Bill Sanders

CSU Mentor, Long Beach, California, United States

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Publications (15)14.27 Total impact

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    ABSTRACT: Young female injection drug users (IDUs) are at risk for HIV/HCV, and initiating the use of a new drug may confer additional and unexpected risks. While gender differences in the social context of injection drug use have been identified, it is unknown whether those differences persist during the initiation of a new drug. This mixed methods study examined the accounts of 30 young female IDUs in Los Angeles, California from 2004-2006, who described the social context of initiating injection drug use and initiating ketamine injection. The analysis aimed to understand how the social context of young women's injection events contributes to HIV/HCV risk. Women's initiation into ketamine injection occurred approximately 2 years after their first injection of any drug. Over that time, women experienced changes in some aspects of the social context of drug injection, including the size and composition of the using group. A significant proportion of women described injection events characterized by a lack of control over the acquisition, preparation, and injection of drugs, as well as reliance on friends and sexual partners. Findings suggest that lack of control over drug acquisition, preparation, and injection may elevate women's risk; these phenomena should be considered as a behavioral risk factor when designing interventions.
    ISRN Addiction. 05/2013; 2013.
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    ABSTRACT: Longitudinal studies that research homeless persons or transient drug users face particular challenges in retaining subjects. Between 2005 and 2006, 101 mobile young injection drug users were recruited in Los Angeles into a 2-year longitudinal study. Several features of ethnographic methodology, including fieldwork and qualitative interviews, and modifications to the original design, such as toll-free calls routed directly to ethnographer cell phones and wiring incentive payments, resulted in retention of 78% of subjects for the first follow-up interview. Longitudinal studies that are flexible and based upon qualitative methodologies are more likely to retain mobile subjects while also uncovering emergent research findings.
    Substance Use &amp Misuse 04/2010; 45(5):684-99. · 1.11 Impact Factor
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    ABSTRACT: Gang youth are notoriously difficult to access for research purposes. Despite this difficulty, qualitative research about substance use among gang youth is important because research indicates that such youth use more substances than their nongang peers. This manuscript discusses how a small sample of gang youth (n = 60) in Los Angeles was accessed and interviewed during a National Institute of Drug Abuse-funded pilot study on substance use and other risk behaviors. Topics discussed include the rationale and operationalization of the research methodology, working with community-based organizations, and the recruitment of different gang youth with varying levels of substance use.
    Substance Use &amp Misuse 04/2010; 45(5):736-53. · 1.11 Impact Factor
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    ABSTRACT: This article describes how the drug type injected at the first injection event is related to characteristics of the initiate, risk behaviors at initiation, and future drug-using trajectories. A diverse sample (n=222) of young injection drug users (IDUs) were recruited from public settings in New York, New Orleans, and Los Angeles during 2004 and 2005. The sample was between 16 and 29 years old, and had injected ketamine at least once in the preceding two years. Interview data was analyzed both quantitatively and qualitatively. Young IDUs initiated with four primary drug types: heroin (48.6%), methamphetamine (20.3%), ketamine (17.1%), and cocaine (14%). Several variables evidenced statistically significant relationships with drug type: age at injection initiation, level of education, region of initiation, setting, mode of administration, patterns of self-injection, number of drugs ever injected, current housing status, and their hepatitis C virus (HCV) status. Qualitative analyses revealed that rationale for injection initiation and subjective experiences at first injection differed by drug type.
    Journal of drug issues 01/2010; 40(2):241-262. · 0.38 Impact Factor
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    ABSTRACT: Gang youth are at an increased likelihood of participating in unsafe sexual behaviors and at an elevated risk of exposure to sexually transmitted infection (STIs), including HIV. This manuscript presents quantitative and qualitative data on sexual behaviors among a sample of predominately heterosexual, male gang youth aged 16 to 25 years interviewed in Los Angeles between 2006 and 2007 (n = 60). In particular, sexual identity, initiation and frequency of sex, and number of sexual partners; use of condoms, children, and other pregnancies; group sex; and STIs and sex with drug users. We argue that gang youth are a particular public health concern, due to their heightened risky sexual activity, and that behavioral interventions targeting gang youth need to include a component on reducing sexual risks and promoting safe sexual health.
    International Journal for Equity in Health 11/2009; 2(1):61-71. · 1.71 Impact Factor
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    ABSTRACT: Gang youth often come from socially and economically marginalized communities. Such youth report significantly higher rates of participation in violence, substance use, and risky sexual behaviors than their nongang peers. This manuscript argues that gang-identified youth constitute a vulnerable population. Data are drawn from the general research literature and a case example of how a nurse in Los Angeles partnered with law enforcement to provide preventive health care to gang youth and youth at-risk for joining gangs. Gang youth are a vulnerable population amenable to nursing intervention. Gang youth may have particular health care needs and may need special access to health care.
