The association between planning abilities and sharing injection drug use equipment among injection drug users in Baltimore, MD

Injection drug use continues to be a significant public health problem due to the association with HIV, Hepatitis C, and other infectious diseases. Harm reduction programmes aim to reduce sharing of injection equipment among injection drug users (IDUs). This study explored the association between performance on the Tower of London (TOL), a cognitive measure of planning ability, and the sharing of injection equipment among current IDUs. Data from 225 IDUs from the Baltimore NEURO-Study were used. Logistic regression analyses indicated that performance on the Total Moves Score of the TOL moderated the association between frequency of injection drug use and sharing of injection drug use equipment within the past 6 months. Findings suggest that impaired planning ability moderates the association between frequency of injection use and risky injection practices. Executive functioning abilities are potentially useful constructs to consider when developing harm reduction strategies.