title: Prevalence and Correlates of the Use of Prefilled Syringes Among Persons Who Inject Drugs in San Diego, CA.
abstract: Persons who inject drugs (PWID) are at increased risk for blood-borne virus (BBV) infections and overdose resulting from high-risk injecting practices. Studies of prefilled syringe use ([PFSU] using a syringe that already contained drug solution when it was obtained by the user), an injection practice previously described in Eastern Europe, suggest that it increases susceptibility to BBV. However, little is known about this practice in the USA. Data were obtained from an ongoing cohort study of PWID to determine the prevalence and assess correlates of PFSU in San Diego, CA. Baseline interviews assessed socio-demographics and drug use behaviors. Logistic regression was used to identify factors independently associated with ever using a prefilled syringe (yes/no). Participants (n = 574) were predominately males (73.9%) and white (50.9%) with a mean age of 43.4 years (range 18-80); 33.3% reported ever using prefilled syringes, although only 4.9% reported use in the past 6 months. In multivariable analyses, PFSU was independently associated with ever having a rushed injection due to police presence [adjusted odds ratio (AOR) = 2.51, 95% CI 1.66, 3.79], ever being in prison (AOR = 1.80, 95% CI 1.23, 2.63), injecting most often in public versus private places in the past 6 months (AOR = 1.66, 95% CI 1.11, 2.48), and injecting drugs in Mexico (AOR = 1.70, 95% CI 1.16, 2.49). Results indicate that a history of PFSU is common and associated with environmental factors that may also increase risk for adverse health outcomes. Studies are needed to better understand PFSU in order to develop interventions to prevent adverse outcomes associated with their use.
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA.|Division of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Armenta
authors.affiliation: Department of Community Health & Prevention, School of Public Health, Drexel University, Philadelphia, PA, USA.
authors.forename: Alexis M
authors.initials: AM
authors.lastname: Roth
authors.affiliation: School of Community Health Sciences, University of Nevada, Reno, NV, USA.
authors.forename: Karla D
authors.initials: KD
authors.lastname: Wagner
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA.
authors.forename: Steffanie A
authors.initials: SA
authors.lastname: Strathdee
authors.affiliation: Division of Epidemiology, Graduate School of Public Health, San Diego State University, San Diego, CA, USA.
authors.forename: Stephanie K
authors.initials: SK
authors.lastname: Brodine
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA.
authors.forename: Jazmine
authors.initials: J
authors.lastname: Cuevas-Mota
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA.
authors.forename: Fatima A
authors.initials: FA
authors.lastname: Munoz
authors.affiliation: Division of Global Public Health, Department of Medicine, School of Medicine, University of California San Diego, 9500 Gilman Drive, MC-0507, San Diego, CA, 92093-0507, USA. rgarfein@ucsd.edu.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Garfein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D055030:Drug Users / Q000706:statistics & numerical data*; D005260:Female; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012309:Risk-Taking; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013594:Syringes / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HIV; Hepatitis C; Injection drug use; Overdose; Prefilled syringes