Online Program

289480
Association between executive function, risky injection practices, and HCV among injection drug users


Monday, November 4, 2013

Joy Scheidell, MPH, Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL
Maria Khan, PhD, School of Public Health, Department of Epidemiology and Biostatistics, University of Florida, Gainesville, FL
Lisa Clifford, PhD, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
Eugene Dunne, MA, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
William Latimer, PhD, MPH, Department of Clinical and Health Psychology, University of Florida, Gainesville, FL
Aim: To measure associations between impaired executive functioning (e.g., planning ability) measured by the Tower of London (TOL) and risky injection practices and Hepatitis C Virus (HCV) among injection drug users (IDU).

Hypothesis: Among male and female IDUs, impaired executive function (EF) will be associated with risky injection and HCV. Methods: Data from the Neuro-HIV Epidemiologic Study, a study of neurobehavioral risk factors of infectious disease among drug users in Baltimore, were restricted to those who had ever injected (n=458). We estimated gender-specific adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for associations between impaired EF, defined as a TOL standardized total excess moves score below the 10th percentile, and dichotomous outcomes of risky injection practices (ever having shared needles, cookers, cotton, or rinse water and ever having backloaded) and HCV as indicated by a positive antibody blood test result.

Results: Among men, impairment on the TOL was significantly associated with over twice the odds of each risky injection practice and appeared to be independently associated with HCV infection (AOR: 2.76, 95% CI: 0.83-9.15) of HCV. Analyses suggested that risky injection practices mediated the association between TOL and HCV. Associations differed significantly by gender; among females, impaired planning was not associated with risky injection or HCV.

Conclusion: There is evidence interventions designed to improve planning may reduce risky injection and infection among men. Given risky injection and infection are high among all women, including those with intact EF, additional factors must be considered to reduce women's infection risk.

Learning Areas:

Epidemiology

Learning Objectives:
Compare levels of executive functioning and its effect on infectious disease risk. Analyze the impact of planning abilities on one's odds of engaging in risky injection practices and of Hepatitis C virus among injection drug users.

Keyword(s): Drug Injectors, Hepatitis C

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a Master of Public Health student who will have completed the degree at the time of presentation. I have worked as a research assistant and conducted independent research on infectious disease and risk behaviors for multiple projects. My research interests involve socio-behavioral determinants of infectious disease, specifically those related to sexual and substance abusing behavior.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.