Rudolph Abby E, Upton Elizabeth, McDonald Madelyn J, Young April M, Havens Jennifer R
Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA, United States.
Department of Mathematics and Statistics, Boston University, Boston, MA, United States; Department of Mathematics and Statistics, Williams College, Williamstown, MA, United States.
Int J Drug Policy. 2020 Nov;85:102604. doi: 10.1016/j.drugpo.2019.11.012. Epub 2019 Nov 15.
This analysis aims to assess whether injection drug use cessation among peers predicts injection drug use cessation among individuals and explores whether this association varies by relationship type and strength.
Data were collected through baseline and 6-month assessments for the Social Networks among Appalachian People study (2008-2011). Interviewer-administered surveys collected sociodemographic and drug use behaviors (past 6 months and lifetime). Participants also listed sex, drug use, and social support partners (past 6 months). Listed names were cross-referenced with survey participants to identify relationships between study participants. The analytic sample was further restricted to include only those relationship pairs where both individuals reported a history of injection drug use at baseline (n = 244 unique individuals and 746 dyads). We fit a generalized estimating equations logistic regression model to (1) assess the relationship between peer injection cessation and individual injection cessation and (2) determine whether the strength of this association differs by relationship-level variables (i.e., relationship role, relationship type, relationship duration, frequency of interaction, residential proximity).
Overall, those with a network member who ceased injection drug use were more likely to stop injecting over the following 6-month period (AOR=1.65). The magnitude of this association was greater for social support partners (AOR=2.95), family members (AOR=3.56), those with whom the participant interacted at least daily (AOR=2.17), and those who the participant knew longer (AOR=2.09). Further, among family members, the effect size was greater when relationships were further restricted to immediate family members (AOR=5.35).
Our findings suggest that in this rural community, closer, more supportive relationships, may be more influential for modeling injection cessation; however, relationship-types were not mutually exclusive so differences in effect size across strata may not be statistically significant. In this setting, social support through the recovery process (including cessation attempts with peers) may increase likelihood of injection cessation.
本分析旨在评估同伴停止注射吸毒是否能预测个体停止注射吸毒，并探讨这种关联是否因关系类型和强度而异。
通过阿巴拉契亚人群社会网络研究（2008 - 2011年）的基线和6个月评估收集数据。由访员进行的调查收集了社会人口统计学和吸毒行为（过去6个月及终生情况）。参与者还列出了性别、吸毒情况以及社会支持伙伴（过去6个月）。将列出的名字与调查参与者进行交叉核对，以确定研究参与者之间的关系。分析样本进一步限制为仅包括那些在基线时双方都报告有注射吸毒史的关系对（n = 244名独特个体和746个二元组）。我们拟合了一个广义估计方程逻辑回归模型，以（1）评估同伴停止注射与个体停止注射之间的关系，以及（2）确定这种关联的强度是否因关系层面变量（即关系角色、关系类型、关系持续时间、互动频率、居住距离）而异。
总体而言，有停止注射吸毒的网络成员的人在接下来的6个月内更有可能停止注射（调整后比值比[AOR]=1.65）。这种关联的强度在社会支持伙伴（AOR = 2.95）、家庭成员（AOR = 3.56）、参与者至少每天与之互动的人（AOR = 2.17）以及参与者认识时间更长的人（AOR = 2.09）中更大。此外，在家庭成员中，当关系进一步限制为直系家庭成员时，效应大小更大（AOR = 5.35）。
我们的研究结果表明，在这个农村社区，更亲密、更具支持性的关系可能对示范停止注射吸毒更有影响力；然而，关系类型并非相互排斥，因此各阶层效应大小的差异可能没有统计学意义。在这种情况下，通过康复过程提供的社会支持（包括与同伴一起尝试停止吸毒）可能会增加停止注射吸毒的可能性。
