The 130th Annual Meeting of APHA

4089.0: Tuesday, November 12, 2002 - Board 8

Abstract #41872

Predictors of cessation of injection and subsequent relapse among a cohort of injection drug users, Baltimore MD

Nina G Shah, MSc1, Noya Galai, PhD2, David D. Celentano, ScD3, David Vlahov, PhD4, and Steffanie Strathdee, PhD3. (1) Department of Epidemiology, Bloomberg School of Public Health, 627 N. Washington St., Baltimore, MD 21205, (410) 955-4317,, (2) Dept of Epidemiology, Ben-Gurion University of the Negev, PO Box 653, Beer-Sheva, Israel, (3) Department of Epidemiology, Johns Hopkins School of Public Health, Infectious Diseases Program, 615 N. Wolfe Street, Baltimore, MD 21205, (4) New York Academy of Medicine, Center for Urban Epidemiologic Studies, 1216 Fifth Avenue, New York, NY 10029-5293

Objective: To determine predictors of cessation of injection and subsequent relapse among a cohort of injection drug users (IDUs) in Baltimore, MD. Methods: IDUs enrolled in 1988 or 1994 in a prospective cohort study of HIV risks and infection having at least 2 years of semi-annual follow-up were studied. Factors affecting time from baseline to first cessation, and subsequently to first relapse, were assessed using parametric survival models assuming lognormal distribution. Results were presented as time ratios showing the relative lengthening of time to event. Results: Of 1327 IDUs, 94.8% were African American, 77.2% male, with a median age of 34 years. At baseline, the majority of IDUs injected heroin (72%) or speedball (69%). The median time from baseline to cessation was 3.97 years; given cessation (n=898), median time to relapse was 0.99 years. Factors independently associated with a shorter time to cessation were: age <30 years, HIV+serostatus, enrollment in methadone maintenance or detoxification programs, abstinence from cigarette and alcohol use, stable housing, injecting <daily, not having an IDU sex partner, and not injecting speedballs. Factors independently associated with shorter time to relapse were male gender, HIV+serostatus, homelessness, alcohol use, cigarette use, noninjection cocaine use, not being sexually active and experiencing 1.5 years to the first cessation. Conclusions: This study confirms the important role of drug treatment programs in curbing injection drug use, providing strong support for expanding such services. Supports are especially needed to sustain treatment-seeking behaviors of HIV+ IDUs and unstably housed individuals to prevent relapse.

Learning Objectives: From this poster, the learner will be able to

Presenting author's disclosure statement:
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.

Special Populations and Substance Abuse Poster Session II

The 130th Annual Meeting of APHA