Internet use and Uptake of a Web-Based Prevention and Risk Reduction Intervention for Persons who use Drugs in New York City – Webhealth4Us Study (2013–2016)
Restricted accessResearch articleFirst published online December, 2022
Internet use and Uptake of a Web-Based Prevention and Risk Reduction Intervention for Persons who use Drugs in New York City – Webhealth4Us Study (2013–2016)
Background: Data on Internet utilization is needed, particularly during a time when in-person services are limited or only available virtually. The purpose of this study was to identify characteristics of Internet use among persons who use drugs and assess adoption of an interactive, risk reduction informational website – WebHealth4Us. Methods: Participant recruitment occurred in pharmacies participating in the New York State pharmacy syringe access program (n = 209). ACASI surveys were conducted on-site to ascertain Internet use and related sociodemographics and risk behaviors. Internet users (use ≥ once/month) were shown a website WebHealth4Us highlighting social services and risk reduction information on four topic areas: mental health, HIV, HCV, and other STI; users could also sign-up for weekly text messages for any topic area. Follow-up ACASI occurred at four weeks to assess user experiences and website adoption. Results: Study sample (n = 196) was mostly male (60%), average age 46, black/Latinx (76%), had a history of incarceration (79%), and reported past/current injection (53%) or non-injection (51%) drug use. Internet use was high (79%), accessed >4 times/week (60%) most commonly for: housing (61%), health issues (54%), and drug treatment (45%). Over one-third accessed WebHealth4Us during follow-up, and 35% of those opted for weekly text messages (mental health most common topic selected). After adjustment, younger age (AOR = 0.96) and alcohol use (AOR = 2.26) predicted WebHealth4Us access. Conclusion: Internet use was high with considerable WebHealth4Us access, and specifically for mental health needs. Web-based interventions warrant large-scale investigation in high-risk communities, prioritizing social determinants and behavioral health.
Mackesy-AmitiME, DonenbergGR, OuelletLJ.Psychiatric correlates of injection risk behavior among young people who inject drugs. Psychol Addict Behav.2014;28(4):1120–1095.
3.
PilowskyDJ, WuL-T, BurchettB, BlazerDG, LingW. Depressive symptoms, substance use, and HIV-related high-risk behaviors among opioid-dependent individuals: results from the clinical trials network. Subst Use Misuse.2011;46(14):1716–1725.
4.
DegenhardtL, HallW, WarnerSM.Using cohort studies to estimate mortality among injecting drug users that is not attributable to AIDS. Sex Transm Infect.2006;82(suppl_3):iii56–63.
5.
CornfordC, CloseH.The physical health of people who inject drugs: complexities, challenges, and continuity. Br J Gen Pract.2016;66(647):286–287.
6.
WinkelmanTN, ChangVW, BinswangerIA.Health, polysubstance use, and criminal justice involvement among adults with varying levels of opioid use. JAMA Netw Open.2018;1(3):e180558.
7.
DegenhardtL, PeacockA, ColledgeSGlobal prevalence of injecting drug use and sociodemographic characteristics and prevalence of HIV, HBV, and HCV in people who inject drugs: a multistage systematic review. Lancet Glob Heal.2017;5(12):e1192–e1207.
8.
MathersBM, DegenhardtL, PhillipsBGlobal epidemiology of injecting drug use and HIV among people who inject drugs: a systematic review. The Lancet. Lancet.2008;372(9651):1733–1745.
9.
RothAM, AumaierBL, FelsherMAAn exploration of factors impacting preexposure prophylaxis eligibility and access among syringe exchange users. Sexual Trans Dis.2018;45(4):217–221.
10.
VolkowND, BalerRD, ComptonWM, WeissSRB.Adverse health effects of marijuana use. N Engl J Med.2014;370(23):2219–2227.
11.
AzofeifaA, MattsonME, SchauerG, McAfeeT, GrantA, LyerlaR. National estimates of marijuana use and related indicators - National Survey on Drug Use and Health, United States, 2002–2014. MMWR Surveill Summ.2016;65(11):1–25.
12.
WitkiewitzK, VowlesKE. Alcohol and opioid use, co-use, and chronic pain in the context of the opioid epidemic: a critical review. Alcohol Clin Exp Res.2018;42(3):478–488.
13.
Substance Abuse and Mental Health Services Administration. Results from the 2011 National Survey on Drug Use and Health: mental health findings. Rockville, MD: Substance Abuse and Mental Health Services Administration; 2012.
14.
YearbyR.Racial disparities in health status and access to healthcare: the continuation of inequality in the united states due to structural racism: continuing racial health disparities. Am J Econ Sociol.2018;77(3–4):1113–1152.
15.
JohnsonT.Intersection of bias, structural racism, and social determinants with health care inequities. Pediatrics.2020;146(2):e2020003657.
16.
NealeJ, TompkinsC, SheardL.Barriers to accessing generic health and social care services: a qualitative study of injecting drug users. Health Soc Care Community.2008;16(2):147–154.
17.
