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Monk-Turner E, Fu H, Li J, Yang X. Perceptions of drug users and community gate keepers on the causes and consequences of synthetic drug use in Kunming: A three-level social-ecological approach. J Ethn Subst Abuse 2021; 22:659-680. [PMID: 34632964 DOI: 10.1080/15332640.2021.1982805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Synthetic drug use (SDU) is on the rise in China. Utilizing a grounded three-level social-ecological theoretical model, we aim to better understand how users, medical professionals, and other community gatekeepers perceive the causes and consequences of synthetic drug use in Kunming, China. Past work typically relies on drug users confined to rehabilitation facilities. Utilizing qualitative methods, our work integrates how various community actors perceive problems around synthetic drug use. Thirty face-to-face interviews were conducted in Kunming that were audio-recorded and transcribed. We identify emergent personal, interpersonal and societal level themes shaping SDU which provided our grounded theoretical model. Regardless of their social position, informants identified curiosity, peer networks that facilitated exposure, and the communality of sharing the drug experience as reasons to try synthetic drugs. Drug users reported negative consequences of SDU including the inability to sleep, a fear that others might discover one was using, and the difficulty of quitting. Medical professionals and others in the community were more likely to identify potential harms of SDU. Still, these community members felt synthetic drugs were less problematic than traditional drugs and reported less prejudice and stigma about these new drugs. Overall, medical professionals felt ill-prepared to deal with this new epidemic.
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Affiliation(s)
| | - Hongyun Fu
- Eastern Virginia Medical School, Norfolk, VA
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Yang X, Xia G. Causes and Consequences of Drug Abuse: A Comparison Between Synthetic Drug and Heroin Users in Urban China. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2019; 31:1-16. [PMID: 30742480 PMCID: PMC6823082 DOI: 10.1521/aeap.2019.31.1.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This article examined the differences in causes and health consequences between synthetic drug and heroin abuse in urban China. Two-group comparisons were conducted to quantify differences in individual characteristics, causes of drug use, and HIV/STI risky sexual behavior between synthetic drug and heroin users; logistic regressions were employed to assess the net effect of synthetic drug use on risky sexual behavior. Results revealed that causes of synthetic drug use differed from those of heroin use; a combination of the knowledge gap concerning the harmful impact of synthetic drugs and the lesser punishment for their use appeared a main reason behind the shift from heroin to synthetic drugs; and synthetic drug use was a significant and powerful risk factor for HIV/STI risky sexual behavior. Educational and behavioral interventions are urgently needed to prevent the initiation of synthetic drug use among users to reduce their HIV/STI risky sexual behavior.
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Affiliation(s)
- Xiushi Yang
- Department of Sociology and Criminal Justice, Old Dominion University, Norfolk, Virginia
| | - Guomei Xia
- Shanghai Academy of Social Sciences, Shanghai, China
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A Multiple Indicators Multiple Causes (MIMIC) model of internal barriers to drug treatment in China. Drug Alcohol Depend 2015; 148:143-9. [PMID: 25640152 DOI: 10.1016/j.drugalcdep.2014.12.033] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Revised: 12/12/2014] [Accepted: 12/27/2014] [Indexed: 11/21/2022]
Abstract
BACKGROUND Although evidence exists for distinct barriers to drug abuse treatment (BDATs), investigations of their inter-relationships and the effect of individual characteristics on the barrier factors have been sparse, especially in China. A Multiple Indicators Multiple Causes (MIMIC) model is applied for this target. METHODS A sample of 262 drug users were recruited from three drug rehabilitation centers in Hunan Province, China. We applied a MIMIC approach to investigate the effect of gender, age, marital status, education, primary substance use, duration of primary drug use, and drug treatment experience on the internal barrier factors: absence of problem (AP), negative social support (NSS), fear of treatment (FT), and privacy concerns (PC). RESULTS Drug users of various characteristics were found to report different internal barrier factors. Younger participants were more likely to report NSS (-0.19, p=0.038) and PC (-0.31, p<0.001). Compared to other drug users, ice users were more likely to report AP (0.44, p<0.001) and NSS (0.25, p=0.010). Drug treatment experiences related to AP (0.20, p=0.012). In addition, differential item functioning (DIF) occurred in three items when participant from groups with different duration of drug use, ice use, or marital status. CONCLUSIONS Individual characteristics had significant effects on internal barriers to drug treatment. On this basis, BDAT perceived by different individuals could be assessed before tactics were utilized to successfully remove perceived barriers to drug treatment.
