Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital , Boston, MA, USA.
The Fenway Institute, Fenway Health , Boston, MA, USA.
J Psychoactive Drugs. 2020 Nov-Dec;52(5):412-420. doi: 10.1080/02791072.2020.1804648. Epub 2020 Aug 14.
Injection drug use (IDU) is of increasing public health concern in the United States. Misuse of and addiction to opioids has contributed to declining life expectancies and rebounding risk of HIV and HCV acquisition among people who inject drugs. While some effective treatment strategies for individuals with substance use disorders have been established, effective interventions to prevent IDU require greater tailoring to subpopulations and social contexts. To better understand contextual variables associated with initiation of IDU, we conducted a narrative review of the existing literature that assessed correlates of age of first injection. We found sixteen studies that met our inclusion criteria. Across studies, later IDU initiation was associated with being African American and female, while early initiation was associated with earlier illicit substance use, childhood trauma, and incarceration. We also found that early initiation was associated with riskier substance-using behaviors, though the findings were mixed with respect to differences between early and late initiates in infectious disease prevalence. These correlates of age of first injection can potentially inform tailored injection prevention strategies. By identifying the features and behaviors of relevant subpopulations before they inject, interventions to prevent IDU could become more effective.
在美国，注射毒品的行为（IDU）日益引起公众关注。滥用和成瘾阿片类药物导致注射毒品者的预期寿命下降，艾滋病毒和丙型肝炎病毒感染的风险再次上升。虽然已经确立了一些针对药物使用障碍患者的有效治疗策略，但需要针对亚人群和社会背景对预防 IDU 的有效干预措施进行更精细的调整。为了更好地了解与 IDU 起始相关的背景变量，我们对评估首次注射年龄相关因素的现有文献进行了叙述性综述。我们发现了十六项符合我们纳入标准的研究。在这些研究中，IDU 起始较晚与非裔美国人和女性有关，而起始较早与较早的非法药物使用、童年创伤和监禁有关。我们还发现，早期开始使用与风险更高的物质使用行为有关，尽管在早期和晚期开始者之间在传染病流行率方面的差异方面存在不一致的发现。这些首次注射年龄的相关因素可以为定制的注射预防策略提供信息。通过在人们开始注射之前识别相关亚人群的特征和行为，预防 IDU 的干预措施可能会更加有效。
