Use of supervised injection facilities and injection risk behaviours among young drug injectors

Bravo, María J.; Royuela, Luis; Fuente, Luís de la; Brugal, M. Teresa; Barrio, Gregorio; Domingo‐Salvany, Antònia

doi:10.1111/j.1360-0443.2008.02474.x

Cited by 58 publications

(47 citation statements)

References 14 publications

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“…The prevalence of HIV infection is higher than that observed in previous studies in Spain [5,32] , although it is consistent with that observed among IDUs admitted for treatment of drug abuse or dependency in 2005 (32.7%) [33] and that observed in young injectors recruited in Madrid and Barcelona (31.7%) [34] . The differences between the studies are due in part to the different methodological approaches and the different populations recruited in each case.…”

Section: Discussioncontrasting

confidence: 50%

Sexually Transmitted Infections and Sexual Practices among Injecting Drug Users in Harm Reduction Centers in Catalonia

Folch

Casabona

Brugal³

et al. 2011

Eur Addict Res

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Background: The objectives of the study were to estimate the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae and sexual risk practices, and to identify factors associated with infection by C. trachomatis/N. gonorrhoeae. Methods: Injecting drug users were interviewed at harm reduction centers and biological samples were collected to estimate the prevalence of C. trachomatis and N. gonorrhoeae. Results: The prevalence of C. trachomatis was 2.3%, and this was higher among immigrants (3.6%); the prevalence of N. gonorrhoeae was 0.7% (no differences between Spanish-born and immigrants). Respondents aged ≤25 years had a higher risk of sexually transmitted infections (STIs) (OR 3.39), as did women (OR 3.08). Also associated with having an STI were not having registered employment (OR 4.70), injecting drugs daily (OR 4.21), and having unprotected sex with a stable partner (OR 3.37). Conclusion: Although the prevalence of STIs observed is low, scant condom use makes it necessary for prevention programs to include messages related to sexual risk practices, especially among young people and women.

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Section: Discussioncontrasting

confidence: 50%

Sexually Transmitted Infections and Sexual Practices among Injecting Drug Users in Harm Reduction Centers in Catalonia

Folch

Casabona

Brugal³

et al. 2011

Eur Addict Res

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“…These behavioural changes relate to PWID needle sharing behaviour outside of the SIF. Kerr et al [13] and Bravo et al [33] found that PWID who used the Vancouver SIF also reduced their needle-sharing activities significantly outside of Insite, with an odd ratio of 0.30. This has been incorporated into a number of cost-benefit and cost-effectiveness analyses for SIFs [8,14,15,18,28].…”

Section: Introductionmentioning

confidence: 99%

“…This has been incorporated into a number of cost-benefit and cost-effectiveness analyses for SIFs [8,14,15,18,28]. Because of its widespread use for Insite, and its empirical evidence [13,33] we incorporate such behavioural change for Ottawa in the analyses below.…”

Section: Introductionmentioning

confidence: 99%

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada

Jozaghi

Reid

Andresen

et al. 2014

Subst Abuse Treat Prev Policy

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BackgroundSupervised injection facilities (SIFs) are venues where people who inject drugs (PWID) have access to a clean and medically supervised environment in which they can safely inject their own illicit drugs. There is currently only one legal SIF in North America: Insite in Vancouver, British Columbia, Canada. The responses and feedback generated by the evaluations of Insite in Vancouver have been overwhelmingly positive. This study assesses whether the above mentioned facility in the Downtown Eastside of Vancouver needs to be expanded to other locations, more specifically that of Canada’s capital city, Ottawa.MethodsThe current study is aimed at contributing to the existing literature on health policy by conducting cost-benefit and cost-effective analyses for the opening of SIFs in Ottawa, Ontario. In particular, the costs of operating numerous SIFs in Ottawa was compared to the savings incurred; this was done after accounting for the prevention of new HIV and Hepatitis C (HCV) infections. To ensure accuracy, two distinct mathematical models and a sensitivity analysis were employed.ResultsThe sensitivity analyses conducted with the models reveals the potential for SIFs in Ottawa to be a fiscally responsible harm reduction strategy for the prevention of HCV cases – when considered independently. With a baseline sharing rate of 19%, the cumulative annual cost model supported the establishment of two SIFs and the marginal annual cost model supported the establishment of a single SIF. More often, the prevention of HIV or HCV alone were not sufficient to justify the establishment cost-effectiveness; rather, only when both HIV and HCV are considered does sufficient economic support became apparent.ConclusionsFunded supervised injection facilities in Ottawa appear to be an efficient and effective use of financial resources in the public health domain.

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“…Nevertheless, during the study period neither city had a naloxone distribution program, nor were there systematic measures for overdose prevention. On the other hand, both cities had supervised injection facilities, and although there are more of these facilities in Barcelona, it seems unlikely that this would have an impact on mortality [30]. We observed no difference between the two cities in the prevalence of drug use in solitary [18].…”

Section: Discussionmentioning

confidence: 75%

Lethality of Opioid Overdose in a Community Cohort of Young Heroin Users

Espelt¹,

Barrio

Álamo-Junquera

et al. 2015

Eur Addict Res

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Background: The aim of the study was to estimate the lethality of opioid overdose among young heroin users. Methods: A prospective community cohort study was conducted in Barcelona and Madrid, Spain. Participants included 791 heroin users aged 18-30 years who were followed up between 2001 and 2006. Fatal overdoses were identified by record linkage of the cohort with the general mortality register, while non-fatal overdoses were self-reported at baseline and follow-up interviews. The person-years (py) at risk were computed for each participant. Fatal and non-fatal overdose rates were estimated by city. Transition towards injection shortly before the overdose could not be measured. Overdose lethality (rate of fatal overdose in proportion to total overdose) and its 95% CI was estimated using Bayesian models. Results: The adjusted rates of fatal and non-fatal opioid overdose were 0.7/100 py (95% CI: 0.4-1.1) and 15.8/100 py (95% CI: 14.3-17.6), respectively. The adjusted lethality was 4.2% (95% CI: 2.5-6.5). Conclusions: Four out of 100 opioid overdoses are fatal. These are preventable deaths that could be avoided before or after the overdose takes place. Resources are urgently needed to prevent fatal opioid overdose.

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Use of supervised injection facilities and injection risk behaviours among young drug injectors

Abstract: SIFs attract highly disadvantaged drug injectors who engage none the less in less borrowing of used syringes than non-users of these facilities. The risks of indirect sharing should be emphasized when counselling SIF attendees.

Cited by 58 publications

References 14 publications

Sexually Transmitted Infections and Sexual Practices among Injecting Drug Users in Harm Reduction Centers in Catalonia

Sexually Transmitted Infections and Sexual Practices among Injecting Drug Users in Harm Reduction Centers in Catalonia

A cost-benefit/cost-effectiveness analysis of proposed supervised injection facilities in Ottawa, Canada

Lethality of Opioid Overdose in a Community Cohort of Young Heroin Users

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