RT Journal Article
SR Electronic
T1 Unsafe injection practices in a cohort of injection drug users in Vancouver: Could safer injecting rooms help?
JF Canadian Medical Association Journal
JO CMAJ
FD Canadian Medical Association
SP 405
OP 410
VO 165
IS 4
A1 Wood, Evan
A1 Tyndall, Mark W.
A1 Spittal, Patricia M.
A1 Li, Kathy
A1 Kerr, Thomas
A1 Hogg, Robert S.
A1 Montaner, Julio S.G.
A1 O'Shaughnessy, Michael V.
A1 Schechter, Martin T.
YR 2001
UL http://www.cmaj.ca/content/165/4/405.abstract
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.