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Injecting Equipment (injecting + equipment)
Selected AbstractsInjecting risk behaviour and related harm among men who use performance- and image-enhancing drugsDRUG AND ALCOHOL REVIEW, Issue 6 2008BRIONY LARANCE Abstract Introduction and Aims. Performance- and image-enhancing drugs have the potential to be a significant public health issue. Detailed data on PIEDs injection are difficult to obtain because of the illicit and unsupervised way in which many PIEDs are used, and the hidden nature of the group. Our study examines the patterns of use, risk behaviours and related harm associated with PIEDs injection. We also report the ways in which PIEDs users currently seek injecting equipment and harm-reduction advice. Design and Method. Data were obtained via a structured questionnaire administered in face-to-face interviews with 60 men who used PIEDs (primarily anabolic androgenic steroids) for non-medical purposes. Results. Although the rates of needle sharing were low (5%), the men more frequently reported re-use of needles/equipment, injecting from a shared container (bladders, vials, etc.), injecting other illicit drugs, injecting insulin and targeting small muscle groups. Self-reports of being hepatitis C antibody positive were associated with lifetime use of heroin and injection of other illicit drugs. All HIV positive participants were gay/bisexual men. Participants reported a range of other injection-related injuries and diseases such as fevers, scarring and abscesses. ,Risky' injectors (38% of participants) were more likely to initiate PIEDs use at a younger age, use PIEDs in a larger number of cycles per year and report involvement in a violent/aggressive incident than ,low risk' injectors and report involvement in a violent/aggressive incident than ,low risk' injectors. Participants mainly reported seeking information about PIEDs from internet sites (62%) and friends (55%). Conclusions. An over-reliance on personal networks and internet forums limits this groups' access to objective harm reduction advice and primary care services. Targeted, PIEDs-specific interventions are needed. [source] Client satisfaction and risk behaviours of the users of syringe dispensing machines: a pilot studyDRUG AND ALCOHOL REVIEW, Issue 1 2008MD MOFIZUL ISLAM MSc Abstract Introduction and Aims. The study examines risk behaviours of the users of syringe dispensing machines (SDMs) and evaluates the usefulness of these machines in providing injecting drug users (IDUs) with sterile injecting equipment. Design and Methods. Self-administered questionnaires were used among users of SDMs in an Area Health Service of Sydney. Results. The majority of the 167 participants reported being happy with the quality of the SDM services. Problems identified with machines were that they were often broken or jammed (32.8% respondents), not in the right place (21.9%) or require money (16.7%). Just over half (50.9%) of the IDUs use SDMs only from 5 p.m. to 9 a.m., the time when almost all other outlets for accessing sterile injecting equipment remain closed. Relatively young IDUs (age , 30 years) were more likely to prefer SDMs over staffed needle syringe programmes (NSPs) compared with older users (age > 30) and to identify stigma (a desire to hide their identity or not liking the way people treat them at staffed NSPs or chemists) as a main reason for using these machines. Primary users of SDMs do not differ from primary users of NSP/chemists in terms of sharing of needles. Those users who had shared in the last month were nearly four times as likely to have never used condoms in sexual encounters over that period (95% confidence interval: 1.2,14.5). Discussion and Conclusion. SDMs appear to complement other outlets of NSPs. Providing free-of-cost equipment from SDMs should be considered carefully, as needing money to buy equipment was a reason given for sharing of needles by 35% of those who shared. [source] Evidence for the effectiveness of sterile injecting equipment provision in preventing hepatitis C and human immunodeficiency virus transmission among injecting drug users: a review of reviewsADDICTION, Issue 5 2010Norah Palmateer ABSTRACT Aims To review the evidence on the effectiveness of harm reduction interventions involving the provision of sterile injecting equipment in the prevention of hepatitis C virus (HCV) and human immunodeficiency virus (HIV) transmission among injecting drug users (IDUs). The interventions assessed were needle and syringe programmes (NSP), alternative modes of needle/syringe provision (pharmacies, vending machines and outreach) and the provision of injecting equipment other than needles/syringes. Methods Systematic searches of the English language literature to March 2007 were undertaken to identify systematic, narrative or meta-analytical reviews (also known as a review of reviews) of the impact of interventions on HCV transmission, HIV transmission or injecting risk behaviour (IRB). Critical appraisal criteria classified the reviews as either high quality (,core') or supplementary: a framework based on the quality of reviews, the reviewers' conclusions and the designs/findings of the primary studies was used to derive evidence statements. Results Three core and two supplementary reviews of injecting equipment interventions were identified. According to the proposed framework, this study found (a) insufficient evidence to conclude that any of the interventions are effective in preventing HCV transmission; (b) tentative evidence to support the effectiveness of NSP in preventing HIV transmission; (c) sufficient evidence to support the effectiveness of NSP (and tentative evidence of an additional impact of pharmacy NSP) in reducing self-reported IRB; and (d) little to no evidence on vending machines, outreach or providing other injecting equipment in relation to any of the outcomes. Conclusions The evidence is weaker than