title: Gender differences in planning ability and hepatitis C virus among people who inject drugs.
abstract: Hepatitis C virus (HCV) is primarily spread through risky injection practices, including sharing needles, cookers, cottons, rinse water, and the practice of backloading. An important aspect of harm reduction for people who inject drugs (PWID) is to identify factors that contribute to safer injection. Planning ability may influence risky injection practices and gender differences in factors that drive injection practices indicate a need to examine associations between planning and injection behaviors in men versus women. Data from the NEURO-HIV Epidemiologic Study was restricted to those who had ever injected in their lifetime (n=456). Impaired planning ability was assessed with the Tower of London and defined as a standardized total excess move score below the 10th percentile. We used logistic regression to estimate the gender-specific adjusted odds ratios (AOR) and 95% confidence intervals (CI) for associations between impaired planning, each injection practice, and biologically-confirmed HCV. Impaired planning ability was associated with sharing needles (AOR=2.93, 95% CI: 1.33, 6.47), cookers (AOR=3.13, 95% CI: 1.22, 8.02), cottons (AOR=2.89, 95% CI: 1.23, 6.78), rinse water (AOR=2.43, 95% CI: 1.15, 5.14), and backloading (AOR=2.68, 95% CI: 1.26, 5.70) and HCV (AOR=3.42, 95% CI: 1.03, 11.38) among men. Planning ability was not significantly associated with the injection behaviors or HCV among women, suggesting that other factors likely contribute to risky injection practices. Interventions to promote harm reduction among PWID should ascertain and strengthen planning ability. Women may have additional barriers to practicing safe injection beyond impaired planning abilities, which should also be addressed.
authors: Department of Epidemiology, College of Public Health & Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL 32610, United States. Electronic address: Joy.Scheidell@nyumc.org.
authors: J D
authors: JD
authors: Scheidell
authors: Department of Epidemiology, College of Public Health & Health Professions, College of Medicine, University of Florida, 2004 Mowry Road, PO Box 100231, Gainesville, FL 32610, United States.
authors: M R
authors: MR
authors: Khan
authors: Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, PO Box 100165, Gainesville, FL 32610, United States.
authors: L M
authors: LM
authors: Clifford
authors: Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, PO Box 100165, Gainesville, FL 32610, United States.
authors: E M
authors: EM
authors: Dunne
authors: Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, PO Box 100165, Gainesville, FL 32610, United States; Department of Psychology, College of Natural and Health Sciences, Virginia State University, United States.
authors: L D
authors: LD
authors: Keen
authors: Department of Clinical and Health Psychology, College of Public Health & Health Professions, University of Florida, 1225 Center Drive, PO Box 100165, Gainesville, FL 32610, United States.
authors: W W
authors: WW
authors: Latimer
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D040261:Harm Reduction; D006526:Hepatitis C / Q000150:complications* / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D012309:Risk-Taking; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000523:psychology*; D055815:Young Adult
keywords: Gender differences; Hepatitis C virus; Injection drug use