A Preliminary Ethnographic Decision Tree Model of Injection Drug Users' (IDUs) Needle Sharing

Based on a 1988–91 sample of 422 drug-using arrestees in Los Angeles, this study compares the drug-related risk behavior of users whose preferred injection drug is cocaine and users with a preference for heroin or no preference between the two drugs. Cocaine preference is unrelated to the likelihood of needle sharing overall, needle sharing with strangers, needle sharing at shooting galleries, and failure to use bleach as a needle disinfectant. In analyses restricted to users who reported needle sharing, the frequency of sharing is no more closely related to heroin injection frequency than to cocaine injection frequency. These results suggest that local preventive education programs do not need to address distinctive patterns of drug-related risk behavior among injection cocaine users and injection heroin users in Los Angeles.

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Self-Reported Reasons for Needle Sharing and Not Carrying Bleach among Injection Drug Users in Baltimore, Maryland

Journal of Drug Issues ◽

10.1177/002204269502500413 ◽

1995 ◽

Vol 25 (4) ◽

pp. 865-870 ◽

Cited By ~ 14

Author(s):

Carl A. Latkin ◽

Wallace Mandell ◽

David Vlahov ◽

Amy R. Knowlton ◽

Maria Oziemkowska ◽

...

Keyword(s):

Hiv Prevention ◽

Injection Drug Users ◽

Drug Users ◽

Unintended Consequence ◽

Injection Drug ◽

Needle Sharing ◽

Preventive Interventions ◽

Sense Of Time ◽

Drug Paraphernalia ◽

Time Urgency

Stated reasons for sharing needles and not intending to carry bleach for 413 injection drug users in the Stop AIDS for Everyone (SAFE) study in Baltimore, Maryland, were analyzed. Over two-thirds (69%) reported they knew individuals who had “gotten in trouble” by police for carrying needles. Of the injection drug users, 38% stated the main reason they shared needles without cleaning them first with bleach was a sense of time urgency, and 30% reported that clean needles were not available. The most common reason given by 24% of the participants for not intending to carry bleach was that they inject at home where bleach is available. Another frequently mentioned reason for not intending to carry bleach was wanting to stop using drugs. These results have implications for HIV prevention and suggest the importance of preventive interventions that emphasize drug users' planning where and when they will inject drugs. The findings also suggest that needle sharing may be in part an unintended consequence of Maryland's current drug paraphernalia laws.

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Adaptation of the Information-Motivation-Behavioral Skills Model to Needle Sharing Behaviors and Hepatitis C Risk

SAGE Open ◽

10.1177/2158244016666126 ◽

2017 ◽

Vol 7 (1) ◽

pp. 215824401666612

Author(s):

William T. Robinson

Keyword(s):

Hepatitis C ◽

Risk Behaviors ◽

Injection Drug Users ◽

Structural Equation ◽

Drug Users ◽

Equation Model ◽

Injection Drug ◽

Needle Sharing ◽

Imb Model ◽

Behavioral Skills

The current study adapts the Information-Motivation-Behavioral Skills (IMB) model of health behavior to injection drug using risk behaviors and risk for Hepatitis C (HCV). Briefly, this model postulates that prevention behaviors are directly influenced by an individual’s knowledge about a disease, their motivation to avoid the disease and their skills and capacity to engage in prevention behaviors, while information and motivation also directly influence behavioral skills. Scales for HCV information, motivation and behavioral skills were included in the New Orleans arm of the National HIV Behavioral Surveillance (NHBS) of Injection Drug Use study. A structural equation model was tested on a sample of 108 current injection drug users recruited in December 2012. Results showed good fit of the IMB model. Although participants had high levels of information and knowledge about HCV transmission, information was not found to relate to either behavioral skills or needle sharing. Higher levels of skills were directly related to lower levels of needle sharing. In addition, motivation had an indirect effect on needle sharing that was mediated through skills. Many approaches to HIV and HCV prevention focus on increasing awareness and information about HIV and risk behaviors. This model, however, appears to indicate that increasing awareness may not be as effective as interventions or programs that increase behavioral skills or motivation coupled with skills building. Although some HIV/STD prevention interventions, such as motivational interviews do attempt to capitalize on this relationship, more efforts should be made to incorporate this important link into high impact prevention programs.

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