title: Prospective risk factors for traumatic event reexposure in community syringe exchange participants.
abstract: BACKGROUND
  Traumatic event reexposure in injecting drug users is associated with increased drug use and potential for psychiatric symptoms. This is the first study to examine fixed and time-varying factors that are prospectively associated with new traumatic event reexposure in injecting drug users.
  
  
  METHODS
  Injecting drug users registered in a syringe exchange program were enrolled in a 16-month parent study comparing strategies to increase drug abuse treatment enrollment. Participants (N=162) completed baseline measures of demographics, psychiatric treatment history, and lifetime traumatic event exposure. Monthly follow-ups assessed past-month traumatic event exposure, days of heroin and cocaine use, criminal activity, and drug abuse treatment participation. Generalized estimating equations models tested the influence of fixed baseline and time-varying factors on traumatic event reexposure in the same month, the following month, and two months later.
  
  
  RESULTS
  Significant fixed risk factors for traumatic event reexposure include female gender and past psychiatric treatment. In addition, each past traumatic event exposure was associated with an increased likelihood of reexposure. After accounting for all other factors, each day of cocaine use was associated with a small but persistent increased risk of traumatic event reexposure. Reexposure to a traumatic event in the prior month more than doubled the risk of subsequent reexposure.
  
  
  CONCLUSIONS
  Injecting drug users experience a pattern in which drug use is associated with increased risk of subsequent traumatic event reexposure, and traumatic event reexposure is associated with further drug use and continued reexposure. Implications for addressing these concerns in injecting drug users are presented.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224, United States. Electronic address: jmpeirce@jhmi.edu.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Peirce
authors.affiliation: Department of Psychology, University of Maryland, Baltimore County, 1000 Hilltop Circle, Math/Psychology Building, Room 312, Baltimore, MD 21250, United States.
authors.forename: Rebecca L
authors.initials: RL
authors.lastname: Schacht
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224, United States.
authors.forename: Robert K
authors.initials: RK
authors.lastname: Brooner
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224, United States.
authors.forename: Van L
authors.initials: VL
authors.lastname: King
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Mason F. Lord, 6 East, 5200 Eastern Avenue, Baltimore, MD 21224, United States.
authors.forename: Michael S
authors.initials: MS
authors.lastname: Kidorf
mesh_terms: D000328:Adult; D003415:Crime; D005260:Female; D006801:Humans; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D018671:Needle-Exchange Programs; D010342:Patient Acceptance of Health Care; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000523:psychology*; D055815:Young Adult
keywords: Cocaine; Gender differences; Injecting drug users; Risk; Syringe exchange; Traumatic event