Prevalence and correlates of multiple injections per injection episode among people who inject drugs in rural U.S. communities

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy Pub Date : 2025-05-30 DOI:10.1016/j.drugpo.2025.104837

L. Sarah Mixson , William Zule , Stephanie A. Ruderman , Judith Feinberg , Thomas J. Stopka , Adams L. Sibley , Suzan M. Walters , Georgiy Bobashev , Ryan Cook , Karli R. Hochstatter , Carolyn A. Fahey , Lawrence J Ouellet , Rob Fredericksen , Hannah L.F. Cooper , April M. Young , Jon Zibbell , Dalia Khoury , Peter D. Friedmann , William C. Miller , P. Todd Korthuis , Joseph Delaney

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引用次数: 0

Abstract

Background

Multiple injections per injection episode (MIPIE) is increasingly common among people who inject drugs (PWID). While MIPIE may lower overdose risk, it could elevate infectious disease risk. This study examined the prevalence of MIPIE among rural PWID in the United States and its associations with injection behaviors associated with disease transmission (e.g., syringe mediated drug sharing, receptive supply sharing) and health outcomes (e.g., hepatitis C virus (HCV) status, naloxone possession, and overdose).

Methods

The Rural Opioid Initiative includes eight research cohorts of rural people who use drugs from across the U.S., recruited from 01/2018 to 03/2020. MIPIE was dichotomized as any vs. none using the question: “How many times in the past 30 days did you inject more than one time in one sitting?” We employed a fixed effects meta-analytic approach to examine cross-sectional associations through adjusted regression analyses.

Results

Among 2441 PWID, most reported MIPIE (71% [n=1729]). In adjusted analyses, MIPIE was associated with a higher prevalence of past 30-day receptive syringe sharing (Prevalence Ratio (PR)=2.02; 95% confidence interval (CI)=1.74–2.34), syringe-mediated drug sharing (PR=1.92; 95%CI=1.69–2.18), receptive supply sharing (PR=1.99; 95%CI=1.75–2.26), distributive supply sharing (PR=2.30; 95%CI=1.99–2.65), HCV (PR=1.26; 95%CI=1.11–1.44), naloxone possession (PR=1.32; 95%CI=1.17–1.50), overdose ever (PR=1.42; 95%CI=1.25-1.57), and overdose in the prior 90 days (PR=2.09; 95%CI=1.52–2.87).

Conclusions

MIPIE is a common practice among rural PWID and is associated with injection behaviors associated with disease transmission, HCV, and overdose. Intervention studies should develop harm reduction strategies that address both overdose prevention and infectious disease mitigation related to MIPIE.

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在美国农村社区注射毒品的人群中，每次注射多次注射的流行程度及其相关性

背景：每次注射发作多次注射（MIPIE）在注射吸毒者（PWID）中越来越普遍。虽然MIPIE可能会降低过量服用的风险，但它可能会增加传染病的风险。本研究调查了MIPIE在美国农村PWID中的流行程度，以及它与与疾病传播相关的注射行为（例如，注射器介导的药物共享、接受性供应共享）和健康结果（例如，丙型肝炎病毒（HCV）状态、纳洛酮持有和过量）的关系。农村阿片类药物倡议包括八个研究队列，从2018年1月1日至2020年3月招募来自美国各地的农村吸毒人员。MIPIE被分为有和没有，使用的问题是：“在过去的30天里，你一次注射了多少次？”我们采用固定效应元分析方法，通过调整回归分析来检验横断面关联。结果在2441例PWID中，大多数报告MIPIE （71% [n=1729]）。在调整分析中，MIPIE与过去30天内接受性注射器共用的较高患病率相关(患病率比(PR)=2.02；95%可信区间(CI)= 1.74-2.34)，注射器介导的药物共享(PR=1.92；95%CI= 1.69-2.18)，接受性供给共享(PR=1.99；95%CI= 1.75-2.26)，分配供应共享(PR=2.30；95%ci = 1.99-2.65), HCV (pr =1.26；95%CI= 1.11-1.44)，纳洛酮占有率(PR=1.32；95%CI= 1.17-1.50)，用药过量(PR=1.42；95%CI=1.25-1.57)，前90天用药过量(PR=2.09；95% ci = 1.52 - -2.87)。结论smipie是农村PWID患者的普遍做法，与疾病传播、HCV和用药过量相关的注射行为有关。干预研究应制定减少危害的战略，既要解决与药物过量有关的预防问题，又要减轻与药物过量有关的传染病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Drug Policy SUBSTANCE ABUSE-

CiteScore

7.80

自引率

11.40%

发文量

307

审稿时长

62 days

期刊介绍： The International Journal of Drug Policy provides a forum for the dissemination of current research, reviews, debate, and critical analysis on drug use and drug policy in a global context. It seeks to publish material on the social, political, legal, and health contexts of psychoactive substance use, both licit and illicit. The journal is particularly concerned to explore the effects of drug policy and practice on drug-using behaviour and its health and social consequences. It is the policy of the journal to represent a wide range of material on drug-related matters from around the world.