Injecting drug use opportunities and reasons for choosing not to inject: A population-based study of Australian young adults who use stimulants

Introduction: Understanding reasons for choosing not to inject drugs, among those who have never injected before, may be helpful for reducing transitions to injecting drug use. This study examines opportunities to inject and reasons for never injecting in young adults who used stimulants. Methods: Data are from a population-based study of young adults who used ecstasy and methamphetamine (n = 313), recruited in Queensland, Australia in 2008/2009. At the follow-up, participants who had never injected (n = 293) completed a 13-item instrument on reasons for never injecting. We conducted a principal components analysis to identify types of reasons (scored 0–100) and multivariate regression to predict endorsement of these reasons. Results: Approximately one-in-five of all participants ever had an opportunity to inject and there was no gender difference in the propensity to accept an opportunity. Four types of reasons, labelled risk perception, subjective effects, social environment and aversion, were identified. Male gender was associated with lower endorsement of risk perception (β = −7.94; 95% confidence interval [CI] −13.37, −2.51) and social environment (β = −7.35; 95% CI −13.15, −1.54). Having friends who injected was associated with lower endorsement of the social environment (β = −8.88; 95% CI −14.83, −2.94), and higher endorsement of aversion (β = 7.67; 95% CI 1.44, 13.89). Discussion and Conclusions: Our findings suggest that injecting drug use opportunities are common among young adults engaged in recreational drug use, with males and females equally likely to accept an opportunity. A strong aversion to injecting and a hedonic preference for non-injecting drug use may reduce the likelihood of accepting these opportunities.