Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis

• Published in: AIDS and behavior Vol. 27; no. 2; pp. 484 - 495
• Main Authors: Shrader, Cho-Hee, Borquez, Annick, Vasylyeva, Tetyana I., Chaillon, Antoine, Artamanova, Irina, Harvey-Vera, Alicia, Vera, Carlos F., Rangel, Gudelia, Strathdee, Steffanie A., Skaathun, Britt
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2023; Springer Nature B.V
• Subjects: Behavior; Borders; COVID-19; Drug abuse; Drug use; Drug Users; Drugs; Harm Reduction; Health behavior; Health Psychology; Health risks; HIV; HIV Infections - epidemiology; HIV Infections - prevention & control; Human immunodeficiency virus; Humans; Indexes; Infectious Diseases; Latent class analysis; Medicine; Medicine & Public Health; Norms; Original Paper; Public Health; Reduction; Risk; Risk assessment; Risk taking; Social networks; Social organization; Substance Abuse, Intravenous - complications; Substance Abuse, Intravenous - epidemiology; Substance-Related Disorders; Vulnerability; Drug users; Mexico; HIV infections; Social Networks; Latent class analysis
• ISSN: 1090-7165; 1573-3254; 1573-3254
• DOI: 10.1007/s10461-022-03783-6

The COVID-19 related U.S.-Mexico border-crossing restrictions disrupted social networks and HIV harm reduction services among people who inject drugs (PWID) in San Diego and Tijuana. We assessed associations of descriptive network norms on PWID’s HIV vulnerability during this period. Between 10/2020 and 10/2021, 399 PWID completed a behavioral and egocentric questionnaire. We used Latent Profile Analysis to categorize PWID into network norm risk profiles based on proportions of their network (n = 924 drug use alters) who injected drugs and engaged in cross-border drug use (CBDU), among other vulnerabilities. We used logistic and linear regressions to assess network profile associations with individual-level index of HIV vulnerability and harm reduction behaviors. Fit indices specified a 4-latent profile solution of descriptive network risk norms: lower (n = 178), moderate with (n = 34) and without (n = 94) CBDU and obtainment, and higher (n = 93). Participants in higher risk profiles reported more HIV vulnerability behaviors and fewer harm reduction behaviors. PWID’s gradient of HIV risk was associated with network norms, warranting intervention on high-vulnerability networks when services are limited.