Effects of drug treatment for heroin sniffers: a protective factor against moving to injection?

• Published in: Social science & medicine (1982) Vol. 58; no. 10; pp. 2083 - 2092
• Main Authors: Kelley, Margaret S, Chitwood, Dale D
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2004; Elsevier; Pergamon Press Inc
• Series: Social Science & Medicine
• Subjects: Acquired Immune Deficiency Syndrome; Addiction; Adult; AIDS; AIDS Transition to injection Heroin Heroin sniffers USA; Biological and medical sciences; Drug abusers; Drug addictions; Drug Injection; Drug therapy; Drug treatment; Drug treatment HIV; Drugs; Effects; Female; Florida; Florida - epidemiology; Health; Heroin; Heroin Dependence - complications; Heroin Dependence - epidemiology; Heroin Dependence - psychology; Heroin Dependence - therapy; Heroin sniffers; HIV; HIV Seropositivity - complications; HIV Seropositivity - epidemiology; HIV/AIDS; Human viral diseases; Humans; Infectious diseases; Injections; Intravenous drug addiction; Male; Medical sciences; Medical treatment; Medicine; Middle Aged; Motivation; Patient Acceptance of Health Care; Prevention; Proportional Hazards Models; Protection; Risk Factors; Risk-Taking; Social sciences; Substance Abuse Treatment Centers - utilization; Substance Abuse, Intravenous - epidemiology; Substance Abuse, Intravenous - prevention & control; Substance Abuse, Intravenous - psychology; Time; Toxicology; Transition to injection; Treatment; Treatment Outcome; Treatment Outcomes; U.S.A; USA; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Florida; United States; North America; America; United States > US; HIV/AIDS; USA; Transition to injection; Drug treatment; Heroin; Heroin sniffers; Replacement therapy; Intravenous administration; Route of administration; Prevention; Health policy; Evolution; Public health; Human; Immunopathology; Retroviridae; AIDS; Injection; Immune deficiency; Lentivirus; Inhalation; Infection; Virus; Viral disease; Human immunodeficiency virus
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/j.socscimed.2003.08.006

We explore the relationship between contact with treatment and transition to injection for heroin sniffers. Our primary research question is, does contact with treatment delay onset of injection for heroin sniffers? A stratified network-based sample was recruited from multiple communities in South Florida which were known for high drug use. Three categories of respondents were recruited based on injection outcome: long-term injectors, short-term injectors, and sniffers ( n=900). We answer our research question in two steps. First, we investigate the prevalence of drug treatment for heroin sniffers and injectors using case-control methods. The preliminary findings indicate a positive relationship between contact with treatment and injection status outcome. Second, we further examine the relationship by attempting to identify the causal factors that delay initial injection for a subgroup of current injectors using survival regression procedures. Delaying or preventing transition to injection could significantly decrease risk of HIV transmission by reducing or eliminating risky injecting behaviors. We conclude with a discussion of policy implications and suggestions for future research.