given credit for in the literature. The lack of evidence for effectiveness of NSP vis-à-vis biological outcomes (HCV and HIV incidence/prevalence) reflects the limitations of studies that have been undertaken to investigate these associations. Particularly for HCV, low levels of IRB may be insufficient to reduce high levels of transmission. New studies are required to identify the intervention coverage necessary to achieve sustained changes in blood-borne virus transmission. [source] Estimating population attributable risk for hepatitis C seroconversion in injecting drug users in Australia: implications for prevention policy and planningADDICTION, Issue 12 2009Handan Wand ABSTRACT Objective To determine risk factors and estimate their population-level contribution to hepatitis C virus (HCV) burden. Methods Established and potentially modifiable risk factors were estimated using partial population attributable risk (PARp) in a cohort of new injecting drug users (IDUs) in Sydney, Australia. Results A total of 204 hepatitis C seronegative IDUs were recruited through street-based outreach, methadone clinics and needle and syringe programmes (NSPs) and followed-up at 3,6-monthly intervals. A total of 61 HCV seroconversions were observed during the follow-up [overall incidence rate of 45.8 per 100 person-years (95% confidence interval: 35.6,58.8)]. Overall, five potentially modifiable risk factors (sharing needles/syringes, sharing other injecting equipment, assisted injecting, frequency of injection and not being in drug treatment) accounted for approximately 50% of HCV cases observed. Conclusion While sharing needles/syringes or other injecting equipment were associated most strongly with increased risk of HCV infection, the PARp associated with these behaviours was relatively modest (12%) because they are relatively low-prevalence behaviours. Our analyses suggest that more HCV infection could be avoided by changing more common, but less strongly associated behaviours such as assisted injecting or daily injecting. Results suggest that to have a very substantial effect on HCV, a range of risk factors need modifying. The most efficient use of scarce resources in reducing HCV infections will require complex balancing between the PAR for a given risk factor(s), the efficacy of interventions to actually modify the risk factor, and the cost of these interventions. [source] The National Treatment Outcome Research Study (NTORS): 4,5 year follow-up resultsADDICTION, Issue 3 2003Michael Gossop ABSTRACT Aims ,The National Treatment Outcome Research Study (NTORS) is the first prospective national study of treatment outcome among drug misusers in the United Kingdom. NTORS investigates outcomes for drug misusers treated in existing services in residential and community settings. Design, setting and participants,The study used a longitudinal, prospective cohort design. Data were collected by structured interviews at intake to treatment, 1 year, 2 years and at 4,5 years. The sample comprised 418 patients from 54 agencies and four treatment modalities. Measurements, Measures were taken of illicit drug use, injecting and sharing injecting equipment, alcohol use, psychological health and crime. Findings, Rates of abstinence from illicit drugs increased after treatment among patients from both residential and community (methadone) programmes. Reductions were found for frequency of use of heroin, non-prescribed methadone, benzodiazepines, injecting and sharing of injecting equipment. For most variables, reductions were evident at 1 year with outcomes remaining at about the 1 year level or with further reductions. Crack cocaine and alcohol outcomes at 4,5 years were not significantly different from intake. Conclusions, Substantial reductions across a range of problem behaviours were found 4,5 years after patients were admitted to national treatment programmes delivered under day-to-day conditions. The less satisfactory outcomes for heavy drinking and use of crack cocaine suggest the need for services to be modified to tackle these problems more effectively. Despite differences between the United Kingdom and the United States in patient populations and in treatment programmes, there are many similarities between the two countries in outcomes from large-scale, multi-site studies. [source] Risk behaviours of young Indo-Chinese injecting drug users in Sydney and MelbourneAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 1 2001Lisa Maher Objective: To investigate patterns of drug use and injection-related risk behaviours among young Indo-Chinese injecting drug users (IDUs). Method: Cross-sectional survey. A structured questionnaire was administered to 184 Indo-Chinese IDUs aged 15 to 24 in Sydney and Melbourne. Participants were recruited using snowball sampling techniques; measures included patterns of heroin and other drug use, injection-related risk behaviours, perceived susceptibility to HIV and HCV infection and access to services. Results: Despite perceived high availability of sterile injecting equipment, 36% had ever shared a needle and syringe and 22% had done so in the preceding month. Lifetime sharing was significantly associated with duration of injecting, history of incarceration and residence in Sydney. Sharing of injecting paraphernalia other than needles and syringes was also common, with young women and Sydney residents significantly more likely to report sharing equipment in the preceding month. Conclusions: Young Indo-Chinese IDUs are at high risk of infection with hepatitis C and other blood-borne viruses. Results indicate an urgent need for culturally appropriate and sustainable risk reduction programs which specifically target this population. Implications: Health services must respond swiftly to implement effective blood-borne virus prevention programs for young Indo-Chinese IDUs. Failure to do so may sustain the current epidemic of hepatitis C among IDUs. [source] | ||||||||||