of PrEP information within their social networks. Conclusions Findings highlight the significance of PrEP disclosure and discussions within the social networks of PWID experiencing homelessness, suggesting a need for continued social network and intervention research—particularly to establish the feasibility and acceptability of peer-based interventions for promoting PrEP—with this marginalized population.

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Section: Introductionmentioning

confidence: 99%

PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report

et al. 2023

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“…Alternately, this could be attributable to other social or macro-level factors serving as important predictors of centrality, but not being captured in this study. For instance, injection venues, proximity in space to HIV prevention services or residential neighborhood characteristics are integral spatial components of the HIV risk environment [54]. Prior analyses evince the importance of injection venues for HIV transmission in this setting [21,22].…”

Section: Discussionmentioning

confidence: 99%

Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India

Prata Menezes,

Mehta,

Wesolowski

et al. 2023

Addiction

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Background and aimsNetwork centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual‐level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as peer navigators or change agents in network‐based interventions in settings where sociometric data are unavailable. We assessed the relationship between network centrality and HIV prevention service engagement to determine whether centrally‐positioned PWID share measurable commonalities.DesignObservational study and survey using baseline data from a sociometric network cohort of PWID, enumerated using network software and biometric data (2017‐2020). Network ties corresponded to direct injection partnerships in the prior month.SettingNew Delhi, India.ParticipantsA total of 2512 PWID who were ≥18 years, provided written informed consent, and reported illicit injection drug use within the 24 months before study enrollment.MeasurementsInterviewer‐administered questionnaires measured demographics and substance use behaviors. Central versus peripheral network position was categorized using betweenness centrality 75th%ile. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) between network position and HIV testing, medication for opioid use disorder (MOUD), or syringe service use. Lasso models selected predictors of central network position among 20 covariates detailing demographic, biologic, and substance use information. Predictive accuracy was evaluated using model performance metrics.FindingsOverall, median age was 26 years (interquartile range 22–34); 99% were male; 628 were classified as central. Compared with PWID at the periphery, central PWID were more likely to use MOUD (aOR: 1.59, 95%CI: 1.30–1.94) and syringe services (aOR: 2.91, 95%CI: 2.25, 3.76) in the prior six months. Findings for HIV testing were inconclusive (aOR: 1.30, 95%CI: 1.00–1.69). The lasso variable selector identified several predictors of network centrality: HIV and hepatitis C infection, number of PWID seen in the prior month, injecting heroin and buprenorphine (vs. heroin only) six months prior, sharing injection equipment six months prior, experiencing drug overdose in the past year, and moderate/severe depression (vs. none/mild). Average agreement between model‐predicted vs. observed values was 0.75; area under the receiver operator curve was 0.69.ConclusionsIn a socioeconomic network of people who inject drugs (PWID) in New Delhi, India, there are common characteristics among individuals based on their network position (central vs. peripheral) but individual‐level predictors have only moderate predictive accuracy. Although central network members appear to be more likely to use HIV prevention services than peripheral network members, their potential as change agents may be limited by other factors that impede their ability to adopt or promote HIV prevention service use.

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“…There were very few rural injection networks to serve as appropriate comparators to the observed network ( West, 2019 ; Young et al, 2013 ). As we aimed to characterize and identify potential unique qualities of this network and their potential contribution to HIV transmission, we instead compared the observed Scott County network to the agent-built simulated networks.…”

Section: Methodsmentioning

confidence: 99%

Network structure and rapid HIV transmission among people who inject drugs: A simulation-based analysis

et al. 2021

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As HIV incidence among people who inject drugs grows in the context of an escalating drug overdose epidemic in North America, investigating how network structure may affect vulnerability to rapid HIV transmission is necessary for preventing outbreaks. We compared the characteristics of the observed contact tracing network from the 2015 outbreak in rural Indiana with 1000 networks generated by an agent-based network model with approximately the same number of individuals ( n = 420) and ties between them ( n = 913). We introduced an initial HIV infection into the simulated networks and compared the subsequent epidemic behavior (e.g., cumulative HIV infections over 5 years). The model was able to produce networks with largely comparable characteristics and total numbers of incident HIV infections. Although the model was unable to produce networks with comparable cohesiveness (where the observed network had a transitivity value 35.7 standard deviations from the mean of the simulated networks), the structural variability of the simulated networks allowed for investigation into their potential facilitation of HIV transmission. These findings emphasize the need for continued development of injection network simulation studies in tandem with empirical data collection to further investigate how network characteristics played a role in this and future outbreaks.

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Social Networks of Substance-Using Populations: Key Issues and Promising New Approaches for HIV

Cited by 8 publications

References 103 publications

PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report

PrEP disclosure and discussions within social networks of people who inject drugs experiencing homelessness: a brief report

Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India

Network structure and rapid HIV transmission among people who inject drugs: A simulation-based analysis

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