Citation

Hunter K, Park JN, Allen ST, Chaulk P, Frost T, Weir BW, Sherman SG. Int. J. Drug Policy 2018; 57: 25-31.

Affiliation

Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Baltimore, MD 21205, USA. Electronic address: ssherman@jhsph.edu.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.drugpo.2018.03.026

PMID

29660732

Abstract

The spaces in which drug use occurs constitutes a key aspect of the "risk environment" of people who inject drugs (PWID). We aimed to add nuance to the characterization of "safe" and "unsafe" spaces in PWID's environments to further understand how these spaces amplify the risk of morbidities associated with injection drug use. PWID were recruited through the Baltimore City syringe service program and through peer referral. Participants completed a socio-behavioral survey. Multivariable logistic regression was used to identify associations between utilization of public, semi-public and private spaces with arrest, non-fatal overdose, and receptive syringe sharing. The sample of PWID (N = 283) was mostly 45 years and older (54%), male (69%), Black (55%), and heroin users (96%). Compared to PWID who primarily used private settings, the adjusted odds of recent overdose were greater among PWID who mostly used semi-public and public locations to inject drugs. We also found independent associations between arrest and semi-public spaces, and between receptive syringe sharing and public spaces (all p < 0.05). This study highlights the need for safe spaces where PWID can reduce their risk of overdose, likelihood of arrest and blood-borne diseases, and the dual potential of the environment in promoting health and risk.

Copyright © 2018 Elsevier B.V. All rights reserved.

Language: en

Keywords

Drug; HIV risk; Heroin; Overdose; Substance use