Syringe Coverage in an Australian Setting: Does a High Level of Syringe Coverage Moderate Syringe Sharing Behaviour?

Abstract

We examined individual-level syringe coverage among 417 people who inject drugs who were recruited from pharmacies in New South Wales in 2009. There was a U-shaped distribution of syringe coverage with many people having very high (51%) or very low (23%) coverage. Overall, two-thirds of respondents (63%) reported adequate coverage (≥ 100%). Respondents who had not used a needle and syringe program in the previous month were more likely to report inadequate coverage (AOR 2.25, 95% CI 1.25-4.05) as were those who reported daily or more frequent injecting (AOR 3.69, 95% CI 2.00-6.81). Inadequate syringe coverage was not independently associated with receptive needle sharing. The level of syringe coverage was high among this sample, and met targets set out by UNAIDS and other organisations. We found that inadequate syringe coverage was not independently correlated with receptive needle sharing, possibly because coverage is sufficient to diminish the relationship between syringe availability and sharing behaviours.

Individual-level needle and syringe coverage in Melbourne, Australia: a longitudinal, descriptive analysis

“…The coverage achieved by NSPs at the population level refers to the proportion of PWID reached by services. At the individual level, coverage is typically defined as the proportion of a PWID’s injecting episodes that utilise a sterile syringe [2]. …”

“…Service management and funding [7], dispensation policy [8], intensive policing practices [1, 9], cohesiveness of PWID networks [2], spatial service access [10], and individual demographics [11, 12] influence the ability of individuals to attain sufficient syringes and service systems to provide sufficient coverage.…”

“…Previous research has shown that insufficient coverage at the individual level is significantly associated with high-frequency injecting and not using NSPs as a primary source of syringe acquisition [2]. Insufficient individual-level coverage has also been associated with syringe re-use and receptive/distributive syringe sharing [11–13].…”

Characteristics and attendance patterns of a fixed-site NSP and nearby SVM: The benefits of 24-hour access to sterile injecting equipment

“…NSPs have formed an important public health measure since the 1980s, aiming to reduce the harms associated with injecting drug use through provision of sterile injecting equipment, access to safe disposal facilities, education and information, and referral to treatment and other health services. In Australia, over 3000 outlets for obtaining injecting equipment have been instated, with national syringe coverage exceeding international standards (Bryant, Paquette, & Wilson, 2012;Mathers et al, 2010). An estimated 96,667 cases of hepatitis C and 32,050 cases of HIV have been averted between 2000 and 2009 as a direct result of NSPs (National Centre in HIV Epidemiology and Clinical Research [NCHECR], 2009), and AUD$70-220 million saved in health costs associated with hepatitis C and HIV (Kwon et al, 2012).…”

Perceived discrimination and injecting risk among people who inject drugs attending Needle and Syringe Programmes in Sydney, Australia

“…Findings from this study shed light on the continued sharing of unsterile injecting equipment even in areas where access to sterile equipment is good. Recent Australian research found no independent relationships between inadequate syringe coverage and receptive equipment sharing (Bryant et al, 2012) indicating that other factors contribute to injecting risk practices. The data further suggest that continued sharing of injecting equipment, especially in the case of being injected by some else, may be indicative of a range of other personal or social factors that may be involved in sharing practices, rather than a lack of access to equipment.…”