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Du J, Sun H, Huang D, Jiang H, Zhong N, Xu D, Zhao Y, Lin S, Wang W, Du Z, Zhao M, Hser YI. Use trajectories of amphetamine-type stimulants (ATS) in Shanghai, China. Drug Alcohol Depend 2014; 143:44-50. [PMID: 25081602 PMCID: PMC4161627 DOI: 10.1016/j.drugalcdep.2014.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 05/29/2014] [Accepted: 06/16/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although amphetamine-type stimulant (ATS) use is an important issue that has caused growing concerns in China as well as other countries, the knowledge of long-term patterns of ATS use in China is limited. This study explored long-term patterns of ATS use in Shanghai, China, and compared the differences by ATS use trajectory groups, seeking to identify risk factors that have implications for the development of targeted intervention programs. METHODS A total of 377 ATS users were recruited from the Compulsory Isolation Center for Drug Rehabilitation in Shanghai. Group-based trajectory modeling was applied to identify distinctive trajectories of ATS use over 8 years at the time of interviews conducted in 2012. The mean number of days using ATS per month over a year from years 2005 to 2012 was analyzed with a censored normal model. RESULTS Three distinctive groups were identified: high-use (19.1%), low-use (66.0%), and increasing-use (14.9%). Relative to the low-use group, the high-use and increasing-use groups were more likely to report having used opiate-type drugs and to have more craving experiences. Psychiatric symptoms following ATS use were frequently reported, with ATS users in the increasing-use and high-use groups more likely to report depression symptoms and suicide behaviors compared to the low-use group. The low-use and increasing-use groups reported more months in drug abuse treatment programs compared to the high-use group. CONCLUSIONS Addressing ATS use should take into consideration patients' use-related psychiatric symptoms as well as other risk factors, particularly among those with persistent high-level ATS use trajectories.
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Affiliation(s)
- Jiang Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Haiming Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - David Huang
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, 90025, USA
| | - Haifeng Jiang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Na Zhong
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Ding Xu
- Shanghai Bureau of Reeducation-through-Labor Administration, Shanghai 200237, China
| | - Yan Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Shuxing Lin
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Wenwen Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Zheyi Du
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Min Zhao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
| | - Yih-Ing Hser
- UCLA Integrated Substance Abuse Programs, University of California, Los Angeles, 90025, USA; China Medical University at Taiwan, Taiwan.
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Kelly BC, Liu T, Yang XY, Zhang G, Hao W, Wang J. Perceived risk of methamphetamine among Chinese methamphetamine users. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2014; 25:1076-83. [PMID: 24925820 DOI: 10.1016/j.drugpo.2014.05.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2014] [Revised: 04/10/2014] [Accepted: 05/12/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Methamphetamine use has grown considerably in China in recent years. Information about perceptions of risk on methamphetamine is important to facilitate health promotion efforts. METHODS Using both survey data and qualitative interview data, the authors evaluate the perceived risk of methamphetamine use among Chinese users using a mixed-methods approach. Through Respondent Driven Sampling, the authors recruited a sample of 303 methamphetamine users in Changsha, China. RESULTS A majority (59.1%) perceive that infrequent methamphetamine use poses no risk to the user, while 11.2% perceive at least moderate risk for light use. A majority (56.7%) perceived at least moderate risk associated with regular methamphetamine use. Most (82.2%) also perceive methamphetamine to be easily obtainable. A path model indicates that perceived risk shapes intentions to use and expectations of future use, as does perceived availability. Qualitatively, while addiction was the most common risk discussed by users, they differed on whether they perceived the drug addictive. Other concerns raised by interviewees included impaired cognition, mental health problems, physical harm, and social dysfunction. CONCLUSION While some users identify significant risks with methamphetamine, others do not perceive its use to be problematic. Collectively, these findings indicate that intervening upon perceptions of risk among Chinese methamphetamine users may be a means to influence intentions to use.
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Affiliation(s)
| | - Tieqiao Liu
- Mental Health Institute of Central South University, China.
| | | | - Guanbai Zhang
- Mental Health Institute of Central South University, China
| | - Wei Hao
- Mental Health Institute of Central South University, China
| | - Jichuan Wang
- Children's National Medical Center, George Washington University, USA
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Kelly BC, Liu T, Zhang G, Hao W, Wang J. Perceptions of HIV risk among methamphetamine users in China. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2013; 39:99-102. [PMID: 23421570 DOI: 10.3109/00952990.2012.762371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Methamphetamine use has emerged in China over the past decade. With the growth in methamphetamine use, it remains uncertain how users in China perceive its association with the HIV epidemic. METHODS The authors utilize qualitative and survey data from a mixed-methods study on methamphetamine use and HIV risk in China to assess the extent to which users perceive a risk for HIV transmission as well as how they conceive of the drug's links to HIV. RESULTS Data indicate that a considerable majority (82.2%) perceived themselves to have zero risk for HIV infection. Qualitative interviews highlight the lack of information about HIV possessed by methamphetamine users given the confusion and disbelief often expressed. Others acknowledged that while there was an intertwining of risk, they were not personally at risk. CONCLUSION Given the known association between methamphetamine use and HIV risk, health promotion initiatives in China should target methamphetamine users to build HIV-related knowledge and inhibit self-exempting beliefs. In particular, educational efforts regarding the association of methamphetamine use with HIV may inhibit risk behaviors.
