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PubMed2000

Needle sharing: a longitudinal study of female injection drug users.

The objective of this study was to examine the psychosocial risk and protective factors related to needle-sharing behavior among female intravenous drug users (IDUs) positive (N = 96) and negative (N = 128) for human immunodeficiency virus (HIV). Participants in this longitudinal study were interviewed individually at two points in time, with a 6-month interval between interviews. The interviewers used a structured questionnaire, which included psychosocial measures and questions about drug and sexual risk behaviors. Data were analyzed using Pearson correlations and hierarchical regression analyses. The findings supported a developmental model in which the psychosocial domains and HIV status predicted T1 (initial) needle-sharing behavior, which in turn was related to T2 (follow-up) needle-sharing behavior. In addition, the relationship between personality and peer risk factors and T2 needle sharing was buffered by family-related protective factors. While HIV-positive status had a direct effect on T1 needle sharing with strangers, its effect was mediated by all of the psychosocial variables in its relation to T1 needle sharing with familiar people. Comparisons of these results were made with a companion study of male IDUs. The results suggest several intervention and treatment approaches that can be implemented at different points in the developmental pathways leading to risky needle-sharing practices among female IDUs.

Adult↗
PubMed2001

Risk factors of HIV infection and needle sharing among injecting drug users in Ho Chi Minh City, Vietnam.

OBJECTIVE: We sought to identify risk factors for needle sharing and HIV infection among injecting drug users (IDUs) in Ho Chi Minh City (HCMC), Vietnam. METHODS: Three cross-sectional surveys among IDUs, both on the street (in 11 urban districts) and in the rehabilitation center for IDUs in HCMC, were carried out in April of 1995, 1997, and 1998. Outreach workers interviewed IDUs about socio-demographic characteristics, drug use and sexual practices, and HIV knowledge and perceptions. The IDUs were also tested for seropositivity to HIV. Independent predictors for HIV positivity and needle sharing were determined by univariate and multivariate logistic regression for the study sample within the rehabilitation center in 1997 and for that on the street in 1998. RESULTS: The HIV prevalence in 1998 among IDUs was 44% for those on the street and 38.5% for those in the rehabilitation center. Independent predictors for HIV infection in IDUs were being injected by drug dealers (for the 1997 sample), injecting on the street, and sharing the drug pots (for the 1998 sample). The reported rate of needle sharing was low and decreased significantly from 20% in 1995 to 12% in 1998 for the sample of IDUs at the street. In the multivariate analysis, predictors for needle sharing for both study samples were injecting on the street, injecting at shooting galleries, and having shared needles in the past. Adequate and easy access to sterile needles and syringes, and a supportive environment of behavior change, especially in street and shooting gallery could reduce risks of virus transmission in the Vietnamese IDU community.

Adult↗
PubMed1991

Needle-sharing among intravenous drug users in New Orleans.

We studied needle sharing among intravenous drug users in New Orleans, where needles are not controlled by prescription. Three hundred and eighty self-identified intravenous drug users were interviewed regarding needle-sharing practices, frequency of drug use, and drug(s) of choice. Overall, 65.8% admitted they regularly used needles which had been used by others. No significant differences in needle sharing were found by sex, race, frequency of injection, or drug of choice. A survey of pharmacies found that 85.5% have self-imposed restrictions on the sale of needles and syringes. Legal availability of injection equipment may not be equivalent to actual availability to the consumer.

Adult↗
PubMed2001

Trends in HIV seroprevalence and needle sharing among Puerto Rican drug injectors in Puerto Rico and New York: 1992-1999.

This study assessed trends in HIV seroprevalence and needle-sharing behaviors among Puerto Rican injection drug users (IDUs) in Puerto Rico and New York. Data from two studies of IDUs conducted from 1992 through 1995 and 1998 through 1999 in Bayamón, Puerto Rico, and East Harlem, New York, were examined to assess trends over this period. Separate analyses were conducted for IDUs who were current crack smokers. Significant decreasing trends in seroprevalence were found among IDUs in the New York and Puerto Rico samples (p <.001). Significant decreasing trends in receptive and distributive needle sharing were found in the New York sample, and a significant decline in receptive sharing was found in the Puerto Rico sample. Overall, higher levels of needle-sharing behaviors were reported in Puerto Rico compared with New York. Decreasing trends in needle sharing and seroprevalence in both communities are an encouraging finding. Ongoing epidemiologic studies to monitor the epidemic and continued prevention efforts to help maintain or further these declines are needed, particularly to address the higher rates of needle sharing in Puerto Rico.

Adolescent↗
PubMed1998

Needle sharing and high-risk sexual behaviors among IV drug users in Southern Thailand.

