Rationale for PRIMER

Our goal is to understand the role that people who inject drugs play in initiating others into injection drug use. Here you can read about why we are doing this and how we plan to do it.

Rationale for PRIMER

Our goal is to understand the role that people who inject drugs play in initiating others into injection drug use. Here you can read about why we are doing this and how we plan to do it.

Background

The primary goal of PRIMER is to learn about how different health programs and policies aimed at people who inject drugs (PWID) can reduce the rate at which new people start injecting as part of their drug use. We have learned that PWID tend to play an important role in helping other people transition into injection drug use. Injecting drugs is one of the main ways that HIV and Hep-C are currently spread. Concurrently, there is a problematic gap in healthcare when it comes to preventing the transition into injection drug use from non-injection drug use. Therefore we believe that programs aimed at helping PWID live healthier lives may also reduce the risk that they will help other people start using injection dugs. With this knowledge, we can create and design approaches that better improve the health of PWID as well as the health of those who are at risk of injecting.

Methodology

PRIMER is a mixed-methods study, taking place in many cities around the world. In order to achieve our main research goal, PRIMER has been divided into four tasks. The first is to investigate PWID helping others to begin injecting. The second is to identify factors (such as age and gender) that affect the chances that PWID will help others begin to inject drugs. The third is to describe different roles that PWID may play (such as being a drug dealer) and how these roles impact the chances that they help someone start to inject. The last is to measure the impact of different programs and policies on whether PWID help others to start injecting. This will all be done by pooling observational data from Vancouver, Canada, San Diego, USA, Tijuana, Mexico, and Paris, Marseille, and Bordeaux, France.

Results

The PRIMER team is conducting a prospective, mixed-methods study of PWID (n = 3050) in four separate cohorts of PWID across North America and France (San Diego, STAHR II; Tijuana, El Cuete IV; Vancouver, V-DUS; Bordeaux, Marseille, Paris and Strasbourg, COSINUS).

Conclusions

PRIMER is the world’s largest study on injection initiation. It is the first study to investigate structural approaches to preventing initiation into injection drug use. Findings can be used to inform the design of new programs and policies aimed at preventing injection drug use.

Documentary

Learn about Dr. Dan Werb and PRIMER in this 13 minute documentary presented by the CBC (Canadian Broadcasting Corporation).

Findings

The results of the PRIMER study can improve future efforts to prevent injection drug use. These findings can inform the creation and design of interventions, policies, and structural approaches to combatting both injection drug use and its related harms. Here you can browse PRIMER publications and download PDF versions of the articles.

Findings

The results of the PRIMER study can improve future efforts to prevent injection drug use. These findings can inform the creation and design of interventions, policies, and structural approaches to combatting both injection drug use and its related harms. Here you can browse PRIMER publications and download PDF versions of the articles.

Featured Publications

Meyers SA, Scheim A, Jain S, Sun X, Milloy MJ, DeBeck K, Hayashi K, Garfein RS, Werb D

This study sought to determine how gender may shape the risk that people who inject drugs help others initiate drug injecting. It collected data from three different settings: San Diego, USA; Tijuana, Mexico; and Vancouver, Canada.

Guise A, Horyniak D, Melo J, McNeill R, Werb D

Qualitative research shows that starting to inject drugs has a range of distinct meanings – pleasure, increasing tolerance, securing belonging, coping with pain – and is shaped by the environments in which people live.

Hamida AB, Rafful C, Jain S, Sun S, González-Zúñiga P, Rangel G, Strathdee SA, Werb D

There are 12 million people worldwide who inject drugs; of which 1.6 million are living with HIV and 6 million are living with hepatitis C. 

Melo JS, Mittal ML, Horyniak D, Strathdee S, Werb D

This review aims to characterize the risk factors for injection drug use initiation associated with migration and describe how these might be addressed through interventions.

Melo JS, Garfein RS, Hayashi K, Milloy MJ, DeBeck K, Sun S, Jain S, Strathdee SA, Werb D

Experts suggest that preventing injection initiation is likely to be more effective in reducing disease incidence than seeking to reduce risks experienced by individuals after they initiate injection.

Mittal ML, Vashistha D, Sun S, Jain S, Cuevas-Mota J, Garfein RS, Strathdee S, Werb D

This study highlights the need to further investigate the potential impact of Medication-assisted treatment (MAT) as a preventive intervention to reduce not only the incidence of negative injection-related health outcomes experienced by opioid users but also incident cases of IDU initiation.

Rafful C, Melo J, Medina-Mora ME, Rangel G, Sun S, Jain S, Werb D

Efforts to prevent injection drug use (IDU) are increasingly focusing on the role that people who inject drugs (PWID) play in facilitating the entry of others into this behavior.

Publications List

Complete Publication List

Read all of our publications here.

A global, evidence-based approach on drug use.

 

© 2019 PRIMER