AhernJ, StuberJ, GaleaS.Stigma, discrimination and the health of illicit drug users. Drug Alcohol Depend.2007;88(2–3):188–196.
18.
SchmittMT, BranscombeNR, PostmesT, GarciaA.The consequences of perceived discrimination for psychological well-being: a meta-analytic review. Psychol Bull.2014;140(4):921–948.
19.
PascoeEA, Smart RichmanL.Perceived discrimination and health: a meta-analytic review. Psychol Bull.2009;135(4):531–554.
20.
GuerreroEG, MarshJC, DuanL, OhC, PerronB, LeeB.Disparities in completion of substance abuse treatment between and within racial and ethnic groups. Health Serv Res.2013;48(4):1450–1467.
21.
LaineC, LinYT, HauckWW, TurnerBJ.Availability of medical care services in drug treatment clinics associated with lower repeated emergency department use. Med Care.2005;43(10):985–995.
22.
TofighiB, LeonardN, GrecoP, HadavandA, AcostaMC, LeeJD.Technology use patterns among patients enrolled in inpatient detoxification treatment. J Addict Med.2019;13(4):279–286.
23.
BrettleRP.HIV and harm reduction for injection drug users. AIDS.1991;5(2):125–136.
24.
HorvathKJ, LammertS, LeGrandS, MuessigKE, BauermeisterJA.Using technology to assess and intervene with illicit drug-using persons at risk for HIV. Curr Opin HIV Aids.2017;12(5):458–466.
25.
ZlotorzynskaM, SullivanP, SanchezT.The Annual American Men's Internet Survey of behaviors of men who have sex with men in the United States: 2015 key indicators report. JMIR Public Health Surveill.2017;3(1):e13.
26.
DowningMJr., ChiassonM, HirshfieldS.Recent anxiety symptoms and drug use associated with sexually transmitted infection diagnosis among an online US sample of men who have sex with men. J Health Psychol.2016;21(12):2799–2812.
FjeldsoeBS, MarshallAL, MillerYD.Behavior change interventions delivered by mobile telephone short-message service. Am J Prev Med.2009;36(2):165–173.
31.
DownerS, MearaJG, Da CostaA.Use of SMS text messaging to improve outpatient attendance. Med J Aust.2005;183(7):366–368.
32.
TofighiB, NicholsonJM, McNeelyJ, MuenchF, LeeJD.Mobile phone messaging for illicit drug and alcohol dependence: a systematic review of the literature. Drug Alcohol Rev.2017;36(4):477–491.
33.
CollinsKM, ArmentaRF, Cuevas-MotaJ, LiuL, StrathdeeSA, GarfeinRS.Factors associated with patterns of mobile technology use among persons who inject drugs. Subst Abus.2016;37(4):606–612.
34.
TofighiB, CampbellANC, PavlicovaM, HuMC, LeeJD, NunesEV.Recent internet use and associations with clinical outcomes among patients entering addiction treatment involved in a web-delivered psychosocial intervention study. J Urban Health.2016;93(5):871–883.
35.
RanjitYS, ShresthaR, CopenhaverM, AlticeFL.Online HIV information seeking and pre-exposure prophylaxis awareness among people who use drugs. J Subst Abuse Treat.2020;111:16–22.
36.
BoumparisN, KaryotakiE, SchaubMP, CuijpersP, RiperH.Internet interventions for adult illicit substance users: a meta‐analysis. Addiction2017;112(9):1521–1532.
37.
KrishnanA, CraveroC.A multipronged evidence-based approach to implement mHealth for underserved HIV-infected populations. Mob Media Commun.2017;5(2):194–211.
38.
ThompsonMA, MugaveroMJ, AmicoKRGuidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel. Ann Intern Med.2012;156(11):817–833.
39.
NoarS.Computer technology-based interventions in HIV prevention: state of the evidence and future directions for research. AIDS Care.2011;23(5):525–533.
40.
LewisCF, LekasHM, RiveraAPharmacy PEP access intervention among persons who use drugs in New York City: iPEPcare study—rethinking biomedical HIV prevention strategies. AIDS Behav.2020;24(7):2101–2111.
41.
CrawfordND, AmestyS, RiveraAV, HarripersaudK, TurnerA, FullerCM.Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City. Am J Public Health.2013;103(9):1579–1582.
42.
CrawfordND, DeanT, RiveraAVPharmacy intervention to improve HIV testing uptake using a comprehensive health screening approach. Public Health Rep.2016;131(1_suppl):139–146.
43.
LewisCF, RiveraAV, CrawfordND, DeCuirJ, AmestyS.Pharmacy-randomized intervention delivering HIV prevention services during the syringe sale to people who inject drugs in New York City. Drug Alcohol Depend.2015;153:72–77.
StrandMA, BratbergJ, EukelH, HardyM, WilliamsC.Community pharmacists’ contributions to disease management during the COVID-19 pandemic. Prev Chronic Dis2020;17.
46.
GoodeJV, OwenJ, PageA, GatewoodS.Community-based pharmacy practice innovation and the role of the community-based pharmacist practitioner in the United States. Pharmacy2019;7(3):106.