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Affiliation(s)
- Brian C Kelly
- Department of Sociology, Purdue University, West Lafayette, IN 47907, USA.
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Role of sexual transmission of HIV among young noninjection and injection opiate users: a respondent-driven sampling study. Sex Transm Dis 2012; 38:1161-6. [PMID: 22082729 DOI: 10.1097/olq.0b013e3182315772] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sexual transmissibility of HIV among young drug users in China has been investigated in few studies. The objective of this study was to examine the role of sexual transmission on HIV infection among injection drug users (IDUs) and noninjection drug users (NIDUs). METHODS Respondent-driven sampling (RDS) was used to recruit 426 young heroin/opium drug users in Yunnan, China. Logistic regression modeling was performed to examine interrelationships among risky sexual behaviors, drug-use modes, and drug-use practices. RESULTS Substantial proportions of NIDUs and IDUs reported engagement in risky sexual behaviors including: (1) multiple sexual partners (42% of NIDUs vs. 37% of IDUs), (2) concurrent sexual partnerships (48% vs. 46%), (3) commercial sex partners (23% vs. 24%), and sex partners who were NIDUs (14% vs. 17%). Both NIDUs and IDUs reported low levels of condom use with nonregular partners (48% vs. 42%) and regular partner (24% vs. 27%), and having a history of recent methamphetamine use (21% vs. 18%). Compared to IDUs, NIDUs reported having had fewer sex partners who were IDUs, fewer IDU network peers, more NIDU network peers, and having lower levels of HIV knowledge and self-perceived HIV risk. CONCLUSIONS Generalization of the HIV epidemic from high-risk groups to the general population may be driven by risky sexual behavior among drug users. Reducing sexual transmission of HIV among both IDUs and NIDUs is the next major challenge for HIV intervention among drug users in China.
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Li J, Liu H, Li J, Luo J, Koram N, Detels R. Sexual transmissibility of HIV among opiate users with concurrent sexual partnerships: an egocentric network study in Yunnan, China. Addiction 2011; 106:1780-7; discussion 1788-9. [PMID: 21457169 PMCID: PMC3142291 DOI: 10.1111/j.1360-0443.2011.03459.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To investigate the patterns of concurrent sexual partnerships among young opiate users and sexual transmissibility of human immunodeficiency virus (HIV) in concurrent sexual partnerships in drug-use and sexual networks. DESIGN Cross-sectional design. PARTICIPANTS A total of 426 young opiate users in Yunnan, China. SETTING Young opiate users recruited from their network ties. MEASUREMENT Respondent-driven sampling (RDS) was used to recruit participants. Multiple logistic regressions were performed to analyze the relationships of concurrent sexual partnerships with egocentric social network components, risky sexual behavior for HIV and drug-use practices. FINDINGS The RDS-adjusted prevalence of concurrent sexual partners was 42.9% among opiate users. Opiate users with concurrent sexual partnerships were more likely to engage in risky HIV-related sexual behavior, compared to those without. Specifically, they were more likely to report having had four or more sexual partners (26.3% versus 2.0%), having had a spouse or boy/girlfriends who also had concurrent sexual partnerships (28.1% versus 8.2%), having exchanged drug for sex (12.4% versus 3.8%), having had sexual partners who were non-injection drug users (22.6% versus 10.1%), having had sexual partners who were injection drug users (25.3% versus 13.5%) and having used club drugs (26.3% versus 13.5%). There were no significant differences in consistent condom use between opiate users with sexual concurrency and those without. The same proportion (25.8%) of opiate users in the two groups reported having consistently used condoms when having sex with regular partners, and 46.3% of opiate users with sexual concurrency and 36.4% of those without such concurrency consistently used condoms with non-regular partners. CONCLUSION The expansion of the human immunodeficiency virus epidemic from high-risk populations to the general population in China may be driven by concurrent sexual partnerships. Behavioral interventions targeting safer sex should be integrated into harm reduction programmes.
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Affiliation(s)
- Jian Li
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Hongjie Liu
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jianhua Li
- Yunnan Institute for Drug Abuse, Kunming, Yunnan, China
| | - Jian Luo
- Yunnan Institute for Drug Abuse, Kunming, Yunnan, China
| | - Nana Koram
- Department of Epidemiology and Community Health, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Roger Detels
- Department of Epidemiology, University of California, Los Angeles, California, USA
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