    Public Health Nursing 08/2009; 26(4):346-52. · 0.78 Impact Factor
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    ABSTRACT: Research indicates a link between drug use and offending, particularly amongst high-risk individuals, such as homeless youth. The extent to which such youth interpret their offending as being related to their drug use, though, is understudied. This manuscript investigates the interpretations of drug-related offenses offered by 151 primarily white, male, homeless IDUs aged 16-29 years. Youth were asked specific questions about their drug-related offenses during in-depth interviews as part of a larger study investigating health risks surrounding drug injection between 2004 and 2006. The first section of the manuscript outlines offenses youth revealed committing either in pursuit of or after using a variety of substances. The second part of the manuscript examines the overall context (motivation, environment), and provides a seven-tiered typology of drug-related offending based on youth's interpretations, linking certain drugs to specific offenses within particular contexts. From here, some theoretical and practical implications of the findings are discussed.
    Journal of drug issues 01/2009; 39(4):777-802. · 0.38 Impact Factor
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    ABSTRACT: Homeless youth are a diverse population of at risk adolescents and young adults who experience various negative health outcomes, including drug dependence, drug overdose, infectious diseases, and victimization. Previous studies have been directed toward understanding subgroups of homeless youth, such as injection drug users (IDUs) and young men who have sex with men (YMSM); yet limited research has focused on describing homeless “travelers,” a migratory subgroup of homeless youth who move from city to city. Based upon a larger three site study of young IDUs recruited in Los Angeles, New Orleans, and New York, a total of 133 travelers were identified. A subsample of 56 travelers participated in follow-up interviews, and provided data points for mapping. Travelers in all sites had extensive histories of criminal justice involvement and injection drug use. Four common traveling routes within and across the United States were identified. Reasons for traveling often related to drug use, money-making opportunities, and law enforcement. Risk-reduction services, such as shelters, syringe exchanges, or HIV/HCV testing, were used infrequently or occasionally. Mapping data documents the mobility of young IDUs across both urban and rural areas, which suggests that migration among IDUs across broad geographic regions may be a factor in the spread of blood-borne viruses.
    09/2008: pages 65-83;
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    ABSTRACT: Research on pregnancy and sexual health among homeless youth is limited. In this study, qualitative interviews were conducted with 41 homeless young injection drug users (IDUs) in Los Angeles with a history of pregnancy. The relationship between recent pregnancy outcomes, contraception practices, housing status, substance use, utilization of prenatal care, and histories of sexual victimization are described. A total of 81 lifetime pregnancies and 26 children were reported. Infrequent and ineffective use of contraception was common. While pregnancy motivated some homeless youth to establish housing, miscarriages and terminations were more frequent among youth who reported being housed. Widespread access to prenatal and medical services was reported during pregnancy, but utilization varied. Many women continued to use substances throughout pregnancy. Several youth reported childhood sexual abuse and sexual victimization while homeless. Pregnancy presents a unique opportunity to encourage positive health behaviors in a high-risk population seldom seen in a clinical setting.
    Journal of Adolescence 09/2008; 32(2):339-55. · 2.05 Impact Factor
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    ABSTRACT: Ketamine is a dissociative anesthetic with powerful sedative and hallucinogenic properties. Despite the wide variability in reported subjective experiences, no study has attempted to describe the particular factors that shape these experiences. This manuscript is based upon a sample of 213 young injection drug users recruited in New York, New Orleans, and Los Angeles with histories of ketamine use. Qualitative interviews focused on specific ketamine events, such as first injection of ketamine, most recent injection of ketamine, and most recent experience sniffing ketamine. Findings indicate that six factors impacted both positive and negative ketamine experiences: polydrug use, drug using history, mode of administration, quantity and quality of ketamine, user group, and setting. Most subjective experiences during any given ketamine event were shaped by a combination of these factors. Additionally, subjective ketamine experiences were particularly influenced by a lifestyle characterized by homelessness and traveling.
    Addiction Research and Theory 02/2008; 16(3):273-287. · 1.03 Impact Factor
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    ABSTRACT: Tryptamines and phenethylamines are two broad categories of psychoactive substances with a long history of licit and illicit use. Profiles of users of recently emerging tryptamines and phenethylamines are nonexistent, however, since surveillance studies do not query the use of these substances. This manuscript describes the types, modes of administration, onset of use, and context of use of a variety of lesser known tryptamines and phenethylamines among a sample of high-risk youth. Findings are based upon in-depth interviews with 42 youth recruited in public settings in Los Angles during 2005 and 2006 as part of larger study examining health risks associated with injecting ketamine. Youth reported that their use of tryptamines and phenethylamines was infrequent, spontaneous, and predominately occurred at music venues, such as festivals, concerts, or raves. Several purchased a variety of these "research chemicals" from the Internet and used them in private locations. While many described positive experiences, reports of short-term negative health outcomes included nausea, vomiting, diarrhea, disorientations, and frightening hallucinations. These findings, based upon pilot study data, move toward an epidemiology of tryptamine and phenethylamine use among high-risk youth.
