Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Naïve People Who Inject Drugs in a Canadian Setting

Ezequiel Blumenkrans; M. Eugenia Socías; Lindsey Richardson; Thomas Kerr; Jean Shoveller; Julio Montaner; M. J. Milloy

doi:10.1007/s10461-020-02781-w

Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Naïve People Who Inject Drugs in a Canadian Setting

Ezequiel Blumenkrans, M. Eugenia Socías, Lindsey Richardson, Thomas Kerr, Jean Shoveller, Julio Montaner, M. J. Milloy

Research output: Contribution to journal › Article › peer-review

Abstract

Sharing used syringes is an important route of HIV transmission, however, factors shaping used syringe-lending among antiretroviral therapy (ART)-naïve HIV-positive people who inject drugs (PWID) are not well-characterized. Multivariable logistic regression analyses using generalized estimating equations (GEE) were employed to investigate correlates of used syringe lending among ART-naïve PWID. Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive illicit drug users in Vancouver, Canada, from 1996 to 2015. The analysis included 482 ART-naïve PWID, of which 116 (24.1%) reported ≥ 1 periods of used syringe lending. In longitudinal analyses, incarceration (Adjusted Odds Ratio [AOR] = 2.18, 95% Confidence Interval [CI] 1.48–3.20), daily cocaine injection (AOR= 1.97, 95% CI 1.33–2.90), and sex work (AOR = 1.61, 95% CI 1.02–2.55) during the 180-day observation period were positively associated with used syringe lending, while having a high school diploma (AOR = 0.63, 95% CI 0.43–0.93) and holding formal employment (AOR = 0.20, 95% CI 0.05–0.82) were negatively associated. We found a high prevalence of used syringe lending among ART-naïve HIV-positive PWID, particularly among those recently incarcerated, involved in sex work or who injected cocaine frequently. Conversely, markers of higher socio-economic status were negatively associated with used syringe lending. These findings highlight the critical need for policies and interventions to decrease socio-economic marginalization and criminalization among PWID living with HIV alongside the scale up of access to harm reduction services.

Original language	English
Pages (from-to)	2163-2168
Number of pages	6
Journal	AIDS and Behavior
Volume	24
Issue number	7
DOIs	https://doi.org/10.1007/s10461-020-02781-w
Publication status	Published - Jul 1 2020
Externally published	Yes

Bibliographical note

Funding Information:
The authors thank the study participants for their contributions to the research, as well as current and past researchers and staff. We would specifically like to thank Jennifer Matthews, Steve Kain, and Paul Sereda for their research and administrative assistance. This work was supported by the US National Institute on Drug Abuse (NIDA) at the US National Institutes of Health (NIH; U01-DA021525). MES is supported by Michael Smith Foundation for Health Research (MSFHR) and Canadian Institutes of Health Research (CIHR) fellowship awards, and a Canada Addiction Medicine Research Fellowship from NIDA at the NIH (R25-DA037756). M-JM is supported in part by NIH (U01-DA021525). M-JM and LR are supported by Scholar Awards from MSFHR and New Investigator awards from CIHR. M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created through unstructured gifts to the university by the Government of British Columbia’s Ministry of Mental Health and Addictions and Canopy Growth, a licensed producer of cannabis. His institution has also received funding from NG Biomed Ltd., a private firm seeking a license to produce cannabis, to support him. JM is supported by the British Columbia Ministry of Health and through an Avant-Garde Award from NIDA at the NIH (1DP1DA026182).

Funding Information:
The authors thank the study participants for their contributions to the research, as well as current and past researchers and staff. We would specifically like to thank Jennifer Matthews, Steve Kain, and Paul Sereda for their research and administrative assistance. This work was supported by the US National Institute on Drug Abuse (NIDA) at the US National Institutes of Health (NIH; U01-DA021525). MES is supported by Michael Smith Foundation for Health Research (MSFHR) and Canadian Institutes of Health Research (CIHR) fellowship awards, and a Canada Addiction Medicine Research Fellowship from NIDA at the NIH (R25-DA037756). M-JM is supported in part by NIH (U01-DA021525). M-JM and LR are supported by Scholar Awards from MSFHR and New Investigator awards from CIHR. M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created through unstructured gifts to the university by the Government of British Columbia?s Ministry of Mental Health and Addictions and Canopy Growth, a licensed producer of cannabis. His institution has also received funding from NG Biomed Ltd., a private firm seeking a license to produce cannabis, to support him. JM is supported by the British Columbia Ministry of Health and through an Avant-Garde Award from NIDA at the NIH (1DP1DA026182).

Publisher Copyright:
© 2020, Springer Science+Business Media, LLC, part of Springer Nature.

