Abstract
OBJECTIVE: The purpose of this study was to evaluate the extent to which demographic, sexual, and non-injection drug use practices predict adolescent initiation of injection drug use. METHODS: Street recruited injection drug users 15-30 years of age in Baltimore, Maryland, who initiated injection within five years of study enrollment, completed a questionnaire that included a year-by-year history regarding the five years prior to initiation of injection. Factors associated with initiation during adolescence (< or = 21 years of age) versus young adulthood (>21 ) were determined using logistic regression. RESULTS: Of 226 participants, most were female (61%) and African American (64%). Median age of participants was 25; median age at initiation of injection was 23. Factors significantly associated with adolescent initiation in multivariate analysis included race other than African American, and practices prior to initiating injection including condom use, lack of cocaine use, exclusive crack smoking just prior to initiation, and smoking marijuana. Adolescent initiates also had shorter durations of illicit drug use prior to initiating injection. CONCLUSION: Short-term non-injection drug use, particularly exclusive crack smoking, was associated with adolescent initiation of injection drug use. Early prevention efforts targeting this high-risk group of younger drug users are warranted in order to delay or prevent onset of injection drug use.
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- Battjes R. J., Leukefeld C. G., Pickens R. W. Age at first injection and HIV risk among intravenous drug users. Am J Drug Alcohol Abuse. 1992;18(3):263–273. doi: 10.3109/00952999209026066. [DOI] [PubMed] [Google Scholar]
- Brook J. S., Cohen P., Jaeger L. Developmental variations in factors related to initial and increased levels of adolescent drug involvement. J Genet Psychol. 1998 Jun;159(2):179–194. doi: 10.1080/00221329809596144. [DOI] [PubMed] [Google Scholar]
- Carneiro M., Fuller C., Doherty M. C., Vlahov D. HIV prevalence and risk behaviors among new initiates into injection drug use over the age of 40 years old. Drug Alcohol Depend. 1999 Mar 1;54(1):83–86. doi: 10.1016/s0376-8716(98)00142-2. [DOI] [PubMed] [Google Scholar]
- Des Jarlais D. C., Friedman S. R., Perlis T., Chapman T. F., Sotheran J. L., Paone D., Monterroso E., Neaigus A. Risk behavior and HIV infection among new drug injectors in the era of AIDS in New York City. J Acquir Immune Defic Syndr Hum Retrovirol. 1999 Jan 1;20(1):67–72. doi: 10.1097/00042560-199901010-00010. [DOI] [PubMed] [Google Scholar]
- Dinwiddie S. H., Reich T., Cloninger C. R. Prediction of intravenous drug use. Compr Psychiatry. 1992 May-Jun;33(3):173–179. doi: 10.1016/0010-440x(92)90026-m. [DOI] [PubMed] [Google Scholar]
- Doherty M. C., Garfein R. S., Monterroso E., Brown D., Vlahov D. Correlates of HIV infection among young adult short-term injection drug users. AIDS. 2000 Apr 14;14(6):717–726. doi: 10.1097/00002030-200004140-00011. [DOI] [PubMed] [Google Scholar]
- Duncan S. C., Duncan T. E., Biglan A., Ary D. Contributions of the social context to the development of adolescent substance use: a multivariate latent growth modeling approach. Drug Alcohol Depend. 1998 Mar 1;50(1):57–71. doi: 10.1016/s0376-8716(98)00006-4. [DOI] [PubMed] [Google Scholar]
- Fennema J. S., Van Ameijden E. J., Van Den Hoek A., Coutinho R. A. Young and recent-onset injecting drug users are at higher risk for HIV. Addiction. 1997 Nov;92(11):1457–1465. [PubMed] [Google Scholar]
- Garfein R. S., Vlahov D., Galai N., Doherty M. C., Nelson K. E. Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses. Am J Public Health. 1996 May;86(5):655–661. doi: 10.2105/ajph.86.5.655. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Gillmore M. R., Catalano R. F., Morrison D. M., Wells E. A., Iritani B., Hawkins J. D. Racial differences in acceptability and availability of drugs and early initiation of substance use. Am J Drug Alcohol Abuse. 1990;16(3-4):185–206. doi: 10.3109/00952999009001583. [DOI] [PubMed] [Google Scholar]
- Kosten T. R., Rounsaville B. J., Kleber H. D. Ethnic and gender differences among opiate addicts. Int J Addict. 1985 Aug;20(8):1143–1162. doi: 10.3109/10826088509056356. [DOI] [PubMed] [Google Scholar]
