The dynamics of injection drug users' personal networks and HIV risk behaviors

• Published in: Addiction (Abingdon, England) Vol. 101; no. 7; pp. 1003 - 1013
• Main Authors: Costenbader, Elizabeth C., Astone, Nan M., Latkin, Carl A.
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01.07.2006; Blackwell
• Subjects: Acquired Immune Deficiency Syndrome; Addictive behaviors; Adolescent; Adult; Adult and adolescent clinical studies; Baltimore - epidemiology; Biological and medical sciences; Drug Abuse; Drug addiction; Drug users; Female; Health; HIV; HIV Infections - epidemiology; HIV Infections - psychology; Human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; injection drug users (IDUs); Interpersonal Relations; Intravenous drug addicts; longitudinal; Longitudinal Studies; Male; Medical sciences; Middle Aged; Needle Sharing - psychology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Risk; risk behaviors; Risk behaviour; Risk-Taking; Social Networks; Social problems; Social Support; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - psychology; Toxicology; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Baltimore; USA, Maryland, Baltimore; Human; Immunopathology; Drug addiction; Intravenous administration; Psychology; social networks; Retroviridae; Social network; AIDS; Risk taking; risk behaviors; Immune deficiency; Lentivirus; Infection; Virus; Addiction; HIV; Dynamics; Follow up study; Viral disease; Human immunodeficiency virus; longitudinal; Psychiatry; injection drug users (IDUs)
• ISSN: 0965-2140; 1360-0443
• DOI: 10.1111/j.1360-0443.2006.01431.x

ABSTRACT Aims  While studies of the social networks of injection drug users (IDUs) have provided insight into how the structures of interpersonal relationships among IDUs affect HIV risk behaviors, the majority of these studies have been cross‐sectional. The present study examined the dynamics of IDUs’ social networks and HIV risk behaviors over time. Design  Using data from a longitudinal HIV‐intervention study conducted in Baltimore, MD, this study assessed changes in the composition of the personal networks of 409 IDUs. We used a multi‐nomial logistic regression analysis to assess the association between changes in network composition and simultaneous changes in levels of injection HIV risk behaviors. Using the regression parameters generated by the multi‐nomial model, we estimated the predicted probability of being in each of four HIV risk behavior change groups. Findings  Compared to the base case, individuals who reported an entirely new set of drug‐using network contacts at follow‐up were more than three times as likely to be in the increasing risk group. In contrast, reporting all new non‐drug‐using contacts at follow‐up increased the likelihood of being in the stable low‐risk group by almost 50% and decreased the probability of being in the consistently high‐risk group by more than 70%. Conclusions  The findings from this study show that, over and above IDUs’ baseline characteristics, changes in their personal networks are associated with changes in individuals’ risky injection behaviors. They also suggest that interventions aimed at reducing HIV risk among IDUs might benefit from increasing IDUs’ social contacts with individuals who are not drug users.