Early Substance Use Experiences and Trajectories Leading to Injection Drug Use among Male and Female Current Injection Drug Users in the Mexico-US Border Region
Year: 2011
Type: dissertation
Abstract: Background: The research proposed herein investigates factors\nassociated with substance use trajectories leading to injection drug use\n(injection) and the circumstances surrounding injection within two different\npopulations of injection drug users (IDUs). This study aims to identify factors\nassociated with: (1) initiation of substance use through injection, (2) lifetime\nand current agua celeste use (an inhalant unique to Northern Mexico), and (3)\ntime to initiation of sex work, and initiation of injection.\nMethods: Three manuscripts form the basis of this dissertation using\nexisting data from two datasets. Manuscript 1 uses data from IDU from the\nProyecto El Cuete phase III dataset, and Manuscript 2 and 3 use data from\nfemale sex workers who inject drugs (FSW-IDU) in the Mujer Mas Segura\ndataset.\nResults: Manuscript 1 identified a sub-group of IDUs who initiated illicit\ndrug use by injecting the drug ('injection first'). 'Injection first' IDUs were more likely to first inject heroin and inject alone, but were not significantly riskier in\ntheir current drug use or sexual behaviors compared to IDUs who used illicit\ndrugs prior to injection. Manuscript 2 found that only FSW-IDUs in Ciudad\nJuarez reported agua celeste use and prevalence overall (53%) and within the\npast 6 months (47%) was high. Manuscript 3 identified that early abuse and\nillicit drug use was associated an accelerated time to initiation of both sex work\nand injection. Low education and a perceived need to enter sex work to\nsupport family were associated with a shorter time to sex work initiation, and\ngeographical migration was found to decelerate time to injection initiation.\nHaving an intimate partner suggest sex work and injecting to deal with feelings\nof depression accelerated time to both sex work and injection initiation when\nthey occurred at the same age.\nConclusions: The unique populations of IDUs studied and novel\nresearch questions make the findings within this dissertation valuable to the\nlarger field of research on substance use careers. These findings build on\nprevious literature showing that inhalant use is an important risk factor for\nsubsequent injection and may help identify possible avenues for intervention\nthat can delay or prevent onset of initiation of injection drug use and/or sex\nwork.
Author: Meghan D. Morris
Language: English
Topic: HIV, Drug Use, Sexual Risk
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funder: National Institute on Drug Abuse
OpenAlex ID: W2219042727