Transitions to injecting drug use among noninjecting heroin users: Social network influence and individual susceptibility

Alan Neaigus, V. Anna Gyarmathy, Maureen Miller, Veronica M. Frajzyngier, Samuel R. Friedman, Don Des Jarlais

Research output: Contribution to journalArticle

Abstract

Objectives: To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Methods: Street-recruited NIUs in New York City, March/ 1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure to injectors) and individual susceptibility. A transition to injecting was the first drug injection following baseline. Hazards ratios (HRs) (P < 0.05) were estimated by Cox proportional hazards regression, stratified by baseline injecting history. Results: Of 369 (64% of 579) followed, former-injectors were more likely to transition to injecting (33% or 53/160 vs. 12% or 25/209; 16.0/100 person-years-at-risk [pyar] vs. 4.6/100 pyar; HR = 3.25). Independent predictors among never-injectors included using ≥2 bags of heroin daily (HR = 7.0); social network influence (communication) and homelessness (HR = 6.3); shorter-term heroin use (HR = 5.3); social network influence (exposure) and physically abused (HR = 4.7); friends approve/condone drug injecting (HR = 3.5); lower perceived social distance from injectors (HR = 2.9); and younger age at first heroin use (HR = 1.2). Independent predictors among former-injectors were social network influence (communication) and lower perceived social distance from injectors (HR = 3.4); white race/ ethnicity (HR = 2.0); not very afraid of needles (HR = 1.8); and younger age (HR = 1.1). Conclusions: The risk of initiating injecting was lower than the risk of resuming injecting. Social network influence facilitates transitioning to injecting among those susceptible. Interventions to prevent injecting should address both social network influence and individual susceptibility.

Original languageEnglish (US)
Pages (from-to)493-503
Number of pages11
JournalJournal of Acquired Immune Deficiency Syndromes
Volume41
Issue number4
DOIs
StatePublished - Apr 1 2006

Fingerprint

Heroin
Social Support
Pharmaceutical Preparations
Social Distance
Communication
Homeless Persons
Needles
Cohort Studies
History
Prospective Studies
Injections
Incidence

Keywords

  • IDU
  • Individual susceptibility
  • Noninjecting heroin users
  • Risk factors for IDU
  • Social networks
  • Transitions to injecting

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

Cite this

Transitions to injecting drug use among noninjecting heroin users : Social network influence and individual susceptibility. / Neaigus, Alan; Gyarmathy, V. Anna; Miller, Maureen; Frajzyngier, Veronica M.; Friedman, Samuel R.; Des Jarlais, Don.

In: Journal of Acquired Immune Deficiency Syndromes, Vol. 41, No. 4, 01.04.2006, p. 493-503.

Research output: Contribution to journalArticle

Neaigus, Alan ; Gyarmathy, V. Anna ; Miller, Maureen ; Frajzyngier, Veronica M. ; Friedman, Samuel R. ; Des Jarlais, Don. / Transitions to injecting drug use among noninjecting heroin users : Social network influence and individual susceptibility. In: Journal of Acquired Immune Deficiency Syndromes. 2006 ; Vol. 41, No. 4. pp. 493-503.
@article{65d0796e4f884d849feecc0d19d5fa65,
title = "Transitions to injecting drug use among noninjecting heroin users: Social network influence and individual susceptibility",
abstract = "Objectives: To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Methods: Street-recruited NIUs in New York City, March/ 1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure to injectors) and individual susceptibility. A transition to injecting was the first drug injection following baseline. Hazards ratios (HRs) (P < 0.05) were estimated by Cox proportional hazards regression, stratified by baseline injecting history. Results: Of 369 (64{\%} of 579) followed, former-injectors were more likely to transition to injecting (33{\%} or 53/160 vs. 12{\%} or 25/209; 16.0/100 person-years-at-risk [pyar] vs. 4.6/100 pyar; HR = 3.25). Independent predictors among never-injectors included using ≥2 bags of heroin daily (HR = 7.0); social network influence (communication) and homelessness (HR = 6.3); shorter-term heroin use (HR = 5.3); social network influence (exposure) and physically abused (HR = 4.7); friends approve/condone drug injecting (HR = 3.5); lower perceived social distance from injectors (HR = 2.9); and younger age at first heroin use (HR = 1.2). Independent predictors among former-injectors were social network influence (communication) and lower perceived social distance from injectors (HR = 3.4); white race/ ethnicity (HR = 2.0); not very afraid of needles (HR = 1.8); and younger age (HR = 1.1). Conclusions: The risk of initiating injecting was lower than the risk of resuming injecting. Social network influence facilitates transitioning to injecting among those susceptible. Interventions to prevent injecting should address both social network influence and individual susceptibility.",
keywords = "IDU, Individual susceptibility, Noninjecting heroin users, Risk factors for IDU, Social networks, Transitions to injecting",
author = "Alan Neaigus and Gyarmathy, {V. Anna} and Maureen Miller and Frajzyngier, {Veronica M.} and Friedman, {Samuel R.} and {Des Jarlais}, Don",
year = "2006",
month = "4",
day = "1",
doi = "10.1097/01.qai.0000186391.49205.3b",
language = "English (US)",
volume = "41",
pages = "493--503",
journal = "Journal of Acquired Immune Deficiency Syndromes",
issn = "1525-4135",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Transitions to injecting drug use among noninjecting heroin users

