PT  - JOURNAL ARTICLE
AU  - Wood, Evan
AU  - Tyndall, Mark W.
AU  - Spittal, Patricia M.
AU  - Li, Kathy
AU  - Kerr, Thomas
AU  - Hogg, Robert S.
AU  - Montaner, Julio S.G.
AU  - O'Shaughnessy, Michael V.
AU  - Schechter, Martin T.
TI  - Unsafe injection practices in a cohort of injection drug users in Vancouver: Could safer injecting rooms help?
DP  - 2001 Aug 21
TA  - Canadian Medical Association Journal
PG  - 405--410
VI  - 165
IP  - 4
4099  - http://www.cmaj.ca/content/165/4/405.short
4100  - http://www.cmaj.ca/content/165/4/405.full
SO  - CMAJ2001 Aug 21; 165
AB  - Background: In several European countries safer injecting rooms have reduced the public disorder and health-related problems of injection drug use. We explored factors associated with needle-sharing practices that could potentially be alleviated by the availability of safer injecting rooms in Canada. Methods: The Vancouver Injection Drug User Study is a prospective cohort study of injection drug users (IDUs) that began in 1996. The analyses reported here were restricted to the 776 participants who reported actively injecting drugs in the 6 months before the most recent follow-up visit, during the period January 1999 to October 2000. Needle sharing was defined as either borrowing or lending a used needle in the 6-month period before the interview. Results: Overall, 214 (27.6%) of the participants reported sharing needles during the 6 months before follow-up; 106 (13.7%) injected drugs in public, and 581 (74.9%) reported injecting alone at least once. Variables independently associated with needle sharing in a multivariate analysis included difficulty getting sterile needles (adjusted odds ratio [OR] 2.7, 95% confidence interval [CI] 1.8–4.1), requiring help to inject drugs (adjusted OR 2.0, 95% CI 1.4–2.8), needle reuse (adjusted OR 1.8, 95% CI 1.3–2.6), frequent cocaine injection (adjusted OR 1.6, 95% CI 1.1–2.3) and frequent heroin injection (adjusted OR 1.5, 95% CI 1.04–2.1). Conversely, HIV-positive participants were less likely to share needles (adjusted OR 0.5, 95% CI 0.4–0.8), although 20.2% of the HIV-positive IDUs still reported sharing needles. Interpretation: Despite the availability of a large needle-exchange program and targeted law enforcement efforts in Vancouver, needle sharing remains an alarmingly common practice in our cohort. We identified a number of risk behaviours — difficulty getting sterile needles, needle sharing and reuse, injection of drugs in public and injecting alone (one of the main contributing causes of overdose) — that may be alleviated by the establishment of supervised safer injecting rooms.