Department of Psychiatry, University of California San Francisco, San Francisco, USA.
Division of Global Public Health, University of California San Diego, San Diego, USA.
Drug Alcohol Rev. 2018 Jan;37(1):128-136. doi: 10.1111/dar.12524. Epub 2017 Mar 24.
Patterns of polydrug use among people who inject drugs (PWID) may be differentially associated with overdose and unique human immunodeficiency virus (HIV) risk factors. Subgroups of PWID in Tijuana, Mexico, were identified based on substances used, route of administration, frequency of use and co-injection indicators.
Participants were PWID residing in Tijuana age ≥18 years sampled from 2011 to 2012 who reported injecting an illicit substance in the past month (n = 735). Latent class analysis identified discrete classes of polydrug use characterised by 11 indicators of past 6 months substance use. Multinomial logistic regression examined class membership association with HIV risk behaviours, overdose and other covariates using an automated three-step procedure in mplus to account for classification error.
Participants were classified into five subgroups. Two polydrug and polyroute classes were defined by use of multiple substances through several routes of administration and were primarily distinguished from each other by cocaine use (class 1: 5%) or no cocaine use (class 2: 29%). The other classes consisted primarily of injectors: cocaine, methamphetamine and heroin injection (class 3: 4%); methamphetamine and heroin injection (class 4: 10%); and heroin injection (class 5: 52%). Compared with the heroin-only injection class, memberships in the two polydrug and polyroute use classes were independently associated with both HIV injection and sexual risk behaviours.
Substance use patterns among PWID in Tijuana are highly heterogeneous, and polydrug and polyroute users are a high-risk subgroup who may require more tailored prevention and treatment interventions. [Meacham MC, Roesch SC, Strathdee SA, Lindsay S, Gonzalez-Zuniga P, Gaines TL. Latent classes of polydrug and polyroute use and associations with human immunodeficiency virus risk behaviours and overdose among people who inject drugs in Tijuana, Baja California, Mexico. Drug Alcohol Rev 2018;37:128-136].
注射吸毒者（PWID）的多药物使用模式可能与过量和独特的人类免疫缺陷病毒（HIV）风险因素有不同的关联。在墨西哥蒂华纳，根据使用的物质、给药途径、使用频率和共同注射指标，确定了 PWID 的亚组。
参与者为 2011 年至 2012 年期间居住在蒂华纳年龄≥18 岁的 PWID，报告过去一个月内注射过非法物质（n=735）。潜在类别分析确定了过去 6 个月 11 个物质使用指标的离散多药物使用类别。使用 mplus 中的自动三步程序，多变量逻辑回归检验了类别成员与 HIV 风险行为、过量和其他协变量的关联，以纠正分类错误。
参与者被分为五个亚组。两种多药物和多途径使用类别是通过多种途径使用多种物质定义的，主要通过可卡因使用（类别 1：5%）或不使用可卡因（类别 2：29%）来区分。其他类别主要由注射者组成：可卡因、甲基苯丙胺和海洛因注射（类别 3：4%）；甲基苯丙胺和海洛因注射（类别 4：10%）；和海洛因注射（类别 5：52%）。与海洛因单一注射类别相比，两种多药物和多途径使用类别的成员与 HIV 注射和性风险行为均独立相关。
蒂华纳 PWID 的药物使用模式高度异质，多药物和多途径使用者是一个高风险亚组，可能需要更有针对性的预防和治疗干预措施。[Meacham MC、Roesch SC、Strathdee SA、Lindsay S、Gonzalez-Zuniga P、Gaines TL。墨西哥下加利福尼亚州蒂华纳注射吸毒者多药物和多途径使用的潜在类别及其与人类免疫缺陷病毒风险行为和过量的关联。药物和酒精评论 2018；37:128-136]。
