The circumstances surrounding the first injection
experience of young injection drug users are significantly
linked to future injection behavior, according to a new
study from researchers at the Johns Hopkins Bloomberg
School of Public Health and other institutions.
The researchers found that people who first injected
drugs with a syringe that had previously been used by
someone else were much more likely to report sharing
syringes later, when compared with those who used a new
syringe at first injection. The study is published in the
March 7 issue of Drug and Alcohol Dependence.
"We need to reach drug users before they start
injecting. They need to be made aware of the dangers of
sharing syringes. We were happy to see that injection drug
users who had heard of the Baltimore, Md., syringe exchange
program before they started using injection drugs were less
likely to share used syringes, which puts them at a lower
risk of contracting HIV, hepatitis C and other diseases,"
said Laura A. Novelli, lead author of the study and a
graduate student at the Bloomberg School at the time the
research was completed.
The study authors reviewed data collected by outreach
workers affiliated with REACH III, a Baltimore-based study
of drug users. The authors reviewed data derived from
interviews with 420 injection drug users, aged 15 to 30
years, who had been injecting drugs for less than five
The researchers found that the majority of study
participants who reported sharing syringes in the six
months prior to their interview were young (median age, 23
years) white males who had not finished high school and did
not have a steady job. Most also were homeless. More than
38 percent of the study participants said they had recently
injected with a used syringe, and of these, 37 percent
reported sharing syringes when they first injected. In
contrast, about half the study participants who said they
did not share needles got their first syringe from a
pharmacy or syringe exchange program.
Drug users who reported sharing syringes at the time
of the first injection were more likely to be younger in
age, to be injected by someone else and to have used a
syringe that had previously been used by someone else, when
compared with injection drug users who reported they did
not currently share syringes.
"How injection drug users start using drugs can
foretell their future injection behaviors and risk of
acquiring infectious diseases. There is understandably an
intense effort to promote healthy practices among injection
drug users, but there are also a number of benefits in
working with noninjection drug users as well — in
preventing transition to injection drug use as well as
education. If we aren't able to prevent injection
initiation, we can educate drug users, which will decrease
their risk of contracting HIV, hepatitis C and other
blood-borne diseases," said Susan G. Sherman, corresponding
author of the study and an assistant professor in the
Department of Epidemiology at the Bloomberg School.
The study was supported by a grant from the National
Institute of Drug Abuse. Additional authors were Jennifer
R. Havens, Marcella Sapun and Steffanie A. Strathdee.