Level of education and injecting drug use among African Americans

Drawing upon a nationally representative survey sample of African American (AA) drug injectors and non-injectors, this study tests for a suspected cau sal association between dropping out of school and the occurrence of inject ing drug use (IDU), which remains a major cause of human immunodeficiency v irus (HIV) transmission in this population. The data are from public use fi les of the National Household Surveys on Drug Abuse (NHSDA) conducted betwe en 1991 and 1995. From within the NHSDA's nationally representative sample of adult household residents, a total of 389 AA adults with a history of ID U were matched on neighborhood of residence with 2253 AA adults with no his tory of IDU. The conditional form of multiple logistic regression was used to estimate the relative risk of having injected a drug for school dropouts relative to a reference category of AA who received the high school diplom a but did not go to college. AAs who dropped out of high school were an est imated two times more likely to have injected drugs. With statistical adjus tment for age, sex, and Hispanic background, the estimated association was 1.9 (95% confidence interval (C.I.)= 1.3-2.6, P < 0.001). Contrary to our a dvance hypothesis, earning the graduate equivalency certificate (GED) did n ot seem to affect the magnitude of excess risk for having started IDU (adju sted odds ratio (aOR) = 2.3, 95% C.I. = 1.4-3.8, P < 0.001). Hence, school dropout prevention might reduce the risk of IDU per se, in addition to the many other general benefits of educational attainment. The issue of GED-ass ociated reduced risk of IDU remains open for future study. (C) 1999 Elsevie r Science Ireland Ltd. All rights reserved.