Globally, people who inject drugs (PWID) are
disproportionately at risk for HIV and HCV due to risky injection drug use
behaviors, such as sharing used needles and injection kits. In response, San
Francisco, one of several cities with a sizable PWID population that had
quickly committed to stopping the spread of HIV/HCV, have expanded needle
access, including in pharmacies and hospitals, in order to ensure that PWID inject
with clean needles. However, there was no current research on whether each
source of needles is equally associated with always using new sterile needles
in San Francisco. Furthermore, no research in San Francisco had examined
behavioral trends in needle-sharing practices, the relationship between PWID
and their injection partners, and knowledge of their injection partners' HIV or
HCV status.
Therefore, we analyzed data from three cycles of the
National HIV Behavioral Surveillance studies from 2005 to 2012 in San Francisco
among PWID.
The results from our analysis suggest that overall risky
drug injection practices, such as injecting with used needles, sharing used
cookers or water, and dividing drugs with a used syringe, among PWID in San
Francisco has decreased from 2005 to 2012. An increasing proportion of PWID are
injecting with their friend/acquaintance than with their sex partner. Also, a
declining portion of PWID report knowing their last injection partner's
HIV-positive or HCV-positive status. In terms of sources of needles, less PWID
are getting their needles from friends and drug dealers while a greater
proportion are using pharmacies and needle exchanges. However, pharmacies as a
source of needles are negatively associated with always using new sterile
needles.
From 2005 to 2012, overall high-risk injection behavior
among PWID in SF has decreased including PWID that are injecting with others.
However, our results suggest caution over the expansion of pharmacies as a source
of needles in San Francisco and in similar cities due to their negative
association with always using a new sterile needle. Since more PWID are
injecting with their friend/acquaintance, interventions at needle access
programs at pharmacies, hospitals, and needle exchanges should stress the
potential to transmit HIV and HCV even in one-on-one sharing situations.
Furthermore, since a decreasing percentage of PWID know about their injection
partner's HIV/HCV status, such interventions should also highlight the
importance of having a conversation about HIV and HCV status with one's
injecting partner.
Purchase full article at:
- 1San Francisco Department of Public Health, United States.
- 2San Francisco Department of Public Health, United States; University of California, San Francisco, United States.
- 3San Francisco Department of Public Health, United States; University of California, San Francisco, United States. Electronic address: hfisher.raymond@sfdph.org
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