ASJC Scopus Subject Areas

Social Psychology
Public Health, Environmental and Occupational Health
Infectious Diseases

PubMed: MeSH publication types

Journal Article

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10.1007/s10461-020-02781-w

Cite this

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title = "Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Na{\"i}ve People Who Inject Drugs in a Canadian Setting",

abstract = "Sharing used syringes is an important route of HIV transmission, however, factors shaping used syringe-lending among antiretroviral therapy (ART)-na{\"i}ve HIV-positive people who inject drugs (PWID) are not well-characterized. Multivariable logistic regression analyses using generalized estimating equations (GEE) were employed to investigate correlates of used syringe lending among ART-na{\"i}ve PWID. Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive illicit drug users in Vancouver, Canada, from 1996 to 2015. The analysis included 482 ART-na{\"i}ve PWID, of which 116 (24.1%) reported ≥ 1 periods of used syringe lending. In longitudinal analyses, incarceration (Adjusted Odds Ratio [AOR] = 2.18, 95% Confidence Interval [CI] 1.48–3.20), daily cocaine injection (AOR= 1.97, 95% CI 1.33–2.90), and sex work (AOR = 1.61, 95% CI 1.02–2.55) during the 180-day observation period were positively associated with used syringe lending, while having a high school diploma (AOR = 0.63, 95% CI 0.43–0.93) and holding formal employment (AOR = 0.20, 95% CI 0.05–0.82) were negatively associated. We found a high prevalence of used syringe lending among ART-na{\"i}ve HIV-positive PWID, particularly among those recently incarcerated, involved in sex work or who injected cocaine frequently. Conversely, markers of higher socio-economic status were negatively associated with used syringe lending. These findings highlight the critical need for policies and interventions to decrease socio-economic marginalization and criminalization among PWID living with HIV alongside the scale up of access to harm reduction services.",

author = "Ezequiel Blumenkrans and Soc{\'i}as, {M. Eugenia} and Lindsey Richardson and Thomas Kerr and Jean Shoveller and Julio Montaner and Milloy, {M. J.}",

note = "Funding Information: The authors thank the study participants for their contributions to the research, as well as current and past researchers and staff. We would specifically like to thank Jennifer Matthews, Steve Kain, and Paul Sereda for their research and administrative assistance. This work was supported by the US National Institute on Drug Abuse (NIDA) at the US National Institutes of Health (NIH; U01-DA021525). MES is supported by Michael Smith Foundation for Health Research (MSFHR) and Canadian Institutes of Health Research (CIHR) fellowship awards, and a Canada Addiction Medicine Research Fellowship from NIDA at the NIH (R25-DA037756). M-JM is supported in part by NIH (U01-DA021525). M-JM and LR are supported by Scholar Awards from MSFHR and New Investigator awards from CIHR. M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created through unstructured gifts to the university by the Government of British Columbia{\textquoteright}s Ministry of Mental Health and Addictions and Canopy Growth, a licensed producer of cannabis. His institution has also received funding from NG Biomed Ltd., a private firm seeking a license to produce cannabis, to support him. JM is supported by the British Columbia Ministry of Health and through an Avant-Garde Award from NIDA at the NIH (1DP1DA026182). Funding Information: The authors thank the study participants for their contributions to the research, as well as current and past researchers and staff. We would specifically like to thank Jennifer Matthews, Steve Kain, and Paul Sereda for their research and administrative assistance. This work was supported by the US National Institute on Drug Abuse (NIDA) at the US National Institutes of Health (NIH; U01-DA021525). MES is supported by Michael Smith Foundation for Health Research (MSFHR) and Canadian Institutes of Health Research (CIHR) fellowship awards, and a Canada Addiction Medicine Research Fellowship from NIDA at the NIH (R25-DA037756). M-JM is supported in part by NIH (U01-DA021525). M-JM and LR are supported by Scholar Awards from MSFHR and New Investigator awards from CIHR. M-JM is the Canopy Growth professor of cannabis science at the University of British Columbia, a position created through unstructured gifts to the university by the Government of British Columbia?s Ministry of Mental Health and Addictions and Canopy Growth, a licensed producer of cannabis. His institution has also received funding from NG Biomed Ltd., a private firm seeking a license to produce cannabis, to support him. JM is supported by the British Columbia Ministry of Health and through an Avant-Garde Award from NIDA at the NIH (1DP1DA026182). Publisher Copyright: {\textcopyright} 2020, Springer Science+Business Media, LLC, part of Springer Nature.",

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Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Naïve People Who Inject Drugs in a Canadian Setting

Abstract

Bibliographical note

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PubMed: MeSH publication types

UN SDGs

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