This study sought to determine the prevalence of needle sharing and high HIV risk sexual behaviors and to identify characteristics associated with these practices in southern Thailand. Data were obtained using a structured questionnaire from 298 male intravenous drug users (IVDUs) seen in a methadone clinic during the previous year. The prevalence of HIV was 37%, and that of needle-sharing in the preceding months was 45%, although only 10% claimed to have had unsafe sex with a casual partner or prostitute in the same period. Determinants for needle sharing included shorter duration of drug injection, diminished knowledge of HIV prevention, a carefree attitude toward risk of HIV infection, and lower levels of income. Young single IVDUs with a low knowledge of HIV prevention were most likely not to use a condom. In conclusion, needle sharing among the study subjects was still a common practice, whereas high HIV risk sexual behavior was not. Attitudinal change may be necessary to reduce needle-sharing behavior and not just information on disease transmission.

Adult↗
PubMed1999

Do actions speak louder than words? Perceived peer influences on needle sharing and cleaning in a sample of injection drug users.

Past research (Dielman, Butchart, Shope, & Miller, 1990; Kandel, 1980) has found peer influence, perceived peer norms and perceived peer behavior as the strongest predictors of drug use in adolescent and young adult populations. The purpose of this study was to investigate whether verbal persuasion (peer norms) and/or observation of peer behavior (modeling) were significantly associated with the injection practices of unclean needle sharing and needle cleaning of 642 high risk for HIV infection active injection drug users in Baltimore, Maryland, in 1991 and 1992. Using regression analyses to examine interview reports of infection practices, it was determined that subjects who reported observing more peer protective HIV-related behavior were also more likely to report lower frequencies of HIV risk behavior (unclean needle sharing) and increased frequencies of HIV protective behavior (always cleaning needles). Reports of verbalizations of peer norms about reducing risk were not associated with decreased HIV risk behavior. Reports of "encouragement by peers to engage in cleaning needles" was paradoxically related to increased risk of sharing unclean needles. In conclusion, peer behavior rather than verbal persuasion appears to influence injection practices.

Adult↗
PubMed1993

A preliminary ethnographic decision tree model of injection drug users' (IDUs) needle sharing.

This article presents a preliminary ethnographic decision tree model of the needle sharing and HIV risk decision-making processes common to injection drug users (IDUs) in Houston, Texas. Ethnographic tree decision modeling is a rigorous qualitative method used to understand and predict how and why people in certain groups do things the way they do. The model was developed from data collected from focus group and individual interviews and naturalistic observations. The research participants were White, African-American and Latino male and female IDUs. The model presents IDUs' needle-sharing routines or scripts based on several prioritized criteria. The model supports other researchers' findings that social roles play an important part in shaping IDUs' needle sharing. Yet, the model attempts to specify the different kinds of roles and relationships. The model suggests that social roles IDUs play and the status hierarchy between roles are the translation mechanisms that organize IDUs' social relationships into drug and HIV risky activities.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Needle sharing in context: patterns of sharing among men and women injectors and HIV risks.

This paper looks at the social contexts within which needle sharing took place among a sample of Glasgow injectors. The intention is to show that needle sharing is rarely random but instead highly patterned and influenced by circumstance and social relationships. Gender can also be seen to have an important influence on sharing patterns. Consideration of the reported instances of needle sharing provides some indication that women injectors may be at increased risk of HIV transmission relative to their male counterparts.

Adolescent↗
PubMed2003

Rise in needle sharing among injection drug users in Pakistan during the Afghanistan war.

The war in Afghanistan in 2001 may have had direct or indirect effects on drug users' behaviors in nearby Pakistan. We studied drug use patterns and correlates of needle sharing among injection drug users (IDUs) in Lahore, Pakistan, before and after the beginning of the Afghanistan war. Between August and October 2001, 244 drug users registering for needle exchange and other services underwent an interviewer-administered survey on sociodemographics, drug use and HIV/AIDS awareness. chi(2)-tests were used to compare drug use behaviors among subjects interviewed before and after October 6th, 2001, coinciding with the start of the Afghanistan war. Correlates of needle sharing among IDUs were identified using logistic regression. Comparing IDUs interviewed before and after October 6th, 2001, levels of needle sharing were significantly higher after the war (56% versus 76%, respectively; P=0.02). Factors independently associated with needle sharing included registering after the war began (adjusted odds ratio, AOR=3.76 (95% CI: 1.23-11.48)), being married (AOR=0.36), being homeless (AOR=3.91), having been arrested (AOR=6.00), and re-using syringes (AOR=6.19). Expansion of needle exchange, drug treatment and supportive services is urgently needed to avoid an explosive HIV epidemic in Pakistan.

Adult↗
PubMed2005

HIV prevalence and correlates of receptive needle sharing among injection drug users in the Mexican-U.s. border city of Tijuana.

