Prevalence and Correlates of Heroin-Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico
Prevalence and Correlates of Heroin-Methamphetamine Co-Injection Among Persons Who Inject Drugs in San Diego, California, and Tijuana, Baja California, Mexico
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DOI：
10.15288/jsad.2016.77.774
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发表时间：
2016-09-01
影响因子：
3.4
通讯作者：
Garfein, Richard S.
中科院分区：
文献类型：
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作者：
Meacham, Meredith C.;Strathdee, Steffanie A.;Garfein, Richard S.
目的：虽然已知美国西部墨西哥边境地区的注射毒品者同时注射海洛因和甲基苯丙胺，但对同时注射这种混合兴奋剂（也称为“goofball”和“Mexican speedball”）的流行率和相关风险知之甚少。方法：同时在加利福尼亚州圣地亚哥和墨西哥蒂华纳进行的PWID平行队列研究的基线数据用于估计海洛因甲基苯丙胺共注射的患病率并确定相关性。在圣地亚哥（n = 576）和蒂华纳（n = 735）招募了过去一个月报告注射非法药物的18岁以上PWID（N = 1，311; 32.7%女性），并完成了访谈者管理的问卷。双变量和多变量逻辑回归分析用于确定海洛因甲基苯丙胺共注射的相关性。结果：过去6个月共注射的患病率总体为39.9%，在蒂华纳（55.8%）高于圣地亚哥（19.8%）。在调整研究队列的多变量分析中，分配注射器共享，购买预充药物的注射器，发现很难获得新的注射器，报告大量或迫切需要治疗，以及年龄较小与联合注射独立相关。在圣地亚哥，过去6个月的药物过量与联合注射的几率高于蒂华纳显著相关。结论：这些发现表明，海洛因甲基苯丙胺共同注射在蒂华纳比在圣地亚哥更常见，但这种做法只与圣地亚哥的过量有关。海洛因-甲基苯丙胺共同注射也与艾滋病毒相关注射风险行为独立相关。过量预防干预措施应解决同时注射镇静剂和兴奋剂的问题。
Objective: Although persons who inject drugs (PWID) in the western United States Mexico border region are known to inject both heroin and methamphetamine, little is known about the prevalence and risks associated with co-injection of this depressant stimulant combination (also known as "goofball" and "Mexican speedball"). Method: Baseline data from parallel cohort studies of PWID conducted concurrently in San Diego, CA, and Tijuana, Mexico, were used to estimate the prevalence and identify correlates of heroin methamphetamine co-injection. PWID older than 18 years of age who reported injecting illicit drugs in the past month (N = 1,311; 32.7% female) were recruited in San Diego (n = 576) and Tijuana (n = 735) and completed interviewer-administered questionnaires. Bivariate and multivariable logistic regression analyses were used to identify correlates of heroin methamphetamine co-injection. Results: The prevalence of co-injection in the past 6 months was 39.9% overall and was higher in Tijuana (55.8%) than in San Diego (19.8%). In multivariable analyses adjusting for study cohort, distributive syringe sharing, purchasing syringes prefilled with drugs, finding it hard to get new syringes, reporting great or urgent need for treatment, and younger age were independently associated with co-injection. Past-6-month overdose was significantly associated with higher odds of co-injection in San Diego than in Tijuana. Conclusions: These findings indicate that heroin methamphetamine co-injection is more common in Tijuana than in San Diego, yet this practice was only associated with overdose in San Diego. Heroin-methamphetamine co-injection was also independently associated with HIV-associated injection risk behaviors. Overdose-prevention interventions should address co-injection of depressants and stimulants.