I inject less as I have easier access to pipes: frequency of injecting declines, frequency of sharing crack-smoking materials declines as needle exchange distributes safer crack-smoking tools
Among injection drug users (IDUs) in Ottawa, the capital of Canada, prevalence rates of HIV (20.6%) and HCV (75.8%) are among the highest in Canada. In April 2005, Ottawa’s needle exchange programme (NEP) commenced the distribution of glass stems, rubber mouthpieces, screens, chopsticks, lip balm and gum to reduce the harms associated with smoking crack. The objective of this study was to evaluate the impact of this initiative on a variety of HIV/HCV-related practices one month and six months following implementation.
Active, street-recruited IDUs consented to personal interviews and provided saliva samples for HIV and HCV testing at three time points – six-months pre-implementation (N=146), one-month (N=133) and six-months (N=175) post-implementation. Descriptive and univariate analyses were completed.
Evidence of change in drug use behavior - transitioning from injecting to smoking - was observed. Following implementation of the initiative, a significant decrease in injection frequency in the month prior to interview was observed. Pre-implementation, 36% of 107 IDUs reported injecting daily compared with 34% of 93 IDUs one-month and 25% of 120 IDUs six-months post-implementation (p=0.04). Conversely, a significant increase in prevalence of crack smoking among IDUs was documented. Pre-implementation, 77% reported smoking crack in the six-months prior to interview, 85% one-month and 89% six-months post-implementation (p=0.01). In addition to a shift to a less harmful method of drug ingestion, HIV/HCV-related risks associated with this method were reduced. Among crack-smoking IDUs sharing pipes or straws, the proportion sharing “every time” declined from 37% of 95 IDUs six-months pre-implementation, to 32% of 95 IDUs one-month, and 12% of 121 IDUs six-months post-implementation (p<0.01).
The distribution of safer crack-smoking materials by a NEP contributes to transition to safer methods of drug ingestion and significantly reduces disease-related risk practices indicating the utility of replicating this initiative at other NEPs.
AIDS 2006 - XVI International AIDS Conference
"L.E.Leonard, et al.
I inject less as I have easier access to pipes: frequency of injecting declines, frequency of sharing crack-smoking materials declines as needle exchange distributes safer crack-smoking tools.
AIDS 2006 - XVI International AIDS Conference: