Research

Risk factors associated with injection initiation among drug users in Northern Thailand

Yingkai Cheng³ , Susan G Sherman³ , Namtip Srirat³ , Tasanai Vongchak³ , Surinda Kawichai³ , Jaroon Jittiwutikarn³ , Vinai Suriyanon³ , Myat Htoo Razak³ , Teerada Sripaipan³ and David D Celentano^1,2,3

¹  Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA

²  Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand

³  Ministry of Public Health, Nonthaburi, Thailand; Family Health International, Bangkok, Thailand

author email corresponding author email

Harm Reduction Journal 2006, 3:10doi:10.1186/1477-7517-3-10

Published:	14 March 2006

Abstract

Background

Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand.

Methods

A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection.

Results

After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation.

Conclusion

Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.