Perceived risk, peer influences, and injection partner type predict receptive syringe sharing among young adult injection drug users in five U.S. cities

Abstract

Objectives: This study examined risk factors for receptive syringe sharing (RSS) during illicit drug injection by persons 15-30 years old in five U.S. cities.

Methods: Participants were recruited through street outreach and respondent-driven referrals in Baltimore, Chicago, Los Angeles, New York, and Seattle between May 2002 and January 2004. Surveys of drug use, sexual behaviors, and correlates were administered through audio computer-assisted self-interviews at baseline and, for the subset of participants who enrolled in an HIV/HCV prevention intervention trial, at 3-months and 6-months post-baseline. The proportions of injections involving RSS at baseline and at follow-up were used as outcomes in multivariate models that adjusted for intervention effects.

Results: At baseline, 54% of 3128 participants reported RSS in the past 3 months. RSS decreased to 21% at 6-months post-baseline for the combined trial arms. Participants were more likely to report RSS if they perceived that their peers were not against RSS and if they injected with sex partners. Lower levels of perceived risk of infection with HIV (baseline, p<.001) or HCV (follow-up, p<.001) through RSS were also significant predictors of greater RSS.

Conclusions: Perceived risks, peer influences, and type of injection partner were robust predictors of RSS. Perceived risks and peer influences are particularly amenable to intervention efforts that may prevent RSS in this age group.