Download Gender Differences in the Provision of Injection Initiation Assistance

Gender Differences in the Provision of Injection Initiation Assistance Among People Who
Inject Drugs in Tijuana, Mexico
Meyers S, Werb D
Abstract
Background
Persons who inject drugs (PWID) play a key role in initiating others into injection drug use.
Further, scientific evidence to date demonstrates that gender may impact the intensity of a range
of injection-related health and social harms. We therefore sought to determine whether gender
also impacted the risk that PWID provide injection initiation assistance to others in Tijuana,
Mexico, a setting disproportionately impacted by injection-driven HIV transmission.
Method
Data from PWID recruited into the Proyecto El Cuete IV cohort in Tijuana, Mexico were
analyzed as part of the PReventing Injecting by Modifying Existing Responses (PRIMER) study.
All participants underwent quantitative interviews assessing a range of socio-demographic (i.e.,
gender, age, living situation, and income) factors as well as participant report of having ever
initiated others into drug injecting, which was defined as the dependent variable. Logistic
regression analyses were employed to assess the relationship between gender and the dependent
variable while adjusting for potential confounders.
Results
In total, 531 participants provided data, among whom 326 (61.39%) are female, and 75 (14.12%)
reported ever initiating others into injecting. In a final fitted logistic regression model, female
gender was negatively associated with ever initiating others into injection drug use (Adjusted
Odds Ratio [AOR] = 0.45, 95% Confidence Interval [CI]: 0.25, 0.79, p < 0.01), as was past 6
month methamphetamine use (AOR = 1.95, 95% CI: 1.17, 3.25, p = 0.01), and past 6 month
cocaine use (AOR = 6.85, 95% CI: 1.73, 27.17, p < 0.01).
Discussion
Being male and a stimulant (i.e. methamphetamine or cocaine) user was significantly associated
with a history of ever providing injection initiation assistance to others. These findings have
implications for the development of tailored interventions and harm reduction services geared
towards reducing the expansion of epidemics of injection-driven HIV transmission in high-risk
settings characterized by frequent initiation into drug injecting among vulnerable populations.