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Differential risks of syringe service program participants in Central Ohio: a latent class analysis

BACKGROUND: Significant heterogeneity exists among people who use drugs (PWUD). We identify distinct profiles of syringe service program (SSP) clients to (a) evaluate differential risk factors across subgroups and (b) inform harm reduction programming. METHODS: Latent class analysis (LCA) was applie...

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Autores principales: Moon, Kyle J., Bryant, Ian, Trinh, Anne, Hasenstab, Kathryn A., Carter, Brittany, Barclay, Rick, Nawaz, Saira
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386257/
https://www.ncbi.nlm.nih.gov/pubmed/37507721
http://dx.doi.org/10.1186/s12954-023-00824-8
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author Moon, Kyle J.
Bryant, Ian
Trinh, Anne
Hasenstab, Kathryn A.
Carter, Brittany
Barclay, Rick
Nawaz, Saira
author_facet Moon, Kyle J.
Bryant, Ian
Trinh, Anne
Hasenstab, Kathryn A.
Carter, Brittany
Barclay, Rick
Nawaz, Saira
author_sort Moon, Kyle J.
collection PubMed
description BACKGROUND: Significant heterogeneity exists among people who use drugs (PWUD). We identify distinct profiles of syringe service program (SSP) clients to (a) evaluate differential risk factors across subgroups and (b) inform harm reduction programming. METHODS: Latent class analysis (LCA) was applied to identify subgroups of participants (N = 3418) in a SSP in Columbus, Ohio, from 2019 to 2021. Demographics (age, sex, race/ethnicity, sexual orientation, housing status) and drug use characteristics (substance[s] used, syringe gauge, needle length, using alone, mixing drugs, sharing supplies, reducing use, self-reported perceptions on the impact of use, and treatment/support resources) were used as indicators to define latent classes. A five-class LCA model was developed, and logistic regression was then employed to compare risk factors at program initiation and at follow-up visits between latent classes. RESULTS: Five latent classes were identified: (1) heterosexual males using opioids/stimulants with housing instability and limited resources for treatment/support (16.1%), (2) heterosexual individuals using opioids with stable housing and resources for treatment/support (33.1%), (3) individuals using methamphetamine (12.4%), (4) young white individuals using opioids/methamphetamine (20.5%), and (5) females using opioids/cocaine (17.9%). Class 2 served as the reference group for logistic regression models, and at the time of entry, class 1 was more likely to report history of substance use treatment, overdose, HCV, sharing supplies, and mixing drugs, with persistently higher odds of sharing supplies and mixing drugs at follow-up. Class 3 was more likely to report history of overdose, sharing supplies, and mixing drugs, but outcomes at follow-up were comparable. Class 4 was the least likely to report history of overdose, HCV, and mixing drugs, but the most likely to report HIV. Class 5 was more likely to report history of substance use treatment, overdose, HCV, sharing supplies, and mixing drugs at entry, and higher reports of accessing substance use treatment and testing positive for HCV persisted at follow-up. CONCLUSIONS: Considerable heterogeneity exists among PWUD, leading to differential risk factors that may persist throughout engagement in harm reduction services. LCA can identify distinct profiles of PWUD accessing services to tailor interventions that address risks, improve outcomes, and mitigate disparities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12954-023-00824-8.
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spelling pubmed-103862572023-07-30 Differential risks of syringe service program participants in Central Ohio: a latent class analysis Moon, Kyle J. Bryant, Ian Trinh, Anne Hasenstab, Kathryn A. Carter, Brittany Barclay, Rick Nawaz, Saira Harm Reduct J Research BACKGROUND: Significant heterogeneity exists among people who use drugs (PWUD). We identify distinct profiles of syringe service program (SSP) clients to (a) evaluate differential risk factors across subgroups and (b) inform harm reduction programming. METHODS: Latent class analysis (LCA) was applied to identify subgroups of participants (N = 3418) in a SSP in Columbus, Ohio, from 2019 to 2021. Demographics (age, sex, race/ethnicity, sexual orientation, housing status) and drug use characteristics (substance[s] used, syringe gauge, needle length, using alone, mixing drugs, sharing supplies, reducing use, self-reported perceptions on the impact of use, and treatment/support resources) were used as indicators to define latent classes. A five-class LCA model was developed, and logistic regression was then employed to compare risk factors at program initiation and at follow-up visits between latent classes. RESULTS: Five latent classes were identified: (1) heterosexual males using opioids/stimulants with housing instability and limited resources for treatment/support (16.1%), (2) heterosexual individuals using opioids with stable housing and resources for treatment/support (33.1%), (3) individuals using methamphetamine (12.4%), (4) young white individuals using opioids/methamphetamine (20.5%), and (5) females using opioids/cocaine (17.9%). Class 2 served as the reference group for logistic regression models, and at the time of entry, class 1 was more likely to report history of substance use treatment, overdose, HCV, sharing supplies, and mixing drugs, with persistently higher odds of sharing supplies and mixing drugs at follow-up. Class 3 was more likely to report history of overdose, sharing supplies, and mixing drugs, but outcomes at follow-up were comparable. Class 4 was the least likely to report history of overdose, HCV, and mixing drugs, but the most likely to report HIV. Class 5 was more likely to report history of substance use treatment, overdose, HCV, sharing supplies, and mixing drugs at entry, and higher reports of accessing substance use treatment and testing positive for HCV persisted at follow-up. CONCLUSIONS: Considerable heterogeneity exists among PWUD, leading to differential risk factors that may persist throughout engagement in harm reduction services. LCA can identify distinct profiles of PWUD accessing services to tailor interventions that address risks, improve outcomes, and mitigate disparities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12954-023-00824-8. BioMed Central 2023-07-28 /pmc/articles/PMC10386257/ /pubmed/37507721 http://dx.doi.org/10.1186/s12954-023-00824-8 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
Moon, Kyle J.
Bryant, Ian
Trinh, Anne
Hasenstab, Kathryn A.
Carter, Brittany
Barclay, Rick
Nawaz, Saira
Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title_full Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title_fullStr Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title_full_unstemmed Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title_short Differential risks of syringe service program participants in Central Ohio: a latent class analysis
title_sort differential risks of syringe service program participants in central ohio: a latent class analysis
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10386257/
https://www.ncbi.nlm.nih.gov/pubmed/37507721
http://dx.doi.org/10.1186/s12954-023-00824-8
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