Sector News

  1. Racialized Risk Environments of those Who Inject Drugs in the United States

    Key terms
    Radicalized Risk Environment: occurs when racial/ethnic groups inhabit places that do not have protective resources (for example, substance abuse treatment programs).

    Risk Environment Model: addresses social situations, structures, and places that generate vulnerability to HIV transmission and other drug-and HIV-related harms among people who inject drugs (PWID).

    Participant population
    The sample included 9170 people who inject drugs from 15 states across the United States.

    – Across all measures black PWID were more likely than white PWID to live in areas associated with vulnerability to HIV and poorer outcomes for those living with HIV.
    – Black PWID lived in more socially and economically distressed areas, had poorer access to substance abuse treatment, experienced greater exposure to drug-related law enforcement, were isolated in environments that lacked ethnic diversity and were more likely to experience the combination of hyper segregation and concentrated poverty.
    – Black PWID participants tended to live in states with laws that did not facilitate access to sterile syringes (where a prescription was required for purchase and possession of syringes). Laws restricting syringe access are connected with higher HIV prevalence. Laws limiting sterile syringe access may exacerbate racial/ethnic disparities in HIV prevalence.
    – Interestingly, the authors found a tendency for a law and order approach in states where people who misuse substances are more likely to be thought of as black and a more public health approach where people who misuse substances are thought to be white.
    – Black PWID had better spatial access to HIV testing than white PWID, yet they had worse access to substance abuse treatment. The US public health system made an effort to increase HIV testing amongst black adults; the authors suggest that similar initiatives are needed to increase access to substance abuse treatment as well.
    – The authors encourage those outside of the US to explore the “racialized risk environment” in their own countries. Previous studies have found large disparities in HIV prevalence in Canada among First Nations, the ethnic minority PWID, vs. the ethnic majority PWID. This may result from systematic differences in exposure to high-risk environments that perpetuate social inequality.

    The environments of people who inject drugs appear to be racialized in the US. Future research should assess risk environments in other countries.

    Cooper, H.L.F., Linton, S.L., Kelley, M.E. (2016). Racialized risk environments in a large sample of people who inject drugs in the United States. International Journal of Drug Policy. 27: pp.43-55.

  2. Social Relationships and Injection Risk Behaviour

    Understanding the social factors associated with the spread of HCV and HIV amongst people who inject drugs (PWID) continues to be a key goal of public health research.

    Overall Study Objective
    The authors examine multiple drug use episodes for each participant to gain an understanding of individual variation of injection risk behavior.

    The study included a total of 835 injection drug user participants who provided data for up to 4 injection episodes.


    • Participants injecting with sexual partners or non-first time partners were more likely to engage in risk behavior. There is a positive association between sexual partnership and injection risk behavior for both males and females.
    • Association between sexual partnership (y=1.14, p=0.014) and risk behaviour was significantly more positive for female injectors than for males.
    • Female-female injection partners and females with sexual injection partners tended to have higher levels of injection risk behavior in comparison to male-male injection partnerships. The authors suggest that this may be due to the norms surrounding female-female injection and/or skill and resource imbalance (previous studies have found that females have lower level of access to equipment and less experience self-injecting).
    • It is the specific injection event that is related to a higher risk for females. For example, a female’s sexual partner may be the one who obtains the drugs and may subsequently obtain greater control over the injection process, such as injecting first and then passing the equipment to the female sexual partner.
    • Authors found that size of injection network may have little effect on injection risk behavior. However, this finding may be due the inherent difficulty of participants recalling the number of injectors in the “same place and time” in the previous six months.
    • Interestingly, authors found significant within person variability in injection risk behavior across injection episodes (13.2% of unexplained variability). Based on this, the authors suggest that partner and setting characteristics are important factors in determining risk behavior for specific drug use episodes.

    Gender continues to be a key factor in the association between partner characteristics and risk behavior, which may be due to resources imbalances or gender norms that may enhance the potential risk of sexual partnerships for female injectors. Interventions could target these relationships to increase communication and promote self-efficacy to reduce risk behavior.

    Janulis, P. (2016). The micro-social risk environment for injection drug use: An event specific analysis of dyadic, situational, and network predictors of injection risk behavior. The International Journal of Drug Policy. Vol, 27. Pp. 56-64.

  3. CATIE Webinar – Best Practice Recommendations for Canadian Harm Reduction Programs – part 2

    Wednesday, September 16, 2015 – 1:00pm ET

    Featuring: Carol Strike, PhD, Associate Professor at the Dalla Lana School of Public Health, University of Toronto

    This webinar will introduce recommendations included in Part 2 of the Best Practice Recommendations for Canadian Harm Reduction Programs. Developed by service providers, service users and researchers from across Canada, the second installment of the recommendations focuses on service models, referrals to services and emerging areas of practice.

    The webinar will include practical recommendations for service providers on:

    • service model design
    • equipment distribution for piercing, tattooing, steroid/hormone injection and smoking crystal methamphetamine
    • referrals for testing, vaccination, treatment, housing, mental health and addiction services
    • relationships with law enforcement


    Please note that this webinar will be presented in English. A French version of this webinar will be presented at a later date. Subscribe to CATIE’s webinar e-mail list to stay informed:

  4. World Health Organization has a new guideline on HIV prevention, diagnosis, and treatment

    This new HIV guideline by the WHO consolidates guidelines relevant to men who have sex with men, people who use drugs, people in prison, sex workers, and transgender people. The hope is that this new guideline will act as one comprehensive package for all key populations. To learn more CLICK HERE

  5. Findings from a 20 year marijuana review shows negative outcomes from chronic use

    The findings from a marijuana study shows there are negative outcomes from chronic marijuana use that we should be made aware of and share with our clients. Some of the negative outcomes include: low reflex rates, low birth weight, higher likelihood of bronchitis and psychological disorders such as a loss of touch with reality and distancing oneself from family and friends. Watch a CTV interview about this topic here.   

  6. The public is more likely to view drug addiction negatively than other mental health issues

    A study conducted by John Hopkins has found that drug addiction is viewed more negatively than other mental health issues. This is problematic because without higher levels of support for people who use drugs (PWUDs), PWUDs may not seek the help they need for a condition that may be treatable.

  7. Overdose more likely to happen around day government assistance cheques are issued

    The International Journal of Drug Policy has recently published an article illustrating how overdose events may be more likely to occur around the day government assistance cheques are issued. Findings may be applicable across Canada, and thus, NSPs may want to talk to their clients about their drug use around the time government assistance cheques are issued.

  8. Treatment staff characteristics are a predictor of positive methadone treatment outcomes

    Studies have found that methadone treatment outcomes are related to the characteristics of clinicians and staff. More frequent counselling and more experienced clinicians are link to positive outcomes such as duration of time patients are in methadone programs and reduction of street-drug use. For more CLICK HERE

  9. Drug Internet Forums: What Are They About?

    We are hearing more and more about unregulated novel psychoactive substances (NPS) which are often referred to as “legal high” and “designer drugs”. Many times these substances are bought and sold through online vendors, but did you know there are online forums where people can gather and share information about the NPS they are using? In a recently published qualitative study, researchers analyzed these online forums and identified the following themes: 1) uncovering the substance facts, 2) dosage and administration, 3) subjective experience, and 4) support and safety. The research team concluded that people who use NPS access these online forums to support each other and keep one another safe. If you’re interested in reading the full study check it out here.