Factors Associated with Syringe Sharing Among Users of a Medically Supervised Safer Injecting Facility

Abstract

Vancouver, Canada recently opened a medically supervised safer injecting facility (SIF) in an effort to reduce HIV and overdose risk and public injection drug use. We sought to examine factors associated with syringe sharing among SIF users. SIF users were randomly recruited into a prospective cohort of SIF users known as the Scientific Evaluation of Supervised Injecting (SEOSI) cohort. We examined the prevalence and correlates of used syringe borrowing among baseline HIV-negative participants and used syringe lending among baseline HIV-infected participants. Between 22 March 2004 and 22 October 2004, 479 baseline HIV-negative subjects (48 [10%] syringe borrowing events) and 103 baseline HIV-infected participants (17 [16.5%] syringe lending events) were recruited into the cohort. For baseline HIV negative participants, syringe borrowing was positively associated with public drug use (p<0.001) and requiring help injecting (p=0.001), whereas exclusive SIF use was inversely associated with syringe sharing (p=0.019). For baseline HIV-infected participants, syringe lending was positively associated with daily cocaine injection (p=0.022) and shooting gallery use (p=0.007). Although ongoing injection-related HIV risk behavior was reported among some SIF users, rates of syringe sharing were substantially lower than the rate observed previously in this community and it is noteworthy that exclusive SIF use was associated with reduced syringe sharing.

The social impact in a high-risk community: A cellular automata model

“…In communities centred on the consumption of illicit drugs, high and low-risk behavioral drug consumption patterns can be spread because of tight social connections within these communities. The transmission of HIV through needle sharing serves as a primary example of these social connections where disease transmission can occur as a result of social interactions between users in a community [1,31].…”

“…This type of modelling is rarely used in the field of criminology, yet this method of analyzing complex and dynamic situations is extremely applicable to this field of study [1,2,12,17,30]. The dynamic social behaviors associated with crime and drug use can be successfully represented in a CA model and improve our understanding of the social and related processes tied to the aetiology of disease transmission, drug addiction patterns and behavior modification among the individuals in a high-risk population [1,31].…”

Risk Factors for Nonfatal Overdose at Seattle-Area Syringe Exchanges

“…8,[26][27][28] Other studies have shown associations of syringe sharing with unstable housing 29,30 and public drug use. 31 Syringe sharing may be a marker for those who have more risky behaviors overall, rather than being causally related to overdose. The association between young age and overdose in multivariate Model 1 has been demonstrated in other studies.…”

Disparities in the Burden of HIV/AIDS in Canada

“…British Columbia stands alone in Canada, as the only jurisdiction showing a steady decline in the rate of HIV new diagnoses. These disparities maybe at least partially attributed to the greater expansion of HAART coverage in British Columbia, especially in the Vancouver Coastal Health Authority [25], as well as the implementation of other HIV prevention interventions, including novel harm reduction strategies aimed at IDUs [26], [27].…”