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. 2021 Apr 1:221:108626.
doi: 10.1016/j.drugalcdep.2021.108626. Epub 2021 Feb 17.

Drug use-related stigma, safer injection norms, and hepatitis C infection among a network-based sample of young people who inject drugs

Leslie D Williams  1 , Mary Ellen Mackesy-Amiti  2 , Carl Latkin  3 , Basmattee Boodram  2
Affiliations

Drug use-related stigma, safer injection norms, and hepatitis C infection among a network-based sample of young people who inject drugs

Leslie D Williams et al. Drug Alcohol Depend. .

Abstract

Background: Identifying risk for hepatitis C (HCV) infection is important for understanding recent increases in HCV incidence among young people who inject drugs (PWID) in suburban and rural areas; and for refining the targeting of effective HCV preventive interventions. Much of the extant research has focused on individual health behaviors (e.g., risky drug injection behaviors) as predictors of HCV infection. The present study examines two social factors (substance use-related stigma and injection-related social norms), and the interaction between these factors, as predictors of HCV infection.

Methods: Baseline data were used from an ongoing longitudinal study of young PWID (N = 279; mean age = 30.4 years) from the Chicago suburbs and their injection risk network members. Adjusted logistic regression models were used to examine relationships among substance use-related stigma, safer injection norms, and HCV infection.

Results: Despite a marginal bivariate association between less safe injection norms and HCV infection (OR = 0.74; 95 % CI[0.39, 1.02]; p = .071), a significant stigma X norms interaction (AOR = 0.68; 95 % CI[0.51, 0.90]) suggested that at high levels of stigma, probability of HCV infection was high regardless of injection norms.

Conclusions: Findings suggest that social factors - specifically, substance use-related stigma and injection norms - are important predictors of HCV infection risk. The interaction found between these social factors suggests that intervening only to change injection norms or behaviors is likely insufficient to reduce risk for HCV infection in high-stigma settings or among high-stigma populations. Future research should develop and evaluate stigma-reduction interventions in combination with safer-injection interventions in order to maximize HCV risk reduction.

Keywords: Drug use-related stigma; Hepatitis C; Injection norms; Young people who inject drugs.

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Conflict of interest statement

Conflict of Interest: None of the authors have any conflicts to report.

Figures

Figure 1.
Figure 1.
Contour Map and Heat Map Depicting the Interaction between Substance Use-related Stigma and Risky Injection Norms
See this image and copyright information in PMC

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