Psychosocial factors associated with HIV-related high-risk injection behavior among people who inject drugs

Abstract

Understanding factors affecting the risky injection practices among people who inject drugs (PWIDs) are critical toward identifying the transition from initial injecting to HIV seropositivity. Increasingly HIV prevention programs have been focusing on targeted interventions in such high-risk groups, which include addressing some of these factors. We reviewed the literature on factors associated with HIV-related high-risk injection behavior among PWIDs using electronic databases such as Pubmed and Google scholar. This was supplemented by manual search for non-indexed and grey literature. The factors studied include age and age of initiation, duration of use, concurrent alcohol use, social networks, stigma, and impact of the intervention. In general, there is a lack of studies from developing countries, and most of the literature are from western settings. Across studies, the risky injection practices have been consistently associated with early age of initiation and social network characteristics such as family member using injections, using injections with the sexual partner. However, studies have shown inconsistent association with current age, duration, and exposure to interventions for substance use disorders. Despite strong theoretical underpinning of a positive association, there is inadequate literature on factors such as alcohol abuse and stigma. This narrative review highlights the need for high-quality studies addressing factors associated with HIV-related high-risk injection behavior.

Keywords

• Human Immunodeficiency virus
• people who inject drugs
• psychosocial
• review
• risk taking