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Gender Differences in Risky Injection Practices Among People Who Inject Drugs in Colombia

Toro-Tobón, David MD*; Berbesi-Fernández, Dedsy PhD; Trejos-Castillo, Elizabeth PhD; Arbelaez, Silvia G. MD*

Addictive Disorders & Their Treatment: September 2019 - Volume 18 - Issue 3 - p 140–148
doi: 10.1097/ADT.0000000000000161
Original Articles

Background: Female who inject drugs are exposed to greater social disapproval, stigmatization, and report a higher risk of unsafe injection practices compared with their male counterparts. Gender differences in injection practices among people who inject drugs (PWID) in Latin America remain understudied.

Objectives: This study aimed to examine gender differences in injection practices among PWIDs in Colombia.

Materials and Methods: Using respondent-driven sampling, N=1081 participants (14% female; mean age: 26 y) from 5 Colombian cities completed the Pan American Health Organization’s Behaviors of High Risk Drug Consumers Survey. A binary logistic regression model was used to examine first and last injection practices and risk injection behaviors among PWIDs.

Results: Female presented high odds of receiving assistance by their sexual partners during the first and last injection episode [adjusted odds ratio (AOR)=8.3, confidence interval (CI)=14.0-16.7; AOR=2.06, CI=1.1-3.7]. Also, female had at least 2 times higher odds of engaging in unsafe injecting practices including sharing drug mix and using drug in a capsule or ready-to-use vial (AOR=2.8, CI=1.4-5.5; AOR=3.4, CI=1.5-7.7) and had lower odds of acquiring the drug to self-inject (AOR=0.4, CI=0.2-0.9) during the last injection episode.

Conclusions: High dependence on sexual partner and risky injection behaviors among female who inject drugs were identified. Study findings contextualized with gender vulnerabilities in Colombia are fundamental for prevention/intervention efforts aimed at helping this at-risk population in the country and in Latin America.

*School of Medicine

School of Nursing, CES University, Medellin, Colombia

Human Development & Family Studies, Texas Tech University, Lubbock, TX

This study was partially funded by the Panamerican Health Organization and was carried out through an agreement between CES University and the Colombian Ministry of Justice and Law under Grant number N°COL/LOA/1400008.001.

The authors declare no conflict of interest.

Reprints: David Toro-Tobón, MD, School of Medicine, CES University, Calle 10A #22-04, Medellin 050021, Colombia (e-mail:

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