Transcript Variations in Paraphernalia Sharing among IDUs

Variations in Paraphernalia Sharing
among IDUs:
Do Attitudes of Other IDUs in the
Neighborhood Matter?
Wei Teng, Robert Heimer, Merrill Singer, Tom
Stopka, David Buchanan
The Hispanic Health Council, Hartford, CT; Yale University, New
Haven, CT; University of Massachusetts, Amherst, MA
The Study Sample
875 IDUs from 24 neighborhoods in three
Northeast cities.
The data were collected through face-toface interviews using a survey instrument
of Syringe Access, Use & Discard
Assessment (SAUDA) from December, 1999
through September, 2001.
Measures I
The General Attitude of Other IDUs in the
Neighborhood towards Drug-Related HIV
Risk Behavior
Measured by 8 items of drug-related HIV risk
& protection behavior.
Participants rated the general attitude of
other IDUs in their neighborhoods regarding
each item on a 5-point scale.
A General Attitude variable was computed
based on the mean scores of the 8 items.
Measures II
 Drug Injection Paraphernalia Sharing
 Indicated by three dichotomous variables of
Syringe Sharing, Water Sharing, and
Cooker/Cotton Sharing
 The three variables were computed based on
the number of times in the past 30 days that a
participant used a syringe, water to mix up drug,
a cooker, or a cotton that had already been used
by another IDU.
Variations in the Prevalence
of Injection Paraphernalia Sharing
Across the Cities
Variations in the Prevalence
of Injection Paraphernalia Sharing
Across the Neighborhoods
15
% of IDUs in
Neighborhood
12
# of Neighborhoods
11
<10%
10
9
10%-20%
8
7
6
20%-30%
6
5
5
>30%
3
2
2
1
0
Syringe Sharing
Water Sharing
Cooker/Cotton
General Attitude of Other IDUs
and Injection Paraphernalia Sharing
Mean Score of
IDUs’ Attitude
Syringe
Sharing
Yes
3.72
No
3.99
Water
Sharing
Yes
3.71
No
3.97
Cooker
Sharing
Yes
3.79
No
3.98
P value of
t-test
P < 0.001
P < 0.001
P < 0.001
Binary Logistic Regression Results:
Syringe Sharing
Independent
Variables
Regression
Coefficient
Signific.
Level
Odds
Ratio
Gender
0.282
ns
1.326
Age
-0.033
< 0.05
0.967
Race (Overall Effect)
NA
ns
NA
Neighborhood
(Overall Effect)
NA
< 0.05
NA
Importance of
Others’ Attitude
-0.087
ns
0.916
Attitude of IDUs
-0.941
P< 0.001
0.390
Binary Logistic Regression Results:
Water Sharing
Independent
Variables
Regression
Coefficient
Signific.
Level
Odds
Ratio
Gender
0.025
ns
1.025
Age
-0.003
ns
0.997
Race (Overall Effect)
NA
< 0.05
NA
Neighborhood
(Overall Effect)
NA
< 0.05
NA
Importance of
Others’ Attitude
-0.094
ns
0.911
Attitude of IDUs
-0.909
< 0.001
0.403
Binary Logistic Regression Results:
Cooker/Cotton Sharing
Independent
Variables
Regression
Coefficient
Signific.
Level
Odds
Ratio
Gender
0.361
ns
1.435
Age
-0.013
ns
0.987
Race (Overall Effect)
NA
ns
NA
Neighborhood
(Overall Effect)
NA
ns
NA
Importance of
Others’ Attitude
-0.120
ns
0.887
Attitude of IDUs
-0.693
< 0.001
0.500
Summary of the Findings
The prevalence of injection paraphernalia
sharing among IDUs varied by neighborhood.
IDUs who did share reported a more
accepting attitude towards risky behavior
from other IDUs in their neighborhoods.
IDUs’ perception of the attitude of other
IDUs in their neighborhoods towards risk
behavior was significantly associated with
their own recent sharing behavior.
Implications of the Findings
Other IDUs’ attitude towards drug-related
HIV risk behavior is an important factor in
determining an IDU’s own HIV risk behavior.
AIDS/HIV prevention/education that target on
not only individual injection drug users but
also local IDUs group and their peer norms
should be more effective.