NDLI: Correlates of duration between initial drug use and first drug injection among people who inject drugs in Iran, 2020

Content Provider	Springer Nature : BioMed Central
Author	Abdolahinia, Zahra Jaafari, Zahra Karamoozian, Ali Mehmandoost, Soheil Ghalekhani, Nima Khezri, Mehrdad Mousavian, Ghazal Shokoohi, Mostafa Mirzazadeh, Ali Haghdoost, Ali Akbar Karamouzian, Mohammad Gooya, Mohammad Mehdi Akbarpour, Samaneh Sharifi, Hamid Tavakoli, Fatemeh
Abstract	Background People who use non-injection drug use are at risk of transitioning to injecting drugs, which increases their vulnerability to HIV and other blood-borne infections. This study aimed to investigate the correlates of the duration between the first drug use and the first drug injection among people who inject drugs (PWID) in Iran, as well as the reasons for injection initiation. Methods We analyzed data from the fourth national bio-behavioral surveillance survey among PWID in Iran, conducted in 2020 across 11 cities using respondent-driven sampling (n = 2,684). A generalized linear mixed model with a gamma-distributed dependent variable and log link function was used to investigate the correlates of transition time from non-injection to injection drug use. Results Among 2,356 participants included in the analysis, the mean ± SD of the duration between the first drug use and the first drug injection was 9.37 ± 6.8 years. Factors associated with earlier injection initiation included: age under 30 years (p-value < 0.001), being single (p-value < 0.001) or divorced/widowed (p-value = 0.007), history of incarceration (p-value = 0.001), sexual debut before age 18 (p-value < 0.001), and history of depression (p-value < 0.001). Peer influence (665;29.1%) and pleasure-seeking behavior (534; 23.3%) were the most common motives for injection initiation. Conclusions The transition to injection drug use among PWID in Iran often occurs within a decade of initial drug use and is influenced by demographic, social, and psychological factors. Prevention strategies should focus on early intervention for at-risk youth, address mental health needs, and leverage peer influence. Policymakers should prioritize evidence-based, multi-faceted approaches that target both individual and structural factors to delay or prevent the transition to injection drug use and reduce associated health risks.
Related Links	https://bmcpublichealth.biomedcentral.com/counter/pdf/10.1186/s12889-025-22357-4.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712458
DOI	10.1186/s12889-025-22357-4
Journal	BMC Public Health
Issue Number	1
Volume Number	25
Language	English
Publisher	BioMed Central
Publisher Date	2025-04-01
Access Restriction	Open
Subject Keyword	Public Health Medicine Epidemiology Biostatistics Vaccine Environmental Health Substance-related disorders People who inject drugs Harm reduction Cross-sectional studies Social determinants of health Iran Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health
Journal Impact Factor	3.5/2023
5-Year Journal Impact Factor	3.9/2023

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1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
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4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
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