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Subst Use Misuse. 2003 Dec;38(14):2049-63.

Explaining the geographical variation of HIV among injection drug users in the United States.

Author information

1
Urban Health Study, Department of Family and Community Medicine, University of California, San Francisco, California 94110, USA. ciccaron@fcm.ucsf.edu

Abstract

Distinct physical and chemical types of street heroin exist worldwide, but their impact on behavior and disease acquisition is not well understood or documented. This article presents a hypothesis to explain the unequal diffusion of HIV among injection drug users in the United States by examining the distribution and use of one type of heroin--"Mexican black tar." Drawing on ethnographic, clinical, epidemiological, and laboratory data, we suggest that the chemical properties of black tar heroin promote the following safer injection practices: (1) the rinsing of syringes with water to prevent clogging; (2) the heating of cookers to promote dissolution; and (3) a rapid transition from venous injection to subcutaneous or intramuscular injections.

PMID:
14677781
PMCID:
PMC1343535
[Indexed for MEDLINE]
Free PMC Article
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