No Turnning Back: A Integrated System Dynamics and Network Ecology View of Chinese Synthetic Drug Users’ Multiplex Network Formation, Maintanance, and Interaction
Jianghong Li, Hongyun Fu, Elizabeth Monk-Turner, Xiushi YangThe fast growing synthetic drug use epidemic in China poses a threat to the nation’s pulic health. Synthetic drug use is associated with multiple sex partners, high risk sexual haviors, and consequently, high risk of sexually transmied infection (STI) and HIV Transmission. Drug users’ risk networks include people who they have sex with, and those use various forms of sythetic drugs such as ice, pony/magu (meth, caffeine and other ingredients), Ketamine, ecastacy and traditional drugs such as heroin. Many evidences support that large and dense risk networks, high proportion of risk ties in social networks are associated with high level of STI/HIV risks. On contrary, strong social support network, adherence and retention in drug treatment are protective factors. However, there is a profound lack of understanding about how sociocultural context, policy, availability of services, and community conditions are associated with Chinese drug users’ risk and support networks’ formation and changing dynamics.
Since August 2016, a team of Sino-US researchers has been condcting a US NIH funded mixed method study in order to understand the causes and consequences of sythetic drug use in China. For the purpose of this presentation, we focus on data collected from Kunming City of Yunnan province. Thirty key informant interviews and twenty five drug user indepth interview transcriptions were selected for content analysis. We will present narrative illustration of the types of drugs being used, social contextual processes of drug use initiation, immedia effects, long term social and health concequenses of drug use, attempts to quite withou and without help with professionals. The nature of drug users’s social network and subnetworks such as drug using networks, sexual networks, and support network will be described. With systems dynamics modeling (SDM) approach, we developed a causal loop diagram (LCD) that sythesize the complex and interactive multilevel factors that shape the formation, maintainence, expansion, and disolution of each subnetworks, as well as overlaps and interactions among subnetworks. This LCD illustrated complex sytems include micro-level contextual factors such as cultural norms (toward social status, fashion, and risks), social acceptance, accessibility of drugs, drug control forces, availability of effective health education program, drug treatment and housing program, drug control forces, un-intended policy consequences such as street economy, comradeship among drug users, social segregation, crime involvement etc.. Micro-level contexual factors interact with processes of drug use initiation, use, consequences, quiting and relapse experiences, in determine over time change pattern of risk and support network size, stability, tie strength and types. The LCD model identifys several feedback loops that contribute the most in driving risk and support network evolution dynamics. We will also discuss methodological implications to network data collection and analysis.