- Labouvie E., Bates M. E., Pandina R. J. Age of first use: its reliability and predictive utility. J Stud Alcohol. 1997 Nov;58(6):638–643. doi: 10.15288/jsa.1997.58.638. [DOI] [PubMed] [Google Scholar]
- Levine O. S., Vlahov D., Brookmeyer R., Cohn S., Nelson K. E. Differences in the incidence of hepatitis B and human immunodeficiency virus infections among injecting drug users. J Infect Dis. 1996 Mar;173(3):579–583. doi: 10.1093/infdis/173.3.579. [DOI] [PubMed] [Google Scholar]
- Lewinsohn P. M., Hops H., Roberts R. E., Seeley J. R., Andrews J. A. Adolescent psychopathology: I. Prevalence and incidence of depression and other DSM-III-R disorders in high school students. J Abnorm Psychol. 1993 Feb;102(1):133–144. doi: 10.1037//0021-843x.102.1.133. [DOI] [PubMed] [Google Scholar]
- Marrero Rodríguez C. A., Robles R. R., Colón H. M., Freeman D. H., Matos T. D., Reyes J. C. HIV risk behaviors and HIV seropositivity among young injection drug users. P R Health Sci J. 1993 Apr;12(1):7–12. [PubMed] [Google Scholar]
- Neaigus A., Friedman S. R., Jose B., Goldstein M. F., Curtis R., Ildefonso G., Des Jarlais D. C. High-risk personal networks and syringe sharing as risk factors for HIV infection among new drug injectors. J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Apr 15;11(5):499–509. doi: 10.1097/00042560-199604150-00011. [DOI] [PubMed] [Google Scholar]
- Nelson K. E., Vlahov D., Solomon L., Cohn S., Muñoz A. Temporal trends of incident human immunodeficiency virus infection in a cohort of injecting drug users in Baltimore, Md. Arch Intern Med. 1995 Jun 26;155(12):1305–1311. [PubMed] [Google Scholar]
- Nicolosi A., Leite M. L., Molinari S., Musicco M., Saracco A., Lazzarin A. Incidence and prevalence trends of HIV infection in intravenous drug users attending treatment centers in Milan and northern Italy, 1986-1990. J Acquir Immune Defic Syndr. 1992;5(4):365–373. [PubMed] [Google Scholar]
- Samuels J. F., Vlahov D., Anthony J. C., Chaisson R. E. Measurement of HIV risk behaviors among intravenous drug users. Br J Addict. 1992 Mar;87(3):417–428. doi: 10.1111/j.1360-0443.1992.tb01942.x. [DOI] [PubMed] [Google Scholar]
- Stanton B., Romer D., Ricardo I., Black M., Feigelman S., Galbraith J. Early initiation of sex and its lack of association with risk behaviors among adolescent African-Americans. Pediatrics. 1993 Jul;92(1):13–19. [PubMed] [Google Scholar]
- Stenbacka M. Initiation into intravenous drug abuse. Acta Psychiatr Scand. 1990 May;81(5):459–462. doi: 10.1111/j.1600-0447.1990.tb05481.x. [DOI] [PubMed] [Google Scholar]
- Telles P. R., Bastos F. I., Guydish J., Inciardi J. A., Surratt H. L., Pearl M., Hearst N. Risk behavior and HIV seroprevalence among injecting drug users in Rio de Janeiro, Brazil. AIDS. 1997 Sep;11 (Suppl 1):S35–S42. [PubMed] [Google Scholar]
- Thomas D. L., Vlahov D., Solomon L., Cohn S., Taylor E., Garfein R., Nelson K. E. Correlates of hepatitis C virus infections among injection drug users. Medicine (Baltimore) 1995 Jul;74(4):212–220. doi: 10.1097/00005792-199507000-00005. [DOI] [PubMed] [Google Scholar]
- Van Ameijden E. J., Van den Hoek J. A., Mientjes G. H., Coutinho R. A. A longitudinal study on the incidence and transmission patterns of HIV, HBV and HCV infection among drug users in Amsterdam. Eur J Epidemiol. 1993 May;9(3):255–262. doi: 10.1007/BF00146260. [DOI] [PubMed] [Google Scholar]
- Villano S. A., Vlahov D., Nelson K. E., Lyles C. M., Cohn S., Thomas D. L. Incidence and risk factors for hepatitis C among injection drug users in Baltimore, Maryland. J Clin Microbiol. 1997 Dec;35(12):3274–3277. doi: 10.1128/jcm.35.12.3274-3277.1997. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Vlahov D., Anthony J. C., Celentano D., Solomon L., Chowdhury N. Trends of HIV-1 risk reduction among initiates into intravenous drug use 1982-1987. Am J Drug Alcohol Abuse. 1991;17(1):39–48. doi: 10.3109/00952999108992808. [DOI] [PubMed] [Google Scholar]
- van Ameijden E. J., van den Hoek J. A., van Haastrecht H. J., Coutinho R. A. The harm reduction approach and risk factors for human immunodeficiency virus (HIV) seroconversion in injecting drug users, Amsterdam. Am J Epidemiol. 1992 Jul 15;136(2):236–243. doi: 10.1093/oxfordjournals.aje.a116489. [DOI] [PubMed] [Google Scholar]