AIMS: To characterize mortality experience among those who only recently started injection. DESIGN: Prospective study. SETTING: Independent study clinic within high drug use neighborhoods. PARTICIPANTS: In 1988-1989, we enrolled 256 adult injection drug users (IDUs) recruited through street outreach who had initiated injection within the prior 2 years. MEASUREMENTS: Consenting participants underwent venipuncture for HIV antibody testing and interviews. We prospectively ascertained date and cause of death through follow-up contact and registry linkages. Analyses included standardized mortality ratios (SMRs) with local, state and national mortality data, adjusted for age, gender and race. FINDINGS: Baseline median age was 30 years, 70% were male, 95% were African-American and 90% injected within the prior 6 months. We identified 69 deaths through October 2000; mortality rate was 3.3/100 person-years. The adjusted SMR with the USA (and Baltimore) as the reference for IDUs was 4.40 (2.43) for 1991-1992, which increased to 8.12 (4.13) by 1993-1994, decreased to 4.43 (2.13) by 1997-1998 and increased slightly to 5.35 (2.79) during 1999-2000. Excluding HIV-related mortality, SMRs remained elevated. Decline in SMRs was not linked to drug abuse treatment. CONCLUSIONS: These data demonstrate excess mortality among new-onset IDUs compared with demographically similar peers in the general population, indicating the need for interventions to prevent premature death among young IDUs.
AIMS: To characterize mortality experience among those who only recently started injection. DESIGN: Prospective study. SETTING: Independent study clinic within high drug use neighborhoods. PARTICIPANTS: In 1988-1989, we enrolled 256 adult injection drug users (IDUs) recruited through street outreach who had initiated injection within the prior 2 years. MEASUREMENTS: Consenting participants underwent venipuncture for HIV antibody testing and interviews. We prospectively ascertained date and cause of death through follow-up contact and registry linkages. Analyses included standardized mortality ratios (SMRs) with local, state and national mortality data, adjusted for age, gender and race. FINDINGS: Baseline median age was 30 years, 70% were male, 95% were African-American and 90% injected within the prior 6 months. We identified 69 deaths through October 2000; mortality rate was 3.3/100 person-years. The adjusted SMR with the USA (and Baltimore) as the reference for IDUs was 4.40 (2.43) for 1991-1992, which increased to 8.12 (4.13) by 1993-1994, decreased to 4.43 (2.13) by 1997-1998 and increased slightly to 5.35 (2.79) during 1999-2000. Excluding HIV-related mortality, SMRs remained elevated. Decline in SMRs was not linked to drug abuse treatment. CONCLUSIONS: These data demonstrate excess mortality among new-onset IDUs compared with demographically similar peers in the general population, indicating the need for interventions to prevent premature death among young IDUs.
Authors: Brooke S West; Daniela A Abramovitz; Patricia Gonzalez-Zuniga; Gudelia Rangel; Dan Werb; Javier Cepeda; Leo Beletsky; Steffanie A Strathdee Journal: Int J Drug Policy Date: 2019-11-24
Authors: David B Rein; Bryce D Smith; John S Wittenborn; Sarah B Lesesne; Laura D Wagner; Douglas W Roblin; Nita Patel; John W Ward; Cindy M Weinbaum Journal: Ann Intern Med Date: 2011-11-04 Impact factor: 25.391
Authors: John Macleod; Lorraine Copeland; Matthew Hickman; James McKenzie; Jo Kimber; Daniela De Angelis; James R Robertson Journal: BMC Public Health Date: 2010-02-26 Impact factor: 3.295
Authors: Ingrid A Binswanger; Traci A Takahashi; Katharine Bradley; Timothy H Dellit; Kathryn L Benton; Joseph O Merrill Journal: J Stud Alcohol Drugs Date: 2008-11 Impact factor: 2.582
Authors: Sandra K Schwarcz; Ling C Hsu; Eric Vittinghoff; Annie Vu; Joshua D Bamberger; Mitchell H Katz Journal: BMC Public Health Date: 2009-07-07 Impact factor: 3.295