Low-frequency Heroin Injection Among Out-of-treatment, Street-recruited Injection Drug Users

Overview

Journal J Urban Health

Publisher Springer

Specialty General Medicine

Date 2012 Jun 13

PMID 22689300

Citations 10

Authors

Jennie L Harris

Jennifer Lorvick

Lynn Wenger

Tania Wilkins

Martin Y Iguchi

Philippe Bourgois

Alex H Kral

Affiliations

Soon will be listed here.

Abstract

In this paper, we explore the understudied phenomenon of "low-frequency" heroin injection in a sample of street-recruited heroin injectors not in drug treatment. We conducted a cross-sectional study of 2,410 active injection drug users (IDUs) recruited in San Francisco, California from 2000 to 2005. We compare the sociodemographic characteristics and injection risk behaviors of low-frequency heroin injectors (low-FHI; one to 10 self-reported heroin injections in the past 30 days) to high-frequency heroin injectors (high-FHI; 30 or more self-reported heroin injections in the past 30 days). Fifteen percent of the sample met criteria for low-FHI. African American race, men who have sex with men (MSM) behavior, and injection and noninjection methamphetamine use were independently associated with low-FHI. Compared to high-FHI, low-FHI were less likely to report syringe sharing and nonfatal heroin overdose. A small but significant proportion of heroin injectors inject heroin 10 or less times per month. Additional research is needed to qualitatively examine low-frequency heroin injection and its relationship to drug use trajectories.

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References

Rhodes T, Singer M, Bourgois P, Friedman S, Strathdee S . The social structural production of HIV risk among injecting drug users. Soc Sci Med. 2005; 61(5):1026-44. DOI: 10.1016/j.socscimed.2004.12.024. View

ZINBERG N . The social setting as a control mechanism in intoxicant use. NIDA Res Monogr. 1980; 30:236-44. View

Kral A, Lorvick J, Gee L, Bacchetti P, Rawal B, Busch M . Trends in human immunodeficiency virus seroincidence among street-recruited injection drug users in San Francisco, 1987-1998. Am J Epidemiol. 2003; 157(10):915-22. DOI: 10.1093/aje/kwg070. View

Gogineni A, Stein M, Friedmann P . Social relationships and intravenous drug use among methadone maintenance patients. Drug Alcohol Depend. 2001; 64(1):47-53. DOI: 10.1016/s0376-8716(00)00230-1. View

Morral A, McCaffrey D, Iguchi M . Hardcore drug users claim to be occasional users: drug use frequency underreporting. Drug Alcohol Depend. 2000; 57(3):193-202. DOI: 10.1016/s0376-8716(99)00048-4. View

Kral A, Bluthenthal R, Lorvick J, Gee L, Bacchetti P, Edlin B . Sexual transmission of HIV-1 among injection drug users in San Francisco, USA: risk-factor analysis. Lancet. 2001; 357(9266):1397-401. DOI: 10.1016/S0140-6736(00)04562-1. View

Bluthenthal R, Watters J . Multimethod research from targeted sampling to HIV risk environments. NIDA Res Monogr. 1995; 157:212-30. View

Bourgois P . The moral economies of homeless heroin addicts: confronting ethnography, HIV risk, and everyday violence in San Francisco shooting encampments. Subst Use Misuse. 1998; 33(11):2323-51. DOI: 10.3109/10826089809056260. View

Darke S . Self-report among injecting drug users: a review. Drug Alcohol Depend. 1998; 51(3):253-63; discussion 267-8. DOI: 10.1016/s0376-8716(98)00028-3. View

10.

ZINBERG N, HARDING W, Stelmack S, Marblestone R . Patterns of heroin use. Ann N Y Acad Sci. 1978; 311:10-24. DOI: 10.1111/j.1749-6632.1978.tb16759.x. View

11.

Richard A, Bell D, Montoya I . Age and HIV risk in a national sample of injection drug and crack cocaine users. Subst Use Misuse. 2000; 35(10):1385-404. DOI: 10.3109/10826080009148221. View

12.

McNeely J, Arnsten J, Gourevitch M . Improving access to sterile syringes and safe syringe disposal for injection drug users in methadone maintenance treatment. J Subst Abuse Treat. 2006; 31(1):51-7. DOI: 10.1016/j.jsat.2006.03.009. View

13.

Bluthenthal R, Kral A, Gee L, Lorvick J, Moore L, Seal K . Trends in HIV seroprevalence and risk among gay and bisexual men who inject drugs in San Francisco, 1988 to 2000. J Acquir Immune Defic Syndr. 2001; 28(3):264-9. DOI: 10.1097/00042560-200111010-00010. View

14.

Iguchi M, Ober A, Berry S, Fain T, Heckathorn D, Gorbach P . Simultaneous recruitment of drug users and men who have sex with men in the United States and Russia using respondent-driven sampling: sampling methods and implications. J Urban Health. 2009; 86 Suppl 1:5-31. PMC: 2705484. DOI: 10.1007/s11524-009-9365-4. View

15.

Longshore D, Hsieh S, Danila B, Anglin M . Methadone maintenance and needle/syringe sharing. Int J Addict. 1993; 28(10):983-96. DOI: 10.3109/10826089309062178. View

16.

CONNORS M . Risk perception, risk taking and risk management among intravenous drug users: implications for AIDS prevention. Soc Sci Med. 1992; 34(6):591-601. DOI: 10.1016/0277-9536(92)90187-u. View