Division of Global Public Health, University of California San Diego, San Diego, CA, USA.
Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
J Urban Health. 2018 Feb;95(1):83-90. doi: 10.1007/s11524-017-0188-4.
Although most people who inject drugs (PWID) report receiving assistance during injection initiation events, little research has focused on risk factors among PWID for providing injection initiation assistance. We therefore sought to determine the influence of non-injection drug use among PWID on their risk to initiate others. We used generalized estimating equation (GEE) models on longitudinal data among a prospective cohort of PWID in Tijuana, Mexico (Proyecto El Cuete IV), while controlling for potential confounders. At baseline, 534 participants provided data on injection initiation assistance. Overall, 14% reported ever initiating others, with 4% reporting this behavior recently (i.e., in the past 6 months). In a multivariable GEE model, recent non-injection drug use was independently associated with providing injection initiation assistance (adjusted odds ratio [AOR] = 2.42, 95% confidence interval [CI] = 1.39-4.20). Further, in subanalyses examining specific drug types, recent non-injection use of cocaine (AOR = 9.31, 95% CI = 3.98-21.78), heroin (AOR = 4.00, 95% CI = 1.88-8.54), and methamphetamine (AOR = 2.03, 95% CI = 1.16-3.55) were all significantly associated with reporting providing injection initiation assistance. Our findings may have important implications for the development of interventional approaches to reduce injection initiation and related harms. Further research is needed to validate findings and inform future approaches to preventing entry into drug injecting.
虽然大多数注射吸毒者（PWID）报告在注射起始事件中获得了帮助，但很少有研究关注 PWID 提供注射起始帮助的风险因素。因此，我们试图确定 PWID 中非注射药物使用对他们开始帮助他人的风险的影响。我们使用纵向数据的广义估计方程（GEE）模型对墨西哥蒂华纳的一个前瞻性 PWID 队列（Proyecto El Cuete IV）进行了研究，同时控制了潜在的混杂因素。在基线时，534 名参与者提供了关于注射起始帮助的数据。总体而言，14%的人报告曾经帮助过他人，其中 4%的人最近（即过去 6 个月）有过这种行为。在多变量 GEE 模型中，最近的非注射药物使用与提供注射起始帮助独立相关（调整后的优势比 [AOR] = 2.42，95%置信区间 [CI] = 1.39-4.20）。此外，在检查特定药物类型的亚分析中，最近非注射使用可卡因（AOR = 9.31，95%CI = 3.98-21.78）、海洛因（AOR = 4.00，95%CI = 1.88-8.54）和甲基苯丙胺（AOR = 2.03，95%CI = 1.16-3.55）均与报告提供注射起始帮助显著相关。我们的研究结果可能对制定干预措施以减少注射起始和相关危害具有重要意义。需要进一步的研究来验证研究结果，并为未来预防药物注射的方法提供信息。
