Background
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.
Methods
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.
Results
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).
Conclusions
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
Disposal mechanism/site | Before 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 container | 19 (46.3) | 8 (19.5) |
Put them in their own sharps container | 11 (26.8) | 6 (14.6) |
Threw them in the garbage | 23 (56.1) | 5 (12.2) |
Dropped them on the ground | 5 (12.2) | 0 (0.0) |
Gave them to another user | 2 (4.9) | 0 (0.0) |
Flushed them down the toilet | 4 (9.8) | 0 (0.0) |
Other | 3 (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
Characteristic | n (%) |
---|---|
Any perceived behavior change | 31 (75.6) |
Less rushed/stressful | 26 (63.4) |
Less injecting outdoors | 23 (56.1) |
No longer share needles | 22 (53.7) |
Clean injection site more often | 18 (43.9) |
Easier to get vein first time | 16 (39.0) |
Reuse own needles less often | 11 (26.8) |
Use clean water more often | 11 (26.8) |
No longer need help injecting | 6 (14.6) |
Other | 3 (7.3) |
Perceived frequency change | |
No change | 27 (65.9) |
Decreased (inject less often) | 5 (12.2) |
Increased (inject more often) | 