Non-injection drug use and injection initiation assistance among people who inject drugs in Tijuana, Mexico

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

Importance of this Study:

  • 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.

  • However, little is known about the risk factors among people who inject drugs (PWID) that are associated with a higher risk of providing injection initiation assistance.

  • Therefore, we sough to asses the impact of non- injection drug use among PWID on their odds to assist others into injection initiation.

Key Concepts

  • Preventing entry into injection drug use is increasingly seen as a public health priority.

  • Understanding such characteristics is essential to build evidence based interventions capable of preventing injection initiation and related harm.

How This Study Was Conducted

  • A prospective cohort of PWID in Tijuana, Mexico was interviewed every 6 months to gather information on their drug use and their involvement in providing injection initiation assistance.

  • The interview data collected from September 2014 to August 2016 was included in this analysis.

Public Health Implications

  • The development of interventions to prevent injection initiation should focus specifically on the subset of people who report both injection and non-injection drug use.

  • Interventions such as medically-supervised consumption facilities may reduce the odds of exposure to injecting behaviors of PWID to injection naïve users, and thereby disrupt their mixing with those at risk of initiating drug injecting.

  • Future research should seek to clarify to what extent such facilities may support broader goals of preventing entry into injection drug use.

What This Study Found

  • Overall, 14% participants reported ever initiating others into drug injection.

  • Non-injection use of cocaine, heroin, and methamphetamine were associated with a tenfold, a fourfold, and a twofold increase in the odds of initiating others respectively .

Key Findings

People who inject drugs and who engage at the same time in non-injection drug use were two times more likely to provide injection initiation assistance.

A global, evidence-based approach on drug use.


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