TY - JOUR
T1 - Longitudinal predictors of injection cessation and subsequent relapse among a cohort of injection drug users in Baltimore, MD, 1988-2000
AU - Shah, Nina G.
AU - Galai, Noya
AU - Celentano, David D.
AU - Vlahov, David
AU - Strathdee, Steffanie A.
N1 - Funding Information:
The authors are indebted to the ALIVE participants for imparting their experiences. We also thank the ALIVE Study staff for their generous time and support in conducting the study. This research was funded by grants DA04334 and DA12568 from the National Institute on Drug Abuse.
PY - 2006/6/28
Y1 - 2006/6/28
N2 - Objective: To determine predictors of injection drug use cessation and subsequent relapse among a cohort of injection drug users (IDUs). Methods: IDUs in Baltimore, MD were recruited through community outreach in 1988-1989. Among IDUs with at least three follow-up visits, parametric survival models for time to injection cessation (≥6 months) and subsequent relapse were constructed. Results: Of 1327 IDUs, 94.8% were African American, 77.2% were male, median age was 34 years, and 37.7% were HIV-infected. Among 936 (70.5%) subjects who ceased injection, median time from baseline to cessation was 4.0 years. Three-quarters subsequently resumed injection drug use, among whom median time to relapse was 1.0 year. Factors independently associated with a shorter time to cessation were: age <30 years, stable housing, HIV seropositivity, methadone maintenance treatment, detoxification, abstinence from cigarettes and alcohol, injecting less than daily, not injecting heroin and cocaine together, and not having an IDU sex partner. Factors independently associated with shorter time to injection relapse were male gender, homelessness, HIV seropositivity, use of alcohol, cigarettes, non-injection cocaine, sexual abstinence and having a longer time to the first cessation. Conclusions: This study provides strong support for targeting cessation efforts among young IDUs and severely dependent, unstably housed, and HIV-infected individuals.
AB - Objective: To determine predictors of injection drug use cessation and subsequent relapse among a cohort of injection drug users (IDUs). Methods: IDUs in Baltimore, MD were recruited through community outreach in 1988-1989. Among IDUs with at least three follow-up visits, parametric survival models for time to injection cessation (≥6 months) and subsequent relapse were constructed. Results: Of 1327 IDUs, 94.8% were African American, 77.2% were male, median age was 34 years, and 37.7% were HIV-infected. Among 936 (70.5%) subjects who ceased injection, median time from baseline to cessation was 4.0 years. Three-quarters subsequently resumed injection drug use, among whom median time to relapse was 1.0 year. Factors independently associated with a shorter time to cessation were: age <30 years, stable housing, HIV seropositivity, methadone maintenance treatment, detoxification, abstinence from cigarettes and alcohol, injecting less than daily, not injecting heroin and cocaine together, and not having an IDU sex partner. Factors independently associated with shorter time to injection relapse were male gender, homelessness, HIV seropositivity, use of alcohol, cigarettes, non-injection cocaine, sexual abstinence and having a longer time to the first cessation. Conclusions: This study provides strong support for targeting cessation efforts among young IDUs and severely dependent, unstably housed, and HIV-infected individuals.
KW - Cessation
KW - HIV infection
KW - Homelessness
KW - Injection drug use
KW - Methadone maintenance
KW - Relapse
UR - http://www.scopus.com/inward/record.url?scp=33746617377&partnerID=8YFLogxK
U2 - 10.1016/j.drugalcdep.2005.11.007
DO - 10.1016/j.drugalcdep.2005.11.007
M3 - Article
C2 - 16364568
AN - SCOPUS:33746617377
SN - 0376-8716
VL - 83
SP - 147
EP - 156
JO - Drug and Alcohol Dependence
JF - Drug and Alcohol Dependence
IS - 2
ER -
