Syringe Sharing in Drug Injecting Dyads: A Cross-Classified Multilevel Analysis of Social Networks
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We examined the association of dyadic-level factors with syringe sharing among people who inject drugs (PWID) in Kerman, Iran. In a cross-sectional study, we collected data on 329 drug-injecting dyads by individual face-to-face interviews. An injecting dyad was defined as 2 PWID who knew each other and injected drugs together during the last 6 months. If they reported at least 1 occasion of syringe sharing, the dyad was considered high-risk. Dyadic-level factors associated with syringe sharing were assessed using cross-classified multilevel logistic regression. The rate of syringe sharing was significantly higher for dyads who were more intimate (adjusted odds ratio [AOR] 4.5, CI 95%, 2.3–8.6), who had instrumental support (AOR 2.1, 95% CI 1.1–4.5), and who pooled money for drugs (AOR 4.1, 95% CI 2.0–8.3). The rate was lower in same-sex dyads (AOR 0.4, 95% CI 0.2–0.9) and in dyads who shared health information (AOR 0.5, 95% CI 0.2–0.9). Findings highlight close-peer influences on syringe-sharing behavior.
KeywordsDyad Syringe sharing People who inject drugs Iran
We wish to acknowledge support from the University of California, San Francisco’s International Traineeships in AIDS Prevention Studies (ITAPS), U.S. NIMH, R25MH064712. We also wish to thank Mr. Masoud Izadpanah and Mrs. Baghizadeh for their efforts in interviews and data collection.
The study was funded by Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study. PWIDs were given 80,000 rialsa (equal to ~ 2.67 USD) primary incentive (80,000 Iranian rials, or ~ 2.67 USD) as an incentive for participating in the study and 30,000 Rials (equal to ~ 1 USD) for each successful recruitment of an injecting peer. The study protocol was reviewed and approved by the Ethics Committee of Shahid Beheshti University of Medical Sciences.
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