Article

The dynamics of injection drug users’ personal networks and HIV risk behaviors. Addiction (Abingdon, England), 101(7), 1003-1013

Substance Abuse Treatment Evaluations and Interventions Program, Research Triangle Institute, International, 3040 Cornwallis Road, Research Triangle Park, NC 27709-2194, USA.
Addiction (Impact Factor: 4.6). 08/2006; 101(7):1003-13. DOI: 10.1111/j.1360-0443.2006.01431.x
Source: PubMed

ABSTRACT While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross-sectional. The present study examined the dynamics of IDUs' social networks and HIV risk behaviors over time.
Using data from a longitudinal HIV-intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi-nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi-nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups.
Compared to the base case, individuals who reported an entirely new set of drug-using network contacts at follow-up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non-drug-using contacts at follow-up increased the likelihood of being in the stable low-risk group by almost 50% and decreased the probability of being in the consistently high-risk group by more than 70%.
The findings from this study show that, over and above IDUs' baseline characteristics, changes in their personal networks are associated with changes in individuals' risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs' social contacts with individuals who are not drug users.

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    • "However, it could be that in the chronic presence of stressors such as PTSD or exchange sex, individuals are not able to develop the capacity to reduce their frequency of sharing as they get older. It may also be that individuals with these stressors have less stable or more frequently changing social networks, something which has also been associated with more risky drug using behavior [24,25]. Factors specific to the social networks or life stressors of injection drug users may in part explain the conflicting results of previous studies regarding age and injection equipment sharing. "
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    • "Identifying supportive others who are not substance users may be an important component of effective treatments. It has been suggested that interventions that aim to supplant drug-using friends with nondrug-using contacts may be most successful in achieving sustained behavioral risk reductions (Costenbader et al., 2006). "
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