Trajectories of Injection Drug Use Over 20 Years (1988-2008) in Baltimore, Maryland
Trajectories of Injection Drug Use Over 20 Years (1988-2008) in Baltimore, Maryland
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DOI：
10.1093/aje/kwq441
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发表时间：
2011-04-01
影响因子：
5
通讯作者：
Mehta, Shruti H.
中科院分区：
文献类型：
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作者：
Genberg, Becky L.;Gange, Stephen J.;Mehta, Shruti H.
这项研究的目的是在与静脉注射体验(ALIVE)研究有关的艾滋病患者中确定20年来注射药物使用的纵向模式，这是一个位于马里兰州巴尔的摩的社区注射吸毒者队列，重点是停止注射。从1988年开始，18岁以上有注射吸毒史的人被招募到这项研究中。参加者每半年提供一次注射毒品使用情况，直至2008年。分析限于1,716名有至少8次研究访问的注射吸毒者。有限混合模型被用来识别随时间推移的注射模式的轨迹和预测因素。参与者的平均年龄为35岁；75%是男性，95%是非洲裔美国人。有5种不同的模式：2种使用模式(32%持续注射，16%经常复发)和3种停止模式(早期停止(19%)、延迟停止(16%)和晚期停止(18%))。有药物治疗史，最近没有使用多种物质，注射频率较低，将早期戒毒组与其他组区分开来。这项研究证明了药物注射行为的多个轨迹，相当大比例的注射吸毒者在延长的时间范围内停止注射。为了最大限度地发挥效力，针对注射吸毒者的公共卫生计划应该是长期的、全面的，并针对个人的使用模式。
The objective of this study was to identify longitudinal patterns of injection drug use over 20 years in the AIDS Linked to the Intravenous Experience (ALIVE) Study, a community-based cohort of injection drug users (IDUs) in Baltimore, Maryland, with a focus on injection cessation. Starting in 1988, persons over 18 years of age with a history of injection drug use were recruited into the study. Participants provided information on their injection drug use semiannually through 2008. The analysis was restricted to 1,716 IDUs with at least 8 study visits. Finite mixture models were used to identify trajectories and predictors of injection patterns over time. The mean age of participants was 35 years; 75% were male, and 95% were African-American. Five distinct patterns were identified: 2 usage patterns (32% engaged in persistent injection and 16% had frequent relapse) and 3 cessation patterns (early cessation (19%), delayed cessation (16%), and late cessation (18%)). A history of drug treatment, no recent use of multiple substances, and less frequent injection distinguished the early cessation group from the other groups. This study demonstrated multiple trajectories of drug injection behaviors, with a substantial proportion of IDUs stopping injection over extended time frames. For maximum effectiveness, public health programs for IDUs should be long-term, comprehensive, and targeted toward individual patterns of use.