The sharing of injection equipment appears to be common behavior in both IV drug users who inject frequently and in those who inject less often (Friedland et al., 1985). However, more frequent injections are likely to mean more episodes with shared equipment, thus increasing the likelihood of HIV infection. In addition, for IV drug users who are addicted, the symptoms of drug withdrawal can heighten the sense of urgency or desire for the drug and decrease the likelihood that safer injection practices will be used.
INFECTIOUS DISEASE SCREENING AND TREATMENT
That’s usually through open cuts or sores, by direct injection (from a needle or syringe), or through a mucous membrane. If you get HIV, antiretroviral drugs can keep the virus from reproducing in your body. Access to prevention services is essential for all persons who inject drugs, who are at greater risk for Viral Hepatitis, HIV, and other infections.
- Approximately one quarter of all AIDS cases diagnosed in this country among adults and adolescents is related to IV drug use (Schuster, 1988).
- Despite heroin’s capacity to suppress fertility to a certain extent in women, Cuskey and Wathey (1982) found that, in New York City, birth rates for addicted women were higher than those for nonaddicted women.
- People who inject drugs account for about 1 in 10 HIV diagnoses in the United States.
- Although the studies that support this conclusion tend to rely heavily on self-reported behavioral modifications, there are enough studies in which there is some independent evidence of change to conclude that the self-reports reflect what has actually occurred.
- In addition to sampling limitations, there are problems with nonrespondents and those who underreport drug use.
Sexual Risk Factors
Once they have been initiated, regular users have to secure both drugs and injection equipment. Because of legal sanctions against the possession of either, many users may be inclined to “shoot up” shortly after a drug purchase. Those who are addicted and suffering drug hunger or withdrawal symptoms may also want to inject promptly. Even if they are not addicted, some users, out of a classical type of conditioning, will feel the urge to inject the drug immediately after purchasing it (Wikler, 1973; Des Jarlais et al., 1985). All of these conditions can increase the likelihood of injection with used equipment.
This fact sheet is based on information from the following sources:
These models are based on sound statistical principles; yet because they require extensive and often elaborate assumptions, for which, unfortunately, there are generally limited supporting data, they do not always produce accurate estimates that can be used with confidence. That literature in turn focuses far more on the maintenance of usage patterns than on turnover, an important factor in gauging both the prevalence of IV drug use at specific points in time and the likelihood of exposure to HIV. Informed guesstimates are produced by looking at any available indicators or other correlates of IV drug-use prevalence and making an informed guess about the number of IV drug users. The accuracy of indirect estimation or informed “guesstimation” can be no greater than the accuracy of the direct estimates on which they depend.
Indeed, as described later in this chapter, the use of the same injection equipment within a close relationship is sometimes not even thought of as “sharing” (Des Jarlais and Friedman, 1988). Because of the link between IV drug use and perinatal transmission of HIV, information is needed about contraceptive and childbearing behaviors in the IV drug-using population. Unfortunately, currently available data permit only a rudimentary picture of these behaviors. Despite heroin’s capacity to suppress iv drug use fertility to a certain extent in women, Cuskey and Wathey (1982) found that, in New York City, birth rates for addicted women were higher than those for nonaddicted women. Others (Densen-Gerber et al., 1972; E. M. Johnson, 1987) have reported an association between drug use and promiscuity and prostitution. In a study that matched women on age, ethnicity, and marital status, Ralph and Spigner (1986) noted that contraception was less frequent among female addicts than among nonaddicted women.
The studies use different outcome measures that range from the increased use of sterile injection equipment to entrance into drug treatment to any self-reported change in behavior. Even when the “same” outcome measure is used in different studies, the wording of the study questionnaires may be sufficiently different as to make comparisons across studies quite difficult. Problems in interpreting the behavioral change data also arise from a lack of specification of the mechanism or “cause” of the behavioral change. Most of the studies that have been conducted did not identify causal factors; of those that did, different analytic frameworks were used to describe the mechanisms of change, which appeared to vary according to the local environment.
