HRJ

official impact factor 1.46

Open Access Research

Giving away used injection equipment: missed prevention message?

Carol Strike1,2*, Daniel Z Buchman1, Russell C Callaghan1,2, Cass Wender3, Susan Anstice4, Brian Lester5, Nick Scrivo5, Janine Luce1 and Margaret Millson2

Author Affiliations

1 Centre for Addiction and Mental Health, 33 Russell Street, Toronto, Ontario Canada

2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario Canada

3 My Sisters' Place - Transitional Support Centre for Women who are Homeless or at Risk of Homelessness, London, ON, Canada

4 Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario Canada

5 Counterpoint Needle Exchange, AIDS Committee of London, London, Ontario, Canada

For all author emails, please log on.

Harm Reduction Journal 2010, 7:2 doi:10.1186/1477-7517-7-2

Published: 9 February 2010

Abstract

Background

Our objective was to examine factors associated with distributive injection equipment sharing and how needle exchange programs (NEPs) can help reduce distributive sharing among injection drug users (IDUs).

Methods

145 English speaking Canadian IDUs ages 16 years and over who had injected in the past 30 days were recruited for a cross-sectional survey. Participants were asked about their socio-demographic characteristics, HIV risk behaviours, social support, drug treatment readiness, program satisfaction, health and social service use and NEP drug use. Bivariate statistics and logistic regression were used to characterize the population and examine correlates of sharing behaviour.

Results

More IDUs reported distributive sharing of cookers (45%) than needles (36%) or other types of equipment (water 36%; filters 29%; swabs 8%). Regression analyses revealed the following factors associated with distributing used cookers: a history of cocaine/crack injection, an Addiction Severity Index (ASI) score indicative of a mental health problem, and older than 30 years of age. Factors associated with giving away used water included: male, injected methadone, injected other stimulants and moved 3+ times in the past 6 months. Factors associated with giving away used filters included: injected cocaine/crack or stayed overnight on the street or other public place. Factors associated with giving away swabs included: an ASI mental health score indicative of a mental health problem, and HCV negative status.

Conclusions

Our findings show that more IDUs give away cookers than needles or other injection equipment. While the results showed that correlates of sharing differed by piece of equipment, each point to distributive sharing by the most marginalized IDUs. Targeting prevention efforts to reduce equipment sharing in general, and cookers in particular is warranted to reduce use of contaminated equipment and viral transmission.