Injection drug use is a growing but understudied problem in Tijuana, a city situated on the northwestern Mexico-U.S border. The authors studied factors associated with receptive needle sharing in an effort to inform prevention activities. In 2003, street-recruited injection drug users (IDUs) in Tijuana underwent interviews on injection risk behaviors and rapid HIV antibody tests. Logistic regression was used to identify correlates of receptive needle sharing at the last injection episode. Of 402 IDUs, 87.6% were male; the median age was 34. HIV prevalence was 4.01% (95% CI: 2.29-6.51). One third reported receptive needle sharing at last injection. Factors independently associated with receptive needle sharing were years living in Tijuana (Adjusted Odds Ratio [AdjOR]= 0.97 per year, 95% CI: 0.96-0.99), being bisexual/homosexual (AdjOR=2.12; 95% CI: 1.30 - 3.44), unemployed (AdjOR=2.5; 95% CI: 1.52-4.10), never having an HIV test (AOR: 4.02; 95% CI: 2.44-6.60), having friends who placed importance on avoiding HIV (AdjOR: 0.36; 95% CI: 0.19-0.68) and last injecting in a shooting gallery (AdjOR=1.98; 95% CI: 1.21-3.24). These results underscore the need to increase access to voluntary HIV testing and counseling to IDUs and migrants in Tijuana, as well as expand access to sterile syringes in an effort to avert widespread HIV transmission.

Adult↗
PubMed2007

Ethnicity and risk factors in needle sharing among intravenous drug users in Sichuan Province, China.

Combining survey and ethnographic data, this research examined differences in the risk factors associated with needle sharing amongst intravenous drug users (IDUs) in the Sichuan Province of China. A comparison was made between the province's majority Han population and its Yi minority. We developed a theoretical framework consisting of risk factors at the individual level (including risk factors such as lack of AIDS knowledge, low self-efficacy, and economic pressure), interpersonal level (having an IDU primary partner and lack of family support), and community level (social discrimination). The findings suggested that the Yi minority group was more socially disadvantaged and had a higher risk of contracting HIV than the Han group. Furthermore, the factors that put them at risk were different to those which affected the Han group. OLS regression results showed that, for Han IDUs, needle sharing was positively associated with having an IDU primary partner and with economic pressure. On the other hand, for the minority group, needle sharing was significantly associated with being male, AIDS knowledge, the lack of family support, and social discrimination. These findings highlight the need for HIV prevention work to target marginalized populations in China, such as ethnic minorities, and to tailor appropriate prevention strategies to meet the specific needs of different groups.

Adult↗
PubMedDate not supplied

Reduction in needle sharing among community wide samples of injecting drug users.

Evidence of reduced levels of needle sharing among injecting drug users (IDUs) has largely been confined to IDUs attending needle exchanges or receiving treatment. In this paper we present the results of a serial cross-sectional study of needle sharing conducted in Glasgow using a multisite sampling strategy. Of the estimated 9400 IDUs in the city, 503 were interviewed in 1990 and 535 in 1991. The proportion of IDUs reporting injecting with, or passing on used needles and syringes in the last 6 months fell significantly as did the number of individuals from whom equipment was received or passed on to. The impact of this level of sharing has been limited in terms of HIV transmission; the prevalence of HIV among the 1990 sample was 2.0% and 1.1% for the 1991 sample. However, the fact that third of IDUs in Glasgow continue to inject, even occasionally, with used equipment gives cause for concern in view of the other pathologies known to be associated with poor injecting hygiene.

Adolescent↗
PubMed1996

Drug use, needle sharing, and HIV risk among injection drug-using street youth.

Infection drug use is the second most common HIV risk behavior in the United States, but little is known about injection drug use and needle-sharing behavior among street youth, a group at high risk for HIV infection. This study investigates the drug use histories, injection drug use behaviors, and needle-sharing practices of 106 injection drug using youth in Los Angeles, California. Respondents report high rates of injection drug use and needle sharing, indicating that these youth are at particularly high risk for HIV infection. Results suggest a need for outreach services tailored to the unique needs of injection drug-using adolescents.

Adolescent↗
PubMed2002

Relationship among gender, depression, and needle sharing in a sample of injection drug users.

The authors explored the relationships among gender, needle sharing, and depression in a sample of 392 male and 121 female street drug users. Using the Risk Behavior Assessment (National Institute on Drug Abuse, 1991) and the Beck Depression Inventory-2 (A. T. Beck, R. A. Steer, & G. K. Brown, 1996), the authors found that women reported higher levels of depression than men and that sharers endorsed higher levels of depression than nonsharers. Further, the authors found that female sharers reported the highest levels of depression of all groups, that is, as compared with male sharers, female nonsharers, and male nonsharers, who did not differ from one another. This suggests the presence of a special dynamic between gender and depression that is related to higher rates of needle sharing among women.

Adolescent↗
PubMed1990

Changes in needle sharing behavior among intravenous drug users: San Francisco, 1986-88.

We analyzed data for San Francisco intravenous drug users entering treatment, April 1986-September 1988 (N = 7,660). The proportion of cases reporting any needle sharing in the month preceding treatment decreased from 50 percent in 1986 to 28 percent in 1988. Similar decreases were reported by two longitudinal cohorts (needle sharing by the same individuals) admitted in 1986 and 1987 (n = 303), and in 1986 and 1988 (n = 205). In a multiple logistic regression model four variables predicted needle sharing: earlier time of admission, cocaine use, younger age, and being White rather than Black.

Acquired Immunodeficiency Syndrome↗