    Substance Use &amp Misuse 02/2008; 43(3-4):389-402. · 1.11 Impact Factor
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    ABSTRACT: Diverse forms of drug use are an emerging theme within research on young people and substance use. This manuscript, based on a three city study of health risks amongst young injection drug users, explores multiple drug use and polydrug use amongst a subset of homeless youth referred to as "travelers." In particular, we outline characteristics of homeless traveler youths and the various ways in which they practiced multiple drug use and polydrug use. From here, we discuss some theoretical and public health implications of multiple drug use and polydrug use amongst this particular population.
    Journal of Ethnicity in Substance Abuse 01/2008; 7(1):23-40.
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    Stephen E Lankenau, Bill Sanders
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    ABSTRACT: Ketamine is a dissociative anesthetic that has emerged as an increasingly popular choice among young drug users. Recent research indicates the presence of hidden populations of young people who inject ketamine in New York and other U.S. cities. Applying an ethno-epidemiological approach, the authors recruited 40 young injection drug users (IDUs) (< 25 years old) in New York City to explore health risks associated with ketamine use. This analysis looks at the varying patterns and frequencies of ketamine injection by examining personal, social, and cultural aspects of these young people's lives. We learned that drug-using histories, experiential dimensions, sociocultural characteristics, and associations with other young people help account for the different patterns of injecting ketamine within the sample. In particular, these findings indicate that young people who were more frequent ketamine injectors had the following characteristics: initiated injection drug use with ketamine; enjoyed the effects of ketamine, were stably housed; lived in the vicinity of New York City; and associated with others who also injected ketamine.
    Journal of psychoactive drugs 04/2007; 39(1):21-9. · 1.10 Impact Factor
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    ABSTRACT: Ketamine, a dissociative anesthetic, has emerged as an increasingly common drug among subgroups of young injection drug users (IDUs) in cities across the United States. In-depth qualitative interviews were conducted with 213 young IDUs aged 16-28 years recruited in New York, New Orleans, and Los Angeles between 2004 and 2006. While some initiated injection drug use with ketamine, the drug was more frequently injected by IDUs with extensive polydrug using histories. IDUs initiating with ketamine commonly self-injected via an intramuscular mode of administration. The injection group provided crucial knowledge and material resources that enabled the injection event to occur, including ketamine, syringes, and injection skills. Injection paraphernalia was commonly shared during the first injection of ketamine, particularly vials of pharmaceutically-packaged liquid ketamine. Injection events infrequently occurred in a rave or club and more typically in a private home, which challenges ketamine's designation as a 'club' drug. The first injection of ketamine was a noteworthy event since it introduced a novel drug or new mode of administration to be further explored by some, or exposed others to a drug to be avoided in the future. Risk reduction messages directed towards young IDUs should be expanded to include ketamine.
    Drug and Alcohol Dependence 04/2007; 87(2-3):183-93. · 3.14 Impact Factor
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    ABSTRACT: In recent years, epidemiological monitoring data has indicated sharp increases in prescription drug misuse. Despite these increases, little is known about the context or patterns associated with prescription drug misuse, particularly among youth or young injection drug users (IDUs). A three-city study of 213 young IDUs found prescription drug misuse to be pervasive, specifically the use of opioids and benzodiazepines. Particular practices not commonly associated with prescription drugs were reported, such as sniffing, smoking, and injection. Associated health risks included initiation into injection drug use, polydrug use, drug overdose, and drug dependency. A greater awareness of the potential health risks associated with prescription drug misuse should be incorporated into services that target IDUs, including street outreach, syringe exchanges, and drug treatment.
    Journal of drug issues 02/2007; 37(3):717-736. · 0.38 Impact Factor

Publication Stats

127 Citations
14.27 Total Impact Points

Institutions

  • 2010
    • CSU Mentor
      Long Beach, California, United States
    • Drexel University
      • Department of Community Health and Prevention
      Philadelphia, PA, United States
  • 2009–2010
    • California State University, Los Angeles
      • School of Criminal Justice and Criminalistics
      Los Angeles, California, United States
  • 2008
    • Children's Hospital Los Angeles
      • Community, Health Outcomes and Intervention Research Program (CHOIR)
      Los Angeles, California, United States
    • University of Southern California
      • Department of Pediatrics
      Los Angeles, CA, United States
  • 2007
    • Keck School of Medicine USC
      Los Angeles, California, United States