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Abstract
Many long-term injection drug users (IDUs) engage in planning strategies. In this pilot study, we examine the relation of one planning strategy to IDUs’ engaging in safer injection practices. Sixty-eight IDUs were recruited in Citation from a New York City (NYC) needle exchange program and referrals to participate in an innovative Staying Safe Intervention that teaches strategies to stay HIV/HCV uninfected. Responses to a baseline 185-item survey were analyzed using correlations and odds ratios. Planning ahead to have steady access to clean equipment was correlated with both individually based and networks-based safety behaviors including storing clean needles; avoiding sharing needles, cookers, and filters with other injectors; and providing clean needles to sex partners. Implications related to resilience in IDUs are discussed and the study's limitations have been noted.
RÉSUMÉ
La résilience chez les usagers de drogues par voie intraveineuse (UDVI): la planification stratégique pour aider les UDVI à se protéger et protéger les autres du VIH/ VHC
Les UDVI ont recours à des stratégies de planification. Dans cette étude pilote, nous avons examiné la relation entre la planification stratégique et les pratiques d'injection à moindre risque. Soixante-huit UDVI ont été recrutés en Citation dans un programme d’échange de seringues (PES) à New York pour participer à une intervention innovante appelée “Staying Safe”. Les réponses au questionnaire de base (185 items) ont été analysées en utilisant des corrélations et des odds ratios. Le fait de planifier à l'avance un accès durable au nettoyage du matériel d'injection était corrélé avec des pratiques d'injection à moindre risque individuelles et collectives telles que stocker des seringues propres, éviter le partage des seringues, des cuillères, et des filtres avec d'autres injecteurs, et fournir des seringues propres aux partenaires sexuels Les implications liées à la résilience des usagers de drogues par voie intraveineuse sont discutées ici.
RESUMEN
Resiliencia entre usuarios de drogas inyectables (UDIs): Estrategias de planificación para ayudar a UDIs a proteger a sí mismos y a otros de VIH/ VHC
Muchos UDIs usan estrategias de planificación. En este estudio piloto, examinamos la relación entre una estrategia de planificación y prácticas de inyección seguras. Sesenta y ocho UDIs, fueron reclutados en Citation de un programa de intercambio de agujas en Nueva York y otras referencias, para participar en una innovadora intervención “Permanecer Seguro” (Staying Safe). Las respuestas al cuestionario de base (185 ítems) fueron analizados mediante correlaciones y odds ratios. Planear con anticipación para tener acceso constante a material de inyección limpio se correlacionó con comportamientos de inyección seguros a nivel individual y de redes incluyendo: almacenar agujas limpias; evitar compartir agujas, cucharas, y filtros con otros inyectores; y proporcionar agujas limpias a las parejas sexuales. Se examinan las implicaciones relacionadas con la resiliencia de UDIs.
THE AUTHORS
Dr. Skultip (Jill) Sirikantraporn, Psy.D., is a postdoctoral fellow in Behavioral Science Training at National Development and Research Institutes, received her doctorate in June Citation2010 in Clinical Psychology from Antioch University Seattle. Her research interests center on resilience, mental health and addiction, and cross-cultural psychology. She has also been involved in several projects funded by the National Institutes of Health (NIH), including the Stay Safe project (Pedro Mateu-Gelabert, PI), an innovative study designed to teach long-term injecting drug users strategies and skills to help themselves and others stay uninfected by HIV/HCV. She is currently a Project Director for a foundation-funded study on co-occurring posttraumatic stress disorder and alcohol use (William Gottdiener, Ph.D., PI), based at John Jay College of Criminal Justice.
Dr. Pedro Mateu-Gelabert, Ph.D., is a sociologist with over 15 years research experience in New York City and internationally. At Vera Institute of Justice, his research team focused on community interactions as they relate to adolescent violence, gangs, policing, and immigration. At National Development and Research Institutes, Inc., (NDRI) in collaboration with Samuel R. Friedman, he has worked on many aspects of HIV epidemiology, community relations, community efforts to prevent harm, disease prevention among stigmatized populations, qualitative methodology, and measures to assess how structural change affects HIV. Dr. Mateu-Gelabert also collaborated as part of interdisciplinary teams on projects in Costa Rica (Gangs, Community, and Policing in Central America), Colombia (heroin use and HIV prevention), Spain (HIV and HCV prevention among injection drug users), and Ukraine (injection behaviors and networks in Kiev). He was Principal Investigator on a pilot intervention called Staying Safe. This National Institute on Drug Abuse (NIDA)-funded research aimed at training injection drug users in strategies and practices to avoid HIV and HCV infections. A consortium of researchers in London, Sydney, Valencia, Vancouver, and Barcelona are collaborating in parallel Staying Safe studies.
Dr. Samuel R. Friedman, Ph.D., is the Director of HIV/AIDS Research at NDRI, Inc., and the Director of the Interdisciplinary Theoretical Synthesis Core in the Center for Drug Use and HIV Research, New York City. He is also associated with the Department of Epidemiology, Johns Hopkins University, and with the Dalla Lana School of Public Health, University of Toronto. Dr. Friedman is an author of about 400 publications on HIV, hepatitis C, sexually transmitted infection (STI), and drug use epidemiology and prevention. Honors include the International Rolleston Award of the International Harm Reduction Association (2009), the first Sociology AIDS Network Award for Career Contributions to the Sociology of HIV/AIDS (2007), and a Lifetime Contribution Award, Association of Black Sociologists (2005). He has published many poems in a variety of publications and a book of poetry [Seeking to make the world anew: Poems of the Living Dialectic (2008). Lanham, MD: Hamilton Books].
Milagros Sandoval, B.A., is currently working on the Measures Study as an Ethnographic Data and Analysis Coordinator, and has worked at NDRI, Inc., (New York) since 1996. Ms. Sandoval has worked on multiple research projects that have included social networks and HIV, STIs among youth, drug users, and drug injectors in high-risk communities, and has more than 15 years of community work experience.
Dr. Rafael A. Torruella, Ph.D., earned his doctorate in social-personality psychology at the Graduate Center of the City University of New York in Citation2010. His dissertation was titled “¿Allá en Nueva York Todo es Mejor?: A Qualitative Study on the Relocation of Drug Users from Puerto Rico to the United States”. Dr. Torruella was a NIDA-funded Behavioral Science Training predoctoral and postdoctoral fellow from 2007 to 2011 at NDRI, Inc., in New York City. Dr. Torruella presented his research at several conferences, published articles, participated as an active member of the Graduate Center's (CUNY) Institutional Review Board, and acts as vice-president on the board of directors of a community-based harm reduction organization. Currently, he is a fellow at the Interdisciplinary Research Training Institute (IRTI) on Hispanic Drug Abuse and Executive Director of CAIM, a community-based organization that offers harm reduction services in northeastern Puerto Rico.