title: Demographic and Clinical Features of Chinese Heroin Users Who Switch from Non-injection to Injection.
abstract: BACKGROUND
  Injection drug users (IDUs) are at high-risk for acquiring human immunodeficiency virus, hepatitis C virus, and other infections, and delaying the switch from non-injection drug use to injection to drug use could reduce the spread of these infections.
  
  
  OBJECTIVE
  To estimate the incidence of switching from non-injected heroin use (usually smoking or "chasing") to injection and to investigate the risk factors for this change.
  
  
  METHODS
  We reviewed the socio-demographic and clinical data of 7305 heroin-dependent patients treated at a detoxification clinic of a university-affiliated psychiatric hospital in China from January 2000 to February 2009.
  
  
  RESULTS
  Within 1 year, the majority of non-injection drug users (NIDUs) transitioned to IDUs (59.4% within 6 months and 76.7% within 12 months). Multiple logistic regression analysis showed that marital status, years of education, employment status, age at onset of heroin use, duration of drug abuse, and initial dose were associated with the switch from NIDU to IDU. Being married (B = -0.410, OR = 0.664), being employed (B = -0.243, OR = 0.784), and older age at onset (B = -0.040, OR = 0.961) were protective factors. More education (B = 0.120, OR = 1.128), longer duration of drug abuse (B = 0.010, OR = 1.010), and a higher dose at initial drug use (B = 0.234, OR = 1.264) were risk factors.
  
  
  CONCLUSIONS
  The study has identified several risk factors for the switch to injection among heroin users. Understanding these factors can help design new approaches to more specifically target high-risk populations and high-risk behaviors to delay or prevent the transition to injection.
authors.affiliation: a Department of Psychology, Beijing Tongren Hospital , Capital Medical University , Beijing , China.
authors.forename: Shaojuan
authors.initials: S
authors.lastname: Cui
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Yaqiong
authors.initials: Y
authors.lastname: Li
authors.affiliation: c Unit of Psychiatry, Faculty of Health Sciences, University of Macau , Macao SAR , China.
authors.forename: Yu-Tao
authors.initials: YT
authors.lastname: Xiang
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Kai-Juan
authors.initials: KJ
authors.lastname: Yan
authors.affiliation: d Jinhua the Second Hospital , Zhejiang , China.
authors.forename: Chanxiao
authors.initials: C
authors.lastname: Fan
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Qun
authors.initials: Q
authors.lastname: Chen
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Wanjun
authors.initials: W
authors.lastname: Du
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Guofu
authors.initials: G
authors.lastname: Zhang
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Le
authors.initials: L
authors.lastname: Xiao
authors.affiliation: e Department of Psychiatry , the Chinese University of Hong Kong , Hong Kong SAR , China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Xiaofei
authors.initials: X
authors.lastname: Yuan
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Kankan
authors.initials: K
authors.lastname: Xie
authors.affiliation: b Beijing Anding Hospital , Capital Medical University , Beijing , China.
authors.forename: Xiaonian
authors.initials: X
authors.lastname: Luo
mesh_terms: D000046:Academic Medical Centers; D000280:Administration, Inhalation; D000328:Adult; D002681:China / Q000453:epidemiology; D003710:Demography; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000453:epidemiology; D006526:Hepatitis C / Q000150:complications / Q000453:epidemiology; D006556:Heroin Dependence / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D013587:Syphilis / Q000150:complications / Q000453:epidemiology
keywords: China; heroin; injection drug users; route of drug administration; transition