The role of safer injection facilities in the response to HIV/AIDS among injection drug users

Kerr, Thomas; Kimber, Jo; DeBeck, Kora; Wood, Evan

doi:10.1007/s11904-007-0023-8

Cited by 48 publications

(29 citation statements)

References 47 publications

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“…These restrictions, in part, divert PWID to unsafe and unhygienic injecting locations within their community such as business bathrooms. Research also suggests that SIF/DCR are capable of successfully managing overdoses, reducing overdose deaths, reducing HIV/HCV risk behaviour, increase uptake of addiction treatment, reduce public injection and public disorder while not increasing drug injection initiation, community drug use, or drug related crime and being cost-effective (Andresen & Boyd, 2010; DeBeck et al, 2011; Freeman et al, 2005; Kerr, Kimber, DeBeck, & Wood, 2007; Kerr et al, 2006; Kerr, Tyndall, Li, Montaner, & Wood, 2005; Kerr, Tyndall et al, 2007; Marshall, Milloy, Wood, Montaner, & Kerr, 2011; Petrar et al, 2007; Salmon, Thein, Kimber, Kaldor, & Maher, 2007; Small, Van Borek, Fairbairn, Wood, & Kerr, 2009; Stoltz et al, 2007; Wood et al, 2004; Wood, Tyndall, Lai, Montaner, & Kerr, 2006; Wood, Tyndall, Zhang, Montaner, & Kerr, 2007; Wood, Tyndall, Zhang et al, 2006). Supervised injection facilities and drug consumption rooms also have the ability to reduce both public injection and improperly disposed syringe sightings as reported by researchers, local residents, and business managers in Vancouver, BC, Canada and Sydney, NSW, Australia making this intervention worthy of further investigation in addition to the education and training of managers in overdose recognition and naloxone use (Petrar et al, 2007; Salmon et al, 2007; Stoltz et al, 2007; Wood et al, 2004).…”

Section: Discussionmentioning

confidence: 99%

Drug use in business bathrooms: An exploratory study of manager encounters in New York City

Wolfson‐Stofko

Bennett

Elliott

et al. 2017

International Journal of Drug Policy

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Background Though public bathroom drug injection has been documented from the perspective of people who inject drugs, no research has explored the experiences of the business managers who oversee their business bathrooms and respond to drug use. These managers, by default, are first-responders in the event of a drug overdose and thus of intrinsic interest during the current epidemic of opioid-related overdoses in the United States. This exploratory study assists in elucidating the experiences that New York City business managers have with people who inject drugs, their paraphernalia, and their overdoses. Methods A survey instrument was designed to collect data on manager encounters with drug use occurring in their business bathrooms. Recruitment was guided by convenience and purposive approaches. Results More than half of managers interviewed (58%, n = 50/86) encountered drug use in their business bathrooms, more than a third (34%) of these managers also found syringes, and the vast majority (90%) of managers had received no overdose recognition or naloxone training. Seven managers encountered unresponsive individuals who required emergency assistance. Conclusion The results from this study underscore the need for additional research on the experiences that community stakeholders have with public injection as well as educational outreach efforts among business managers. This research also suggests that there is need for a national dialogue about potential interventions, including expanded overdose recognition and naloxone training and supervised injection facilities (SIF)/drug consumption rooms (DCR), that could reduce public injection and its associated health risks.

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Section: Discussionmentioning

confidence: 99%

Drug use in business bathrooms: An exploratory study of manager encounters in New York City

Wolfson‐Stofko

Bennett

Elliott

et al. 2017

International Journal of Drug Policy

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“…SIFs are sanctioned spaces where IDUs can inject pre-obtained illicit drugs under medical supervision [33]. Although the services of SIFs vary considerably, they typically provide IDUs with sterile syringes, emergency care in the event of an overdose, primary care services, and referral to addiction treatment [34].…”

Section: Supervised-injecting Facilitiesmentioning

confidence: 99%

“…SIFs have existed in more than two dozen European cities and more recently in Sydney, Australia, and Vancouver, Canada [34]. The literature on the effects of SIFs has been summarized previously [33], and the following section focuses mostly on SIFs in Vancouver, Canada.…”

