Abstract
The prevalence of injection drug use has been of especial interest for assessment of the impact of blood-borne viruses. However, the incidence of injection drug use has been underresearched. Our 2-fold aim in this study was to estimate 1) how many other persons, per annum, an injection drug user (IDU) has the equivalent of full responsibility (EFR) for initiating into injection drug use and 2) the consequences for IDUs' replacement rate. EFR initiation rates are strongly associated with incarceration history, so that our analysis of IDUs' replacement rate must incorporate when, in their injecting career, IDUs were first incarcerated. To do so, we have first to estimate piecewise constant incarceration rates in conjunction with EFR initiation rates, which are then combined with rates of cessation from injecting to model IDUs' replacement rate over their injecting career, analogous to the reproduction number of an epidemic model. We apply our approach to Scotland's IDUs, using over 2,500 anonymous injector participants who were interviewed in Scotland's Needle Exchange Surveillance Initiative during 2008-2009. Our approach was made possible by the inclusion of key questions about initiations. Finally, we extend our model to include an immediate quit rate, as a reasoned compensation for higher-than-expected replacement rates, and we estimate how high initiates' quit rate should be for IDUs' replacement rate to be 1.
| Language | English |
|---|---|
| Pages | 771-780 |
| Number of pages | 10 |
| Journal | American Journal of Epidemiology |
| Volume | 181 |
| Issue number | 10 |
| DOIs | |
| Publication status | Published - 15 May 2015 |
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Keywords
- incarceration rate
- initiator characteristics
- injection drug users
- injector incidence
- replacement rate
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Modeling the initiation of others into injection drug use, using data from 2,500 injectors surveyed in Scotland during 2008-2009. / White, Simon R.; Hutchinson, Sharon J.; Taylor, Avril; Bird, Sheila M.
In: American Journal of Epidemiology, Vol. 181, No. 10, 15.05.2015, p. 771-780.Research output: Contribution to journal › Article
TY - JOUR
T1 - Modeling the initiation of others into injection drug use, using data from 2,500 injectors surveyed in Scotland during 2008-2009
AU - White, Simon R.
AU - Hutchinson, Sharon J.
AU - Taylor, Avril
AU - Bird, Sheila M.
PY - 2015/5/15
Y1 - 2015/5/15
N2 - The prevalence of injection drug use has been of especial interest for assessment of the impact of blood-borne viruses. However, the incidence of injection drug use has been underresearched. Our 2-fold aim in this study was to estimate 1) how many other persons, per annum, an injection drug user (IDU) has the equivalent of full responsibility (EFR) for initiating into injection drug use and 2) the consequences for IDUs' replacement rate. EFR initiation rates are strongly associated with incarceration history, so that our analysis of IDUs' replacement rate must incorporate when, in their injecting career, IDUs were first incarcerated. To do so, we have first to estimate piecewise constant incarceration rates in conjunction with EFR initiation rates, which are then combined with rates of cessation from injecting to model IDUs' replacement rate over their injecting career, analogous to the reproduction number of an epidemic model. We apply our approach to Scotland's IDUs, using over 2,500 anonymous injector participants who were interviewed in Scotland's Needle Exchange Surveillance Initiative during 2008-2009. Our approach was made possible by the inclusion of key questions about initiations. Finally, we extend our model to include an immediate quit rate, as a reasoned compensation for higher-than-expected replacement rates, and we estimate how high initiates' quit rate should be for IDUs' replacement rate to be 1.
AB - The prevalence of injection drug use has been of especial interest for assessment of the impact of blood-borne viruses. However, the incidence of injection drug use has been underresearched. Our 2-fold aim in this study was to estimate 1) how many other persons, per annum, an injection drug user (IDU) has the equivalent of full responsibility (EFR) for initiating into injection drug use and 2) the consequences for IDUs' replacement rate. EFR initiation rates are strongly associated with incarceration history, so that our analysis of IDUs' replacement rate must incorporate when, in their injecting career, IDUs were first incarcerated. To do so, we have first to estimate piecewise constant incarceration rates in conjunction with EFR initiation rates, which are then combined with rates of cessation from injecting to model IDUs' replacement rate over their injecting career, analogous to the reproduction number of an epidemic model. We apply our approach to Scotland's IDUs, using over 2,500 anonymous injector participants who were interviewed in Scotland's Needle Exchange Surveillance Initiative during 2008-2009. Our approach was made possible by the inclusion of key questions about initiations. Finally, we extend our model to include an immediate quit rate, as a reasoned compensation for higher-than-expected replacement rates, and we estimate how high initiates' quit rate should be for IDUs' replacement rate to be 1.
KW - incarceration rate
KW - initiator characteristics
KW - injection drug users
KW - injector incidence
KW - replacement rate
UR - http://www.scopus.com/inward/record.url?scp=84929593654&partnerID=8YFLogxK
U2 - 10.1093/aje/kwu345
DO - 10.1093/aje/kwu345
M3 - Article
VL - 181
SP - 771
EP - 780
JO - American Journal of Epidemiology
T2 - American Journal of Epidemiology
JF - American Journal of Epidemiology
SN - 0002-9262
IS - 10
ER -