Comparing Characteristics of Early-Onset Injection Drug Users to Those With Late-Onset Injection in Kermanshah, Iran.
Characteristics and behaviors of early-onset injection drug users are under studied topics in Iran. This study aimed to identify and compare the demographic characteristics as well as the drug using behaviors of early-onset and late-onset injection drug users in Kermanshah, West Iran.



In this cross-sectional study using snowball and convenience sampling, we recruited 450 people during the Fall of 2014 from two drop in centers in Kermanshah, Iran. We collected data through face-to-face interviews. Early-onset injection is defined as whether the person reported their first injection at 22 years of age or younger. Subsequently, late-onset injection is defined as 23 years of age or older. We compared the characteristics of the two groups through both univariate and multiple logistic analyses.



Overall, 54% (CI 95%: 44.3%, 62.2%) were early injectors. After controlling for low socioeconomic status, initiation of drug use at a young age, multiple drug use and methamphetamine use were all significantly associated with a higher likelihood of early-onset injection. Additionally, early-onset injection was associated with recent syringe borrowing (OR = 2.6, p = 0.001), recent syringe lending (OR = 1.4, p = 0.01), recent cooker sharing (OR = 3.2, p = 0.01) and injecting two or more times a day (OR = 2.2, p = 0.04).



Early-onset injectors were more likely to report a lower socioeconomic status, initiation of first drug use at a younger age, using methamphetamine alongside polydrug use, and engaging in higher risk taking behaviors like borrowing needles. With these associations, the study emphasizes the need for drug-prevention programs to focus on the transition to injection drug use at younger ages.
a Social Determinants of Health Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Zahra
Z
Jorjoran Shushtari
b School of Advanced Technologies in Medicine (SATiM) , Tehran University of Medical Sciences (TUMS) , Tehran , Iran.
Alireza
A
Noroozi
c Department of Epidemiology and Biostatistics , University of California , San Francisco , California , USA.
Ali
A
Mirzazadeh
d Substance Abuse and Dependence Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Elahe
E
Ahounbar
e Mental Health Research Center, Tehran Institute of Psychiatry, Faculty of School of Behavioral Sciences and Mental Health , Iran University of Medical Sciences (IUMS) , Tehran , Iran.
Ahmad
A
Hajbi
d Substance Abuse and Dependence Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Mohammad
M
Najafi
d Substance Abuse and Dependence Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Ali
A
Bazrafshan
d Substance Abuse and Dependence Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Mohammad Hossin
MH
Farhadi
d Substance Abuse and Dependence Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Ali
A
Farhoudian
f Department of Public Health , La Trobe University , Melbourne , Australia.
Peter
P
Higgs
a Social Determinants of Health Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Farahnaz Mohammadi
FM
Shahboulagh
g Brown University School of Public Health , Providence, Rhode Island , USA.
Katherine
K
Waye
a Social Determinants of Health Research Center , University of Social Welfare and Rehabilitation Sciences , Tehran , Iran.
Mehdi
M
Noroozi
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D006801:Humans; D007407:Interviews as Topic; D007492:Iran / Q000453:epidemiology; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data; D012307:Risk Factors; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D055815:Young Adult
Injection drug use; Iran; early-onset injection; late-onset injection