Lin Qinyun, Aguilera Javier Andres Rojas, Williams Leslie D, Mackesy-Amiti Mary Ellen, Latkin Carl, Pineros Juliet, Kolak Marynia, Boodram Basmattee
School of Public Health and Community Medicine, Sahlgrenska Academy, University of Gothenburg.
Center for Spatial Data Science, University of Chicago.
Int J Drug Policy. 2023 Dec;122:104217. doi: 10.1016/j.drugpo.2023.104217. Epub 2023 Oct 18.
Recent studies underscore the significance of adopting a syndemics approach to study opioid misuse, overdose, hepatitis C (HCV) and HIV infections, within the broader context of social and environmental contexts in already marginalized communities. Social interactions and spatial contexts are crucial structural factors that remain relatively underexplored. This study examines the intersections of social interactions and spatial contexts around injection drug use. More specifically, we investigate the experiences of different residential groups among young (aged 18-30) people who inject drugs (PWID) regarding their social interactions, travel behaviors, and locations connected to their risk behaviors. By doing so, we aim to achieve a more comprehensive understanding of the multidimensional risk environment, thereby facilitating the development of informed policies.
We collected and examined data regarding young PWID's egocentric injection network and geographic activity spaces (i.e., where they reside, inject drugs, purchase drugs, and meet sex partners). Participants were stratified based on the location of all place(s) of residence in the past year i.e., urban, suburban, and transient (both urban and suburban) to i) elucidate geospatial concentration of risk activities within multidimensional risk environments based on kernel density estimates; and ii) examine spatialized social networks for each residential group.
Participants were mostly non-Hispanic white (59%); 42% were urban residents, 28% suburban, and 30% transient. We identified a spatial area with concentrated risky activities for each residential group on the West side of Chicago in Illinois where a large outdoor drug market area is located. The urban group (80%) reported a smaller concentrated area (14 census tracts) compared to the transient (93%) and suburban (91%) with 30 and 51 tracts, respectively. Compared to other areas in Chicago, the identified area had significantly higher neighborhood disadvantages. Significant differences were observed in social network structures and travel behaviors: suburban participants had the most homogenous network in terms of age and residence, transient participants had the largest network (degree) and more non-redundant connections, while the urban group had the shortest travel distance for all types of risk activities.
Distinct residential groups exhibit varying patterns of network interaction, travel behaviors, and geographical contexts related to their risk behaviors. Nonetheless, these groups share common concentrated risk activity spaces in a large outdoor urban drug market area, underscoring the significance of accounting for risk spaces and social networks in addressing syndemics within PWID populations.
最近的研究强调，在已经边缘化的社区的社会和环境背景的更广泛背景下，采用共病方法来研究阿片类药物滥用、过量使用、丙型肝炎（HCV）和艾滋病毒感染具有重要意义。社会互动和空间背景是关键的结构因素，但仍相对未得到充分探索。本研究考察注射吸毒周围的社会互动和空间背景的交叉点。更具体地说，我们调查了不同居住群体的18至30岁注射吸毒青年（PWID）在社会互动、出行行为以及与其风险行为相关的地点方面的经历。通过这样做，我们旨在更全面地了解多维风险环境，从而促进制定明智的政策。
我们收集并检查了有关年轻PWID的以自我为中心的注射网络和地理活动空间（即他们居住、注射毒品、购买毒品和结识性伴侣的地点）的数据。参与者根据过去一年所有居住地点的位置进行分层，即城市、郊区和临时居住（城市和郊区都有），以便：i）基于核密度估计阐明多维风险环境中风险活动的地理空间集中情况；ii）检查每个居住群体的空间化社会网络。
参与者大多为非西班牙裔白人（59%）；42%为城市居民，28%为郊区居民，30%为临时居住者。我们在伊利诺伊州芝加哥市西侧为每个居住群体确定了一个风险活动集中的空间区域，那里有一个大型户外毒品市场区域。城市群体（80%）报告的集中区域较小（14个普查区），而临时居住者（93%）和郊区居民（91%）分别有30个和51个普查区。与芝加哥的其他地区相比，确定的区域邻里劣势明显更高。在社会网络结构和出行行为方面观察到显著差异：郊区参与者在年龄和居住方面的网络最为同质化，临时居住者的网络最大（度数）且非冗余连接更多，而城市群体在所有类型的风险活动中的出行距离最短。
不同的居住群体在与其风险行为相关的网络互动、出行行为和地理背景方面表现出不同的模式。尽管如此，这些群体在一个大型户外城市毒品市场区域共享共同的风险活动集中空间，强调了在解决PWID人群中共病问题时考虑风险空间和社会网络的重要性。
