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Drug Alcohol Depend. 2018 Apr 1;185:298-304. doi: 10.1016/j.drugalcdep.2017.12.034. Epub 2018 Feb 21.

Predictors of injecting cessation among a cohort of people who inject drugs in Tijuana, Mexico.

Author information

1
Division of Global Public Health, University of California San Diego, La Jolla, CA, 92093, United States; Behaviours and Health Risks Program, Burnet Institute, Melbourne, VIC, 3004, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, 3004, Australia.
2
Division of Global Public Health, University of California San Diego, La Jolla, CA, 92093, United States.
3
Department of Psychiatry, University of California San Francisco, San Francisco, CA, 94143, United States.
4
United States-Mexico Border Health Commission, Tijuana, BC, 22320, Mexico.
5
Division of Global Public Health, University of California San Diego, La Jolla, CA, 92093, United States. Electronic address: togaines@ucsd.edu.

Abstract

INTRODUCTION:

Little is known about the cessation of injecting drug use (IDU) among people who inject drugs (PWID) in low and middle-income settings, where access to effective interventions for reducing drug use (e.g., opioid substitution treatment; OST), may be limited. We measured the incidence and identified predictors of IDU cessation among a cohort of PWID in Tijuana, Mexico.

METHODS:

Data were drawn from 621 participants in Proyecto El Cuete IV, a prospective cohort of PWID recruited in 2011 and interviewed biannually to 2016. A multivariable Extended Cox model was constructed to identify socio-demographic, drug use, risk environment and health-related predictors of IDU cessation (no IDU for ≥six months).

RESULTS:

141 participants (23%) reported at least one IDU cessation event during follow-up. The crude IDU cessation rate was 7.3 per 100 person-years (95% Confidence Interval [CI]: 6.2-8.7). IDU cessation was negatively associated with injecting at least daily on average and heroin/methamphetamine co-injection in the past six months, and positively associated with testing HIV positive at baseline, being on methadone maintenance therapy in the past six months, and recent arrest. Concern for personal safety was also independently associated with IDU cessation.

CONCLUSIONS:

The rate of IDU cessation among PWID in Tijuana was low. These findings underscore the importance of expansion of services including OST to help reduce drug use and facilitate IDU cessation for those who wish to do so. In this setting, interventions addressing individual-level economic barriers as well as broader social and structural barriers to harm reduction services are integral.

KEYWORDS:

Cessation; Injecting drug use; Mexico

PMID:
29482055
PMCID:
PMC5889739
[Available on 2019-04-01]
DOI:
10.1016/j.drugalcdep.2017.12.034
[Indexed for MEDLINE]

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