HIV prevalence and risk behaviour in needle exchange attenders: a national study

Abstract

Objective: To determine whether needle and syringe exchange programs represent feasible sites to describe the prevalence of HIV and related risk behaviour among injecting drug users. Design: Cross-sectional survey. Setting: 21 needle and syringe exchange programs in all Australian jurisdictions. Participants: All persons attending the needle and syringe exchange programs over one week in March 1995 were eligible to participate in the study once. Intervention: Needle and syringe exchange attenders were asked to complete a brief, self-administered questionnaire and provide a finger-prick blood sample. Main outcome measures: Prevalence of HIV antibody, drug injecting and sexual behaviour, and survey cost. Results: Completed questionnaires with blood samples suitable for testing were provided by 1005 (42%) of 2373 individuals who attended the needle and syringe exchange programs during the survey week. Women were more likely than men to participate in the survey but there was no difference in the response rate by age group. The HIV prevalence was 2.1% and was significantly higher in men who described themselves as homosexual, compared to men who described themselves as heterosexual (22.5% v. 0.7%; P<0.001). Thirty-one per cent of respondents reported using a syringe after someone else in the preceding month. Conclusion: Cross-sectional surveys of needle exchange clients offer a practical method for monitoring risk behaviour and seroprevalence of bloodborne viral infections.

Knowledge and Attitudes about Treatment for Hepatitis C Virus Infection and Barriers to Treatment among Current Injection Drug Users in Australia

“…First, the study population was from 2 inner Sydney sites; therefore, the results may not be representative of other populations of current IDUs in Australia. However, the demographic profile of the study population is similar to much larger current IDU survey populations [10,11]. Second, HCV-positive status was self reported.…”

A Longitudinal Study of Syringe Acquisition by Puerto Rican Injection Drug Users in New York and Puerto Rico: Implications for Syringe Exchange and Distribution Programs

“…In an effort to prevent the transmission of HIV, HCV, and other blood-borne pathogens, diverse strategies have been employed to increase injection drug users' (IDUs') access to sterile syringes, including mobile and fixed syringe exchange programs (SEPs) (Paone et al, 1999;Heimer et al, 1998;Hurley et al, 1997;MacDonald et al, 1997;Normand et al, 1995;Lurie et al, 1993), pharmacy sale of nonprescription syringes (Klein et al, 2001;Gleghorn et al, 1998;Singer et al, 1998;Weinstein et al, 1998;Gund et al, 1995;Valleroy et al, 1995), prescription of syringes by physicians (Rich et al, 2001), needle vending machines (Obadia et al, 1999), and mass distribution (see Coffin, 2000, for a review of syringe exchange modalities). In the face of political pressure and controversy, which is especially acute in the United States, researchers throughout the world continue to evaluate the effectiveness of different syringe exchange and distribution modalities, and to identify new strategies for increasing IDUs' access to sterile syringes.…”

Can drug injectors be encouraged to adopt non‐injecting routes of administration (NIROA) for drugs?

“…Drug injecting is the main route of hepatitis C transmission in Australia [1]. In 2001 there were approximately 16 000 new cases of hepatitis C infection in Australia [2].…”