The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #66612

Laura A. Novelli¹, Susan G. Sherman, MPH, PhD¹, Jennifer R Havens, MPH¹, Marcella Sapun¹, Crystal Fuller, MPH, PhD², and Steffanie A. Strathdee, PhD¹. (1) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, (2) Department of Epidemiology, Columbia University Mailman School of Public Health, 722 W. 168th Street, 4th floor, Room 422, New York, NY 10032

Objective: We hypothesized that circumstances surrounding the first injection episode (“first hit”) may be associated with future needle sharing among young injection drug users (IDUs). Such findings may be important for informing preventive interventions for this vulnerable population.

Methods: Participants (n=431) were IDUs in Baltimore, MD, aged 15-30, who had first injected <5 years ago. Survey data were collected on sociodemographics, circumstances surrounding the first hit, and current drug use. Chi-square tests and logistic regression were used to determine associations between these factors and needle sharing within the last six months.

Results: Participants were primarily white (70.3%), male (59.4%), and initiated drug injection at a median age of 22 years; 23.2% used a used needle for their first hit. IDUs using a used needle for their first hit were more likely than those using a sterile needle to report recent needle sharing (60.6% vs. 32.3%, p<0.001). Factors independently associated with current needle sharing, adjusting for age, gender, and race, included: using an unclean needle at injection initiation (AOR=3.30; 95% CI: 2.01-5.40) and having heard of a needle exchange program (NEP) prior to initiation (AOR=0.59, 95% CI: 0.37-0.92).

Conclusions: Injection-related risks may be established at the onset of injection initiation, supporting the need to educate young non-IDUs about the harms associated with unsafe injection practices. The protective effect of the awareness of NEPs prior to injection initiation suggests that these programs have an important role in disseminating educational messages to drug users, in addition to providing free, sterile injecting equipment.

Learning Objectives:

At the conclusion of this session, a participant will be able to:
• Describe the first injection experience of a cohort of young injection drug users in Baltimore, MD
• Identify associations between the first injection and future needle sharing
• Discuss the apparent benefits of educating persons about safe injection practices and access to needle exchange programs, prior to transitioning from a non-injector to an injector.

Keywords: Injection Drug Users, Needle Sharing Exposure

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.