Examining the Social Context of Injection Drug Use: Social Proximity to Persons Who Inject Drugs Versus Geographic Proximity to Persons Who Inject Drugs

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17 Scopus citations

Abstract

In this analysis, we used social network and spatial data to examine associations between people's drug injection status and their social and/or spatial proximity to others who injected drugs. We recruited 503 rural Kentucky residents who used drugs to participate in the Social Networks among Appalachian People (SNAP) Study (2008-2010). Interviewer-administered surveys collected information on recent (past 6 months) sex, drug-use, and social-support network members (n = 897 ties). Using network simulations, we determined a threshold for the association between social proximity to others who injected drugs and recent injection status ("socially proximal" was defined by a shortest path ≤2). We defined "geographically proximal" as the median road-network distance between pairs of individuals who both injected drugs (≤7 miles (≤11.2 km)). Logistic regression was used to determine the independent and joint associations between the number of socially and/or geographically proximal injecting peers and a person's injection status. After adjustment, the odds of recent injection increased by 0.4% for each injecting peer who was geographically proximal but not socially proximal, 12% for each geographically and socially proximal injecting peer, and 22% for each injecting peer who was socially proximal but not geographically proximal. When implementing networkbased interventions which promote cessation of injection drug use, investigators should consider collecting sociometric network data to examine whether the intervention diffuses through the network and whether there are additive or threshold effects.

Original languageEnglish
Pages (from-to)970-978
Number of pages9
JournalAmerican Journal of Epidemiology
Volume186
Issue number8
DOIs
StatePublished - Oct 15 2017

Bibliographical note

Publisher Copyright:
© 2017 The Author(s). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved.

Keywords

  • Homophily
  • Injection drug use
  • Shortest path
  • Social network analysis
  • Social networks
  • Spatial analysis

ASJC Scopus subject areas

  • Epidemiology

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