Needle acquisition patterns, network risk and social capital among rural PWID in Puerto Rico

Ian Duncan,Kirk Dombrowski,Patrick Habecker,Roberto Abadie,Bilal Khan,Ric Curtis

doi:10.1186/s12954-017-0195-5

Ian Duncan, Kirk Dombrowski + Show 4 more

Open Access

https://doi.org/10.1186/s12954-017-0195-5

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Abstract

BackgroundPeople who inject drugs (PWID) take on significant risks of contracting blood-borne infection, including injecting with a large number of partners and acquiring needles from unsafe sources. When combined, risk of infection can be magnified.MethodsUsing a sample of PWID in rural Puerto Rico, we model the relationship between a subject’s number of injection partners and the likelihood of having used an unsafe source of injection syringes. Data collection with 315 current injectors identified six sources of needles.ResultsOf the six possible sources, only acquisition from a seller (paid or free), or using syringes found on the street, was significantly related to number of partners.ConclusionsThese results suggest that sources of syringes do serve to multiply risk of infection caused by multi-partner injection concurrency. They also suggest that prior research on distinct forms of social capital among PWID may need to be rethought.

Highlights

People who inject drugs (PWID) take on significant risks of contracting blood-borne infection, including injecting with a large number of partners and acquiring needles from unsafe sources
It is often taken for granted that people who inject drugs take on significant risks of infection
The aim of this paper is to examine how, for rural PWID, the number of risk partners in an individual’s injection

Summary

Introduction

People who inject drugs (PWID) take on significant risks of contracting blood-borne infection, including injecting with a large number of partners and acquiring needles from unsafe sources. In addition to the potentially harmful effects that injecting drugs can have in and of itself, there is the additional concern of spreading disease through the sharing of needles or other equipment—such as syringes, cookers, or cotton used to filter the solution before it is drawn into the syringe Despite these risks, people who inject drugs (PWID) often share injection equipment, both as a costcutting measure [1] and as a way to establish and maintain relationships [2]. People who inject drugs (PWID) often share injection equipment, both as a costcutting measure [1] and as a way to establish and maintain relationships [2] This risk behavior has received considerable attention in the past—resulting in early and consistent efforts by syringe exchange and syringe service programs since the 1980s [3]. The aim of this paper is to examine how, for rural PWID, the number of risk partners in an individual’s injection

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