T2 - Social network influence and individual susceptibility

AU - Neaigus, Alan

AU - Gyarmathy, V. Anna

AU - Miller, Maureen

AU - Frajzyngier, Veronica M.

AU - Friedman, Samuel R.

AU - Des Jarlais, Don

PY - 2006/4/1

Y1 - 2006/4/1

N2 - Objectives: To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Methods: Street-recruited NIUs in New York City, March/ 1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure to injectors) and individual susceptibility. A transition to injecting was the first drug injection following baseline. Hazards ratios (HRs) (P < 0.05) were estimated by Cox proportional hazards regression, stratified by baseline injecting history. Results: Of 369 (64% of 579) followed, former-injectors were more likely to transition to injecting (33% or 53/160 vs. 12% or 25/209; 16.0/100 person-years-at-risk [pyar] vs. 4.6/100 pyar; HR = 3.25). Independent predictors among never-injectors included using ≥2 bags of heroin daily (HR = 7.0); social network influence (communication) and homelessness (HR = 6.3); shorter-term heroin use (HR = 5.3); social network influence (exposure) and physically abused (HR = 4.7); friends approve/condone drug injecting (HR = 3.5); lower perceived social distance from injectors (HR = 2.9); and younger age at first heroin use (HR = 1.2). Independent predictors among former-injectors were social network influence (communication) and lower perceived social distance from injectors (HR = 3.4); white race/ ethnicity (HR = 2.0); not very afraid of needles (HR = 1.8); and younger age (HR = 1.1). Conclusions: The risk of initiating injecting was lower than the risk of resuming injecting. Social network influence facilitates transitioning to injecting among those susceptible. Interventions to prevent injecting should address both social network influence and individual susceptibility.

AB - Objectives: To determine the incidence/predictors of transitions to injecting among noninjecting heroin users (NIUs). Methods: Street-recruited NIUs in New York City, March/ 1996-March/2003, were interviewed for a prospective cohort study about social network influence (communication promoting injecting; exposure to injectors) and individual susceptibility. A transition to injecting was the first drug injection following baseline. Hazards ratios (HRs) (P < 0.05) were estimated by Cox proportional hazards regression, stratified by baseline injecting history. Results: Of 369 (64% of 579) followed, former-injectors were more likely to transition to injecting (33% or 53/160 vs. 12% or 25/209; 16.0/100 person-years-at-risk [pyar] vs. 4.6/100 pyar; HR = 3.25). Independent predictors among never-injectors included using ≥2 bags of heroin daily (HR = 7.0); social network influence (communication) and homelessness (HR = 6.3); shorter-term heroin use (HR = 5.3); social network influence (exposure) and physically abused (HR = 4.7); friends approve/condone drug injecting (HR = 3.5); lower perceived social distance from injectors (HR = 2.9); and younger age at first heroin use (HR = 1.2). Independent predictors among former-injectors were social network influence (communication) and lower perceived social distance from injectors (HR = 3.4); white race/ ethnicity (HR = 2.0); not very afraid of needles (HR = 1.8); and younger age (HR = 1.1). Conclusions: The risk of initiating injecting was lower than the risk of resuming injecting. Social network influence facilitates transitioning to injecting among those susceptible. Interventions to prevent injecting should address both social network influence and individual susceptibility.

KW - IDU

KW - Individual susceptibility

KW - Noninjecting heroin users

KW - Risk factors for IDU

KW - Social networks

KW - Transitions to injecting

UR - http://www.scopus.com/inward/record.url?scp=33646786113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33646786113&partnerID=8YFLogxK

U2 - 10.1097/01.qai.0000186391.49205.3b

DO - 10.1097/01.qai.0000186391.49205.3b

M3 - Article

C2 - 16652059

AN - SCOPUS:33646786113

VL - 41

SP - 493

EP - 503

JO - Journal of Acquired Immune Deficiency Syndromes

JF - Journal of Acquired Immune Deficiency Syndromes

SN - 1525-4135

IS - 4

ER -