Attributes Associated with HIV Risk Behaviors in a Network-Based Study of People Who Inject Drugs

Area of Science:

• Epidemiology
• Social Network Analysis
• Public Health

Background:

• People who inject drugs (PWID) participate in social and drug-use networks, increasing HIV transmission risk through unprotected sex or shared equipment.
• Understanding network structures is crucial for controlling HIV transmission within these populations.

Purpose of the Study:

• To identify attributes associated with network connections among PWID during an HIV outbreak in Athens, Greece (2013-2015).

Main Methods:

• Utilized data from the Transmission Reduction Intervention Project (TRIP), a network-based HIV prevention intervention.
• Employed descriptive network statistics and Exponential Random Graph Models (ERGMs) to analyze individual attributes and risk ties among PWID.

Main Results:

• The network comprised 356 participants and 542 connections; participants had a mean age of 36, were predominantly male (79%), and 23% were homeless.
• Network analysis revealed positive degree assortativity, indicating participants connected with others of similar network size.
• ERGMs demonstrated that PWID were more likely to form connections with similar individuals based on sex, nationality, and housing status (e.g., homelessness).

Conclusions:

• Network analysis using ERGMs confirmed that individuals within PWID networks tend to form ties with similar others beyond chance.
• Identified housing instability as a significant factor influencing network ties among PWID in Athens.
• Recommended future longitudinal studies and consideration of identified factors in intervention development for PWID networks.