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PubMed1997

Injecting-related harm and treatment-seeking behaviour among injecting drug users.

AIMS: This study aims to identify the physical harm associated with injecting drug use and examine the treatment-seeking behaviour of injecting drug users (IDUs). Specific attention is given to the factors associated with presentation and non-presentation of injecting-related problems. DESIGN: Participants were interviewed by research staff using a semi-structured questionnaire, then physically examined by a medical team. SETTING: Needles exchanges in Glasgow. PARTICIPANTS: One hundred and twelve injecting drug users. FINDINGS: Respondents' accounts of their current injecting-related problems were found to be consistent with the clinician's findings, suggesting that IDUs are able to self-diagnose injecting-related harm. However, almost three-quarters had not sought help for these problems. Qualitative data suggest the main reasons for non-presentation, or delayed presentation, of injecting-related problems are normalization of injecting-related harm and a reluctance to attend available services. Almost half of those seeking treatment for injecting-related problems did so during an emergency or crisis. CONCLUSIONS: Low threshold services, such as needle exchanges, may have to take a more proactive stance to encourage injectors to present with injecting-related problems. This may help reduce injecting-related harms, especially the resulting medical complications, which would in turn relieve the pressure on other services such as hospital Accident and Emergency Departments.

Abscess↗
PubMed1998

Hepatitis C virus antibody prevalence among injecting drug users in Glasgow has fallen but remains high.

Few data have been published on the prevalence of hepatitis C virus (HCV) among injecting drug users (IDUs) in the United Kingdom. This study compares the prevalence of antibody against HCV (anti-HCV) among IDUs in Glasgow in 1990 (when Glasgow's needle/syringe exchange programme had become established) with that in 1995. Serum left over from specimens taken for named HIV antibody testing was tested anonymously for anti-HCV. The prevalence of anti-HCV fell significantly between 1990 and 1995 among IDUs of all ages (90% to 77%), IDUs aged 15 to 19 years (92% to 29%), and IDUs aged 20 to 24 years (91% to 65%). This study suggests that the incidence of HCV infection among young IDUs fell in the early to mid 1990s, after the establishment of Glasgow's needle/syringe exchange scheme between 1988 and 1990. Since almost a third of injectors under 20 years of age when tested in 1995 had been infected with HCV, however, other interventions may be needed to prevent the spread of HCV in this high risk group.

Adolescent↗
PubMed1998

[Characteristics of attenders of low threshold syringe-exchange centers providing sterile syringes in Switzerland].

BACKGROUND: The objectives of the present study were to evaluate Aids prevention in drug users attending low threshold centres providing sterile injection equipment in Switzerland, to identify the characteristics of these users, and to monitor the progress of indicators of drug-related harm. METHODS: This paper presents results from a cross-sectional survey carried out in 1994. RESULTS: The mean age of attenders was 28 years, and women represented 27% of the sample. 75% of attenders used a combination of hard drugs (heroin and cocaine). Mean duration of heroin consumption was 8 years, and of cocaine 7 years; 76% of attenders had a fixed abode, but only 34% had stable employment; 45% were being treated with methadone; 9% had shared their injection material in the last 6 months; 24% always used condoms in the case of a stable relationship, and 71% in casual relationships. In a cluster analysis constructed on the basis of multiple correspondence analysis, two distinct profiles of users emerge: highly marginalised users with a high level of consumption (21%); irregular users, better integrated socially, of which the majority are under methadone treatment (79%). CONCLUSION: Theses centres play a major role in Aids prevention. Nevertheless, efforts to improve the hygiene conditions of drug injection in Switzerland should be pursued and extended. At the same time, prevention of HIV sexual transmissions should be reinforced.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Update: syringe exchange programs--United States, 1997.

As of December 1997, more than one third (36%) of the 641,086 cases of acquired immunodeficiency syndrome (AIDS) reported to CDC were directly or indirectly associated with injecting-drug use. Syringe exchange programs (SEPs) are one of the strategies employed to prevent infection with human immunodeficiency virus (HIV) among injecting-drug users (IDUs). The goal of SEPs is to reduce the transmission of HIV and other bloodborne infections associated with reuse of blood-contaminated syringes for drug injection by providing sterile syringes in exchange for used, potentially contaminated syringes. This report summarizes a survey of U.S. SEP activities during January-December 1997 and compares the findings with those of two previous surveys during 1994-1995 and 1996. The findings indicate continued expansion in the number, geographic coverage, and activity of SEPs in the United States.

Humans↗