Saturday, December 26, 2015

Self-Reported Changes in Drug Use Behaviors & Syringe Disposal Methods Following the Opening of a Supervised Injecting Facility in Copenhagen, Denmark

In Denmark, the first standalone supervised injecting facility (SIF) opened in Copenhagen’s Vesterbro neighborhood on October 1, 2012. The purpose of this study was to assess whether use of services provided by the recently opened SIF was associated with changes in injecting behavior and syringe disposal practices among people who inject drugs (PWID). We hypothesized that risk behaviors (e.g., syringe sharing), and unsafe syringe disposal (e.g., dropping used equipment on the ground) had decreased among PWID utilizing the SIF.

Between February and August of 2013, we conducted interviews using a survey (in English and Danish) with forty-one people who reported injecting drugs at the SIF. We used descriptive statistics and McNemar’s test to examine sociodemographic characteristics of the sample, current drugs used, sites of syringe disposal before and after opening of the SIF, and perceived behavior change since using the SIF.

Of the interviewed participants, 90.2% were male and the majority were younger than 40 years old (60.9%). Three-quarters (75.6%) of participants reported reductions in injection risk behaviors since the opening of the SIF, such as injecting in a less rushed manner (63.4%), fewer outdoor injections (56.1%), no longer syringe sharing (53.7%), and cleaning injecting site(s) more often (43.9%). Approximately two-thirds (65.9%) of participants did not feel that their frequency of injecting had changed; five participants (12.2%) reported a decrease in injecting frequency, and only two participants (4.9%) reported an increase in injecting frequency. Twenty-four (58.5%) individuals reported changing their syringe disposal practices since the opening of the SIF; of those, twenty-three (95.8%) reported changing from not always disposing safely to always disposing safely (McNemar’s test p-value < 0.001).

Our findings suggest that use of the Copenhagen SIF is associated with adoption of safer behaviors that reduce harm and promote health among PWID, as well as practices that benefit the Vesterbro neighborhood (i.e., safer syringe disposal). As a public health intervention, Copenhagen’s SIF has successfully reached PWID engaging in risk behavior. To fully characterize the impacts of this and other Danish SIFs, further research should replicate this study with a larger sample size and prospective follow-up.

Table 2

Primary locations for disposal of used syringes among a sample of people who inject drugs before and after the opening of a supervised injecting facility in Copenhagen, Denmark ( n  = 41)
Disposal mechanism/siteBefore SIF opened n (%)After SIF opened n (%)
Returned to the needle exchange (or SIF)14 (34.1)36 (87.8)
Put them in an outdoors sharps container19 (46.3)8 (19.5)
Put them in their own sharps container11 (26.8)6 (14.6)
Threw them in the garbage23 (56.1)5 (12.2)
Dropped them on the ground5 (12.2)0 (0.0)
Gave them to another user2 (4.9)0 (0.0)
Flushed them down the toilet4 (9.8)0 (0.0)
Other3 (7.3)0 (0.0)
Note: n’s do not sum to 41 and proportions do not sum to 100% because participants may have identified more than one location as primary site of used syringe disposal.
Note: all data collected between February and August, 2013.

Table 3

Perceived behavior and frequency change among a sample of people who inject drugs at a supervised injecting facility since its opening in Copenhagen, Denmark ( n  = 41)
Characteristicn (%)
Any perceived behavior change31 (75.6)
 Less rushed/stressful26 (63.4)
 Less injecting outdoors23 (56.1)
 No longer share needles22 (53.7)
 Clean injection site more often18 (43.9)
 Easier to get vein first time16 (39.0)
 Reuse own needles less often11 (26.8)
 Use clean water more often11 (26.8)
 No longer need help injecting6 (14.6)
 Other3 (7.3)
Perceived frequency change
 No change27 (65.9)
 Decreased (inject less often)5 (12.2)
 Increased (inject more often)2 (4.9)
 Unsure4 (9.8)
Note: n’s do not sum to 41 and proportions do not sum to 100% due to missing values or where participants endorsed more than one option.
Note: all data collected between February and August, 2013.
Full article at:

By:   Elizabeth N Kinnard,corresponding author Chanelle J Howe, Thomas Kerr, Vibeke Skjødt Hass, and Brandon DL Marshall
Department of Behavioral and Social Sciences, Brown University School of Public Health, 121 South Main Street, Box G-S-121-4 Providence, RI 02912 USA
Department of Epidemiology, Brown University School of Public Health, 121 South Main Street, Box G-S-121-2, Providence, RI 02912 USA
Faculty of Medicine, University of British Columbia, 317 - 2194 Health Sciences Mall, Vancouver, BC V6T 1Z3 Canada
Urban Health Research Initiative, British Columbia Centre for Excellence in HIV/AIDS, 608 – 1081 Burrard Street, Vancouver, BC V6Z 1Y6 Canada
The Saxo Institute, Faculty of Humanities, University of Copenhagen, Karen Blixens Vej 4, DK-2300 Copenhagen, Denmark
Elizabeth N Kinnard, Email: ude.nworb@dranniK_htebazilE.


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