title: Individual and socio-environmental factors associated with unsafe injection practices among young adult injection drug users in San Diego.
abstract: Unsafe injection practices significantly increase the risk of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection among injection drug users (IDUs). We examined individual and socio-environmental factors associated with unsafe injection practices in young adult IDUs in San Diego, California. Of 494 IDUs, 46.9 % reported receptive syringe sharing and 68.8 % sharing drug preparation paraphernalia in the last 3 months. Unsafe injection practices were associated with increased odds of having friends who injected drugs with used syringes, injecting with friends or sexual partners, and injecting heroin. Perceived high susceptibility to HIV and perceived barriers to obtaining sterile syringes were associated with increased odds of receptive syringe sharing, but not with sharing injection paraphernalia. Over half the IDUs reported unsafe injection practices. Our results suggest that personal relationships might influence IDUs' perceptions that dictate behavior. Integrated interventions addressing individual and socio-environmental factors are needed to promote safe injection practices in this population.
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California, San Diego, 9500 Gilman Drive, La Jolla, CA, 92093, USA.
authors.forename: Fátima
authors.initials: F
authors.lastname: Muñoz
authors.forename: José Luis
authors.initials: JL
authors.lastname: Burgos
authors.forename: Jazmine
authors.initials: J
authors.lastname: Cuevas-Mota
authors.forename: Eyasu
authors.initials: E
authors.lastname: Teshale
authors.forename: Richard S
authors.initials: RS
authors.lastname: Garfein
mesh_terms: D040343:Behavioral Risk Factor Surveillance System; D002140:California / Q000453:epidemiology; D003430:Cross-Sectional Studies; D037001:Directive Counseling; D055030:Drug Users / Q000523:psychology / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion; D006526:Hepatitis C / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects / Q000706:statistics & numerical data*; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult