Correlates of injection use of synthetic drugs among drug users in Pakistan: a case controlled study.

OBJECTIVE To assess the various correlates of injection of synthetic drugs among drug users in Pakistan. METHODS In a case controlled study, 141 cases and 272 controls were recruited, from 11 drug sites in Lahore, Pakistan, through multistage sampling techniques at a case control ratio of 1:2. Cases were defined as injecting drug users (IDU's) who switched from non injection routes of drug intake to injecting synthetic drugs, while controls (272) were heroin chasers who had never injected synthetic drugs. Data were collected on various demographic, socioeconomic and personal characteristics, drug use history and practices, and knowledge regarding HIV. While controlling for various confounders, adjusted odds ratios (aOR) with corresponding 95% CI were estimated using multivariate logistic regression. RESULTS Factors found to be independently associated with route transitions were young age (aOR:3.7, 95%CI: 1.9-7.2), homelessness (aOR: 6.4, 95%CI: 3.9-10.2), presence of an IDU friend (aOR:3.7, 95%CI: 2.3-6.1), easy availability (aOR:5.6, 95%CI: 3.3-9.6) and cost of the current drug (aOR:2.6, 95%CI: 1.6-4.3) and poly drug use (aOR:3.2, 95%CI: 1.6-6.4). CONCLUSION Low cost of the current drug of choice, easy availability and polydrug use were strongly associated with IDU of synthetic drugs.