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Social network predictors of recent and sustained injection drug use cessation: findings from a longitudinal cohort study
Author(s) -
Rudolph Abby E.,
Upton Elizabeth,
Young April M.,
Havens Jennifer R.
Publication year - 2021
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.15218
Subject(s) - medicine , injection drug use , gee , generalized estimating equation , social network (sociolinguistics) , logistic regression , demography , cohort , odds ratio , social support , longitudinal study , odds , abstinence , confidence interval , psychiatry , drug injection , psychology , drug , social psychology , pathology , statistics , mathematics , sociology , political science , law , social media
Background and aims The US opioid crisis has led to increases in overdose fatalities and the incidence of HIV, hepatitis C and other infections. This analysis examines social network predictors of recent (self‐report injection followed by non‐injection) and sustained (self‐report non‐injection at two consecutive visits among those who previously injected) injection cessation in Appalachian Kentucky. Design Data were collected through bi‐annual longitudinal assessments for Social Networks among Appalachian People (SNAP; 2008–17). Using logistic regression with generalized estimating equations that clustered on individuals, we regressed non‐injection status on the number of social network members who (a) did not inject and (b) recently stopped injecting and tested for interactions between each social network exposure and prior non‐injection status. Social network exposures were self‐reported. Setting Rural eastern Kentucky, USA. Participants Participants entered the analysis only after reporting recent injection and had to have had at least two consecutive study visits ( n = 326). Measurements Interviewer‐administered surveys collected individual‐level socio‐demographics, recent (past 6 months) drug use behaviors and the names of recent social support, sex and drug‐use partners. Findings After adjusting for confounders, the number of non‐injecting social network members was positively associated with recent/sustained injection cessation (adjusted odds ratio = 1.27; 95% confidence interval = 1.13–1.42) and having more social network members was associated with reduced odds of recent/sustained injection cessation. The number of previously injecting social network members who had recently stopped injecting was not statistically significantly associated with injection cessation. Neither of the interactions we tested for was statistically significant, suggesting that the relationships may be similar for those who recently stopped injecting versus had not injected for at least 1 year. Conclusions For each additional network member who did not inject drugs, there was an increased odds of recent and sustained injection cessation among people with a history of injection drug use in Appalachian Kentucky.