Health trends among drug users attending needle exchange programmes in Switzerland (1994–2000)

Benninghoff, Fabienne; Martineau, Patrick; Geense, R.; Huissoud, Thérèse; Dubois-Arber, Françoise

doi:10.1080/09540120500429018

Cited by 9 publications

(17 citation statements)

References 33 publications

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“…These findings are in line with previously available data from the Swiss Federal Office of Public Health and the SWISS HIV Cohort Study [19,24,26] and underline the effectiveness of measures that have been taken since HIV/AIDS became a major public health concern in the context of open drug scenes that developed in Switzerland’s largest cities in the early 1980s. Between 1985 and 1995, HIV/AIDS incidence and prevalence rates were the highest in Europe [56,57].…”

Section: Discussionsupporting

confidence: 90%

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Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Liebrenz

Stohler²,

Nordt³

2014

Harm Reduction Journal

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BackgroundWe have sought to identify ethnic- and gender-specific differences in HIV prevalence among heroin users receiving opioid maintenance treatment in the canton of Zurich, Switzerland.MethodsWe used a generalized linear model (GEE) to analyze data from the anonymized case register for all opioid maintenance treatments in the canton of Zurich. Patients who received either methadone or buprenorphine between 1991 and 2012 (n = 11,422) were evaluated for gender (male vs. female), ethnic background (Swiss vs. non-Swiss), and lifetime method of drug use (ever injector vs. non-injector). We addressed missing data by multiple imputation.ResultsThe overall prevalence of HIV among patients declined substantially from 33.7% in 1991 to 10.6% in 2012 in the complete dataset. In the imputed datasets, the respective prevalence dropped from 32.8% in 1991 to 9.7% in 2012. Non-injectors had a four to five times lower risk ratio (RR) compared to the reference group, ‘Swiss males who ever injected’. In addition, we found a significantly higher risk ratio of HIV prevalence among females who had ever injected; this was true both for the complete dataset and the imputed dataset (Swiss RR 1.18 CI 95% 1.04–1.34, non-Swiss RR 1.58 CI 95% 1.18–2.12).ConclusionIn this population, gender, ethnic background, and lifetime method of drug use influenced the risk of being HIV positive. Different access to treatment and different characteristics of risk exposure among certain subgroups might explain these findings. In particular, the higher risk for women who inject drugs—especially for those with an immigrant background—warrants additional research. Further exploration should identify what factors deter women from using available HIV-prevention measures and whether and how these measures can be better adapted to high-risk groups.

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Section: Discussionsupporting

confidence: 90%

“…These data resulted from cross-sectional surveys conducted in 1993, 1994, 1996, 2000, and 2006 by means of questionnaires distributed to IDUs in LTFs in ten different cantons in Switzerland [24]. It is thereby estimated that over half of IDUs frequenting LTFs simultaneously receive OMT [23].…”

Section: Introductionmentioning

confidence: 99%

Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Liebrenz

Stohler²,

Nordt³

2014

Harm Reduction Journal

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“…Recent evidence shows that receptive (taking used needles from someone else) and distributive (giving used needles to someone else) sharing among IDUs has declined [3-7]. However, there are also risks associated with re-using drug injection equipment such as cookers, water, filters and alcohol swabs [8-13].…”

Section: Introductionmentioning

confidence: 99%

“…Many studies do not inquire about each piece of equipment independently and/or distinguish between receptive, distributive or communal equipment sharing (i.e., using a communal set of equipment to mix and apportion a drug solution to more than one person) [12]. This is important because evidence suggests that IDUs are more likely to report equipment sharing than needle sharing [3,7,14]. As well, some studies report that IDUs are more likely to distribute than receive used injection equipment [6,7].…”

Section: Introductionmentioning

confidence: 99%

Giving away used injection equipment: missed prevention message?

et al. 2010

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BackgroundOur 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).Methods145 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.ResultsMore 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.ConclusionsOur 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.

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“…The 'newcomers' and the 'heroin-oriented clients' were significantly younger, as expected, heroin still being the first drug injected in Switzerland at the beginning of the injection career [31] . One-day visitors were most frequently in treatment, and newcomers less, as also expected.…”

Section: Discussionmentioning

confidence: 82%

Typology of Injection Profiles of Clients of a Supervised Drug Consumption Facility in Geneva, Switzerland

Dubois-Arber¹,

Benninghoff²,

Jeannin³

2008

Eur Addict Res

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The use of a supervised drug consumption room (DCR) in a newly established low threshold facility in Geneva, Switzerland, in 2002 is analyzed. Two sources of routine data were used: data collected at the first visit by any new client (entry questionnaire) which included some personal details, and data collected on the substances injected at each visit to the DCR. A typology of injection profiles was constructed. Overall, the mean number of injections and days of visits per client over the year was low and cocaine was the main substance injected. However, an important heterogeneity in the use of the DCR was found and five types of clients identified: 1-day clients; standard clients; heroin-oriented clients; high cocaine consumption clients, and newcomers. Typology was associated with some characteristics at the first visit and the drug consumption pattern in the month preceding the first visit was in accordance with the subsequent use of the DCR. This heterogeneity in the use of the DCR highlights the diverse roles of the DCRs in harm reduction.

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Health trends among drug users attending needle exchange programmes in Switzerland (1994–2000)

Cited by 9 publications

References 33 publications

Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Ethnic- and gender-specific differences in the prevalence of HIV among patients in opioid maintenance treatment—a case register analysis

Giving away used injection equipment: missed prevention message?

Typology of Injection Profiles of Clients of a Supervised Drug Consumption Facility in Geneva, Switzerland

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