Injecting behaviour and service use among young injectors in Albania, Moldova, Romania and Serbia

Abstract

Background: This study examines socio-demographic profiles, injecting risk, and use of health services among young injectors (15)(16)(17)(18)(19)(20)(21)(22)(23)(24) in Albania, Moldova, Romania, and Serbia. The objective was to provide age-disaggregated data to identify differences between adolescents (<18) and youth (18)(19)(20)(21)(22)(23)(24), and help fill the gap in knowledge on the youngest injectors in this region. Methods: Cross sectional surveys were conducted in each country using chain-referral sampling to reach diverse networks of people who use drugs (PWID). In Albania and Romania, surveys were conducted in the capitals, respectively Bucharest and Tirana. Respondents were recruited from 3 cities in Moldova (Chisinau, Balti and Tiraspol) and Serbia (Belgrade, Novi Sad and Nis). Data were collected on risk behaviours, service use, and contact with police and other authorities. Analysis focused on associations between unsafe injecting behaviour and key determinants including demographic background, source of needles/syringes, use of harm reduction services, and interactions with law enforcement. Results: Although drug use and health-seeking varied across settings, sources of injecting equipment were significantly associated with sharing needles and syringes in Moldova, Romania and Serbia. Obtaining equipment from formal sources (pharmacies, needle-exchange programmes) reduced likelihood of sharing significantly, while being stopped by the police or incarcerated increased it. Adolescents relied on pharmacies more than public sector services to obtain equipment. Conclusion: Adolescents comprise a small proportion of PWID in this region, but have poorer access to harm reduction services than older peers. Engaging young PWID through private and public sector outlets might reduce unsafe practices, while use of the justice system to address drug use complicates efforts to reach this population.

Reality and feasibility for pharmacy-delivered services for people who inject drugs in Xichang, China: Comparisons between pharmacy staff and people who inject drugs

“…These claims could also be concerns about the financial impact on business (Sheridan et al, 1997; Koester et al, 2002; Fuller et al, 2004; Janulis, 2011; Watson & Hughes, 2012; Zaller et al, 2012; Busza et al, 2013; Pollini et al, 2014). As services receivers, many PWID perceived discrimination, and felt uncomfortable when trying to buy a syringe at any pharmacy (55.1%), and worried about people knowing the reasons for their syringe buying (91.6%).…”

“…Pharmacies are considered as supplementary organization sources of obtaining sterile syringes (Busza et al, 2013). In the world, community pharmacies have been involved in providing services to PWID for many years (Glanz, Byrne, & Jackson, 1989; Sheridan et al, 1997; Myers et al, 1998; Matheson et al, 1999; Coffin et al, 2000; Koester et al,2002; Fuller et al,2004;Cooper et al, 2007; Mackridge&Scott., 2009; Rudolph et al,2010; Torre, Lucas&Barros, 2010; Janulis, 2011; Zaller et al, 2012; Crawford et al, 2013; Busza et al, 2013; Pollini et al, 2014; Rose et al, 2014). Pharmacies are seen as not only feasible in nonprescription syringes sales(NPSS) to PWID, but also as public health venues to provide HIV-testing and vaccination, educational material, coupon syringe program.…”

“…Lack of sufficient training for how to provide services to PWID was common. In addition, concerns about the financial impact on business were also barriers against effective services for PWID (Sheridan et al, 1997; Koester et al,2002; Fuller et al,2004;Janulis, 2011; Zaller et al, 2012;Busza et al, 2013; Pollini et al, 2014). With time, pharmacies have been involved in providing clean syringes as well as opiod substitution.…”

“…As services receivers, PWID have reported problems (such as declined, or asked for picture identification and/or prescription) in obtaining syringes from a pharmacy even when legally available (Koester et al,2002; Fuller et al,2004;Janulis, 2011; Zaller et al, 2012;Busza et al, 2013; Pollini et al, 2014). Pharmacists sold nonprescription syringes less frequently than they claimed( Zaller et al, 2012).…”

Global Epidemiology of HIV Among Women and Girls Who Use or Inject Drugs

“…Particularly vulnerable young people, such as street-based youth, may begin injecting in their early teenage years. 51,52 Young PWID have been observed to have higher levels of injecting-related HIV risk behaviors than their older counterparts. 53 There are very few sex-specific data regarding HIV prevalence among young PWID.…”