Correlations between socioeconomic factors and needle sharing among methamphetamine users

Correlates of shared methamphetamine injection among methamphetamine-injecting treatment seekers: the first report from Iran.

Mehrjerdi ZA, Abarashi Z, Noroozi A, Arshad L, Zarghami M. Int J STD AIDS. 2014 May;25(6):420-7. doi: 10.1177/0956462413512806. Epub 2013 Nov 28.

Shared methamphetamine injection is an emerging route of drug use among Iranian methamphetamine injectors. It is a primary vector for blood-borne infections. The aim of the current study is to determine the prevalence and correlates of shared methamphetamine injection in a sample of Iranian methamphetamine injecting treatment seekers in the south of Tehran. We surveyed male and female methamphetamine injectors at three drop-in centres and 18 drug-use community treatment programmes. Participants reported socio-demographic characteristics, drug use, high-risk behaviours, current status of viral infections and service use for drug treatment. Bivariate and multivariate logistic regression models were used to test associations between participants' characteristics and shared methamphetamine injection. Overall, 209 clients were recruited; 90.9% were male; 52.6% reported current methamphetamine injection without any shared injection behaviour and 47.4% reported current shared methamphetamine injection. Shared methamphetamine injection was found to be primarily associated with living with sex partners (AOR 1.25, 95% CI 1.13-1.98), reporting ≥3 years of dependence on methamphetamine injection (AOR 1.61, 95% CI 1.27-2.12), injection with pre-filled syringes in the past 12 months (AOR 1.96, 95% CI 1.47-2.42), homosexual sex without condom use in the past 12 months (AOR 1.85, 95% CI 1.21-2.25), the paucity of NA group participation in the past 12 months (AOR 0.67, 95% CI 0.41-0.99), the paucity of attending psychotherapeutic sessions in the past 12 months (AOR 0.44, 95% CI 0.28-0.96) and positive hepatitis C status (AOR 1.98, 95% CI 1.67-2.83). Deeper exploration of the relationship between shared methamphetamine injection and sexual risk among Iranian methamphetamine injectors would benefit HIV/sexually transmitted infection prevention efforts. In addition, existing psychosocial interventions for methamphetamine-injecting population may need to be adapted to better meet the risks of shared methamphetamine injectors.

 Abstract access  [1]

Editor’s notes: This study highlights an important area. The authors demonstrate several links between socioeconomic factors and shared needle use among methamphetamine (MA) users. Multi-person use of contaminated injecting equipment was strongly associated with homelessness and with joblessness. Further, people who engaged in multi-use of contaminated needles were more likely to be divorced or separated than people who did not engage in this practice. People who shared needles were also more likely to be living with sex partners than people who do not. The authors suggest that this is because shared injection might be used as a way of expressing love, support, and care. Duration of dependence on MA injection was also associated with the practice of multi-person use of contaminated injecting equipment. People who used MA for three years or more were more likely to share needles than those who had MA use for a shorter time. The authors also found that participants with low attendance at counselling sessions for people who inject drugs were more likely to be needle sharers. An association between multi-person use of contaminated injecting equipment and hepatitis C infection was also found.

Despite the compelling findings, this study has some limitations. The investigators employ a relatively small sample size which is mainly comprised of men, some 90.9%, making it difficult to generalize findings to a wider population. That said, this study is one of the first of its kind and highlights an area where more research is needed. 

Asia [7]
Iran (Islamic Republic of) [8]
  • [9]