Objective: To identify risk factors associated with transition from non-injection to injection drug use (IDU) among drug users in Baltimore, Maryland. Methods: Between 1997-1999, IDU cases and non-IDU controls aged 15-30 were studied. Cases had reported injecting for £ 2 years. Controls had used non-injection heroin, crack or cocaine during the same period and were age-matched to cases (1:1 ratio). Surveys collected year-by-year histories up to 5 years prior. Conditional logistic regression was used to identify risk factors for transition to injection. Results: Of 270 cases and controls, the majority were African-American (78%) and female (61%). Median age was 26. Cases were more likely to report high school drop out (OR=1.80), sex with an IDU (OR=6.43), and test HIV-positive (OR=2.80) compared to controls. Prior to transition, cases were more likely to use PCP (OR=5.50), inhalants (OR=3.57), hallucinogens (OR=3.71), but less likely to snort heroin (OR=0.16). One year prior to transition, cases were more likely to trade sex (OR=2.17). In multivariate models, independent risk factors for transition were: high school dropout (OR=3.10), sex with an IDU (OR=6.43), trading sex one year prior to transition (OR=3.43) and snorting heroin prior to transition (OR=0.21). Conclusion: High school drop-outs who engaged in high risk sexual activities were more likely to begin injecting. While intranasal heroin users were less likely to initiate injection, these individuals may nevertheless be at higher risk of injection drug use over the long term. Prevention programs that discourage young drug users from initiating injection drug use are urgently required.
Learning Objectives: Information regarding early points of intervention and prevention of HIV among young IDUs will be discussed. Participants will be able to use this information to identify early high risk groups for HIV, HCV and other parenteral infections commonly found among IDUs. At the conclusion of the session the participant in this session will be able to 1) recognize street youth at risk of becoming injectors and becoming HIV/HCV infected, 2)effectively evaluate their own communities for similar high risk youth, and 3) analyze any existing data for consistancy and replication of these findings
Keywords: HIV Risk Behavior, Drug Injectors
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.