Department of Health, Behavior, Society; Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Hampton House 184, Baltimore, MD, 21205, USA.
Department of Health Policy and Management; Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, Baltimore, MD, 21205, USA.
Harm Reduct J. 2023 Feb 15;20(1):18. doi: 10.1186/s12954-023-00746-5.
Receptive injection equipment sharing (i.e., injecting with syringes, cookers, rinse water previously used by another person) plays a central role in the transmission of infectious diseases (e.g., HIV, viral hepatitis) among people who inject drugs. Better understanding these behaviors in the context of COVID-19 may afford insights about potential intervention opportunities in future health crises.
This study examines factors associated with receptive injection equipment sharing among people who inject drugs in the context of COVID-19.
From August 2020 to January 2021, people who inject drugs were recruited from 22 substance use disorder treatment programs and harm reduction service providers in nine states and the District of Columbia to complete a survey that ascertained how the COVID-19 pandemic affected substance use behaviors. We used logistic regression to identify factors associated with people who inject drugs having recently engaged in receptive injection equipment sharing.
One in four people who inject drugs in our sample reported having engaged in receptive injection equipment sharing in the past month. Factors associated with greater odds of receptive injection equipment sharing included: having a high school education or equivalent (adjusted odds ratio [aOR] = 2.14, 95% confidence interval [95% CI] 1.24, 3.69), experiencing hunger at least weekly (aOR = 1.89, 95% CI 1.01, 3.56), and number of drugs injected (aOR = 1.15, 95% CI 1.02, 1.30). Older age (aOR = 0.97, 95% CI 0.94, 1.00) and living in a non-metropolitan area (aOR = 0.43, 95% CI 0.18, 1.02) were marginally associated with decreased odds of receptive injection equipment sharing.
Receptive injection equipment sharing was relatively common among our sample during the early months of the COVID-19 pandemic. Our findings contribute to existing literature that examines receptive injection equipment sharing by demonstrating that this behavior was associated with factors identified in similar research that occurred before COVID. Eliminating high-risk injection practices among people who inject drugs requires investments in low-threshold and evidence-based services that ensure persons have access to sterile injection equipment.
接受性注射设备共享（即使用他人用过的注射器、炊具、冲洗水进行注射）在吸毒者中传染病（如 HIV、病毒性肝炎）的传播中起着核心作用。更好地了解这些行为在 COVID-19 背景下的情况，可能会为未来卫生危机中的潜在干预机会提供一些见解。
本研究调查了 COVID-19 背景下吸毒者接受性注射设备共享的相关因素。
2020 年 8 月至 2021 年 1 月，从九个州和哥伦比亚特区的 22 个物质使用障碍治疗项目和减少伤害服务提供者中招募了吸毒者，以完成一项调查，确定 COVID-19 大流行如何影响物质使用行为。我们使用逻辑回归来确定与吸毒者最近接受性注射设备共享相关的因素。
我们样本中四分之一的吸毒者报告在过去一个月内进行了接受性注射设备共享。与接受性注射设备共享的可能性更大相关的因素包括：具有高中或同等学历（调整后的优势比[aOR] = 2.14，95%置信区间[95%CI] 1.24，3.69），每周至少经历一次饥饿感（aOR = 1.89，95%CI 1.01，3.56），以及注射的毒品数量（aOR = 1.15，95%CI 1.02，1.30）。年龄较大（aOR = 0.97，95%CI 0.94，1.00）和居住在非大都市地区（aOR = 0.43，95%CI 0.18，1.02）与接受性注射设备共享的可能性降低呈边缘相关。
在 COVID-19 大流行的早期，我们的样本中接受性注射设备共享相对常见。我们的发现为考察接受性注射设备共享的现有文献做出了贡献，表明这种行为与 COVID 之前类似研究中确定的因素有关。要在吸毒者中消除高危注射行为，需要投资于低门槛和基于证据的服务，以确保人们能够获得无菌注射设备。