Section: Supervised-injecting Facilitiesmentioning

confidence: 99%

HIV among injecting drug users: current epidemiology, biologic markers, respondent-driven sampling, and supervised-injection facilities

Jarlais

Arasteh

Semaan

et al. 2009

Current Opinion in HIV and AIDS

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Purpose of review To describe recent research done primarily during the past 12 months (i.e., primarily in 2008) on the epidemiology of HIV infection among injecting drug users (IDUs). Recent findings Major research developments include a global assessment of HIV infection among IDUs and evidence of a transition from epidemics concentrated among IDUs to generalized, heterosexual epidemics in eastern Europe and Asia. Intervention research also includes several studies of supervised-injecting facilities. Methodological research includes respondent-driven sampling and the use of hepatitis C virus and herpes simplex virus-2 as biomarkers for injecting and sexual risk. Summary There have been important advances in research during the past year, but HIV infection continues to spread rapidly across many areas of the world among IDUs and their nondrug-using sex partners.

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“…The current SIF, known to many Canadians as Insite, despite various restrictions, has proven effective in reducing injections in public, while lowering the rate of fatalities caused by overdose and infectious diseases [35, 36, 48, 74]. Moreover, Insite has not resulted in increased rates of crime, drug dealing, public injection, public syringe disposal, or public disorder around its vicinity [11, 16, 66].…”

Section: Discussionmentioning

confidence: 99%

“…This need to rely on others to help with injection has placed many users at increased risk of violence and drug related harm [47, 51]. Furthermore, there are numerous studies that indicate that drug users who require help injecting drugs, when compared to those who self-inject, are at greater risk of HIV and HCV infections as well as more prone to indulge in the harmful practices of needle sharing and drug overdose [35, 36, 43, 55, 57, 63, 76]. …”

Section: Introductionmentioning

confidence: 99%

Exploring the role of an unsanctioned, supervised peer driven injection facility in reducing HIV and hepatitis C infections in people that require assistance during injection

Jozaghi

2015

Health Justice

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BackgroundSupervised consumption rooms or supervised injection facilities (SIFs) are venues that have reduced the risk of needle sharing and deaths caused by drug overdose among people who inject drugs (PWID). As a result of such a decline in the mortality rate, numerous studies have been able to illustrate its cost-effectiveness. However, studies have neglected to examine the same phenomena for unsanctioned SIFs that are run by peer drug users and provide assisted injections.MethodsThe current study will determine whether the former unsanctioned SIF, that provided assisted injection and was operated by the grass root organization called Vancouver Area Network of Drug Users (VANDU), cost less than the health care consequences of not having such a program in Vancouver, Canada. By analyzing data gathered in 2013, this paper relies on two mathematical models to estimate the number of new HIV and HCV infections prevented by the former unsanctioned facility in Vancouver’s Downtown Eastside.ResultsA conservative estimate indicates that the SIF location that provided assisted injections has a benefit-cost ratio of 33.1:1 due to its low operational cost. At the baseline sharing rate, the facility, on an average, reduced 81 HCV and 30 HIV cases among PWID each year. Such reductions in blood borne infections among PWID resulted in annual savings worth CAN$4.3 million dollars in health care expenditure. In addition to this, the current paper relies on a sensitivity analysis based on different needle sharing rate scenarios.ConclusionsThe sensitivity analysis and the baseline rates indicate that funding SIF facilities operated by peer drug users that facilitate assisted injection appear to be an efficient and effective use of financial resources in the public health domain since they lead to a significant decline in the rate of mortality within a vulnerable population.

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The role of safer injection facilities in the response to HIV/AIDS among injection drug users

Cited by 48 publications

References 47 publications

Drug use in business bathrooms: An exploratory study of manager encounters in New York City

Drug use in business bathrooms: An exploratory study of manager encounters in New York City

HIV among injecting drug users: current epidemiology, biologic markers, respondent-driven sampling, and supervised-injection facilities

Exploring the role of an unsanctioned, supervised peer driven injection facility in reducing HIV and hepatitis C infections in people that require assistance during injection

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