Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India.

Background and aims: Network centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual‐level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as p...

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Publicado en:Addiction Vol. 119; no. 3; pp. 570 - 582
Autores principales: Prata Menezes, Neia, Mehta, Shruti H., Wesolowski, Amy, Clipman, Steven J., Srikrishnan, Aylur K., Kumar, Muniratnam S., Zook, Katie J. C., Lucas, Gregory M., Latkin, Carl, Solomon, Sunil S.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Mar2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Mar2024
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Network centrality and HIV prevention service use among people who inject drugs: Findings from a sociometric network cohort in New Delhi, India.
      aug:
        au:
          Prata Menezes, Neia
          Mehta, Shruti H.
          Wesolowski, Amy
          Clipman, Steven J.
          Srikrishnan, Aylur K.
          Kumar, Muniratnam S.
          Zook, Katie J. C.
          Lucas, Gregory M.
          Latkin, Carl
          Solomon, Sunil S.
        affil: Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore MD,, USA
      sug:
        subj:
          HIV Infections Prevention and Control
          Persons Who Use Intravenous Drugs
          Health Services Accessibility
          Social Networks
          Needle Sharing
          Human
          India
          Nonexperimental Studies
          Male
          Female
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Descriptive Statistics
          Funding Source
          Interviews
          Questionnaires
          Logistic Regression
          Odds Ratio
          Confidence Intervals
          Heroin
          Buprenorphine
          Overdose
          Health Promotion
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Background and aims: Network centrality, an indicator of an individual's importance and potential to drive behavioral change, is rarely used to select peer educators. Individual‐level predictors of network centrality might be useful to identify people who inject drugs (PWID) for potential roles as peer navigators or change agents in network‐based interventions in settings where sociometric data are unavailable. We assessed the relationship between network centrality and HIV prevention service engagement to determine whether centrally‐positioned PWID share measurable commonalities. Design: Observational study and survey using baseline data from a sociometric network cohort of PWID, enumerated using network software and biometric data (2017‐2020). Network ties corresponded to direct injection partnerships in the prior month. Setting: New Delhi, India. Participants: A total of 2512 PWID who were ≥18 years, provided written informed consent, and reported illicit injection drug use within the 24 months before study enrollment. Measurements Interviewer‐administered questionnaires measured demographics and substance use behaviors. Central versus peripheral network position was categorized using betweenness centrality 75th%ile. Logistic regression was used to estimate adjusted odds ratios (aOR) with 95% confidence intervals (95%CI) between network position and HIV testing, medication for opioid use disorder (MOUD), or syringe service use. Lasso models selected predictors of central network position among 20 covariates detailing demographic, biologic, and substance use information. Predictive accuracy was evaluated using model performance metrics. Findings Overall, median age was 26 years (interquartile range 22–34); 99% were male; 628 were classified as central. Compared with PWID at the periphery, central PWID were more likely to use MOUD (aOR: 1.59, 95%CI: 1.30–1.94) and syringe services (aOR: 2.91, 95%CI: 2.25, 3.76) in the prior six months. Findings for HIV testing were inconclusive (aOR: 1.30, 95%CI: 1.00–1.69). The lasso variable selector identified several predictors of network centrality: HIV and hepatitis C infection, number of PWID seen in the prior month, injecting heroin and buprenorphine (vs. heroin only) six months prior, sharing injection equipment six months prior, experiencing drug overdose in the past year, and moderate/severe depression (vs. none/mild). Average agreement between model‐predicted vs. observed values was 0.75; area under the receiver operator curve was 0.69. Conclusions: In a socioeconomic network of people who inject drugs (PWID) in New Delhi, India, there are common characteristics among individuals based on their network position (central vs. peripheral) but individual‐level predictors have only moderate predictive accuracy. Although central network members appear to be more likely to use HIV prevention services than peripheral network members, their potential as change agents may be limited by other factors that impede their ability to adopt or promote HIV prevention service use.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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