Gender differences in the provision of injection initiation assistance: a comparison of three North American contexts

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

Importance of this Study:

  • Past literature highlights the importance of gender in injection drug use initiation processes and related risks.

  • Women are particularly vulnerable to the risk of HIV and hepatitis C transmission when initiating injection drug use as they are more likely to be initiated by a male intimate partner, share drug preparation equipment, and be injected after their initiator.

Key Concepts

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.

How This Study Was Conducted

  • We employed logisCc regression analyses to test the associaCon between gender and having ever provided injecCon iniCaCon assistance across seNngs. The following variables were also included in the analyses: age, years since first injecCon, and non- injecCon and injecCon heroin, cocaine, and methamphetamine use.

Public Health Implications

Understanding how gender impacts the risk that people assist others into drug injecIng is crucial to prevenIng transiIons into injecIon drug use and injecIon-related harms.

What This Study Found

  • Men in Tijuana were twice as likely to have ever provided injection initiation assistance when compared to women in Tijuana, but this gender difference was not found in San Diego or Vancouver.

  • Participants who were older were less likely to have ever provided injection initiation assistance in both San Diego and Vancouver, and those who had been injecting for longer were more likely to have provided assistance in Vancouver.

  • These findings illuminate the differing role of gender in injection initiation across contexts and have implications for efforts to prevent injection drug use and related harms.

Key Findings

  • Findings from the current study suggest that gender may, in part, determine whether people who inject drugs provide injection initiation assistance. Further, this appears to be context-specific and likely related to the social norms and policy that shape local injecting practices.

  • As such, preventing the transition into injection drug use will likely require that existing interventions adapt to address site- specific gender dynamics to ensure effectiveness.

A global, evidence-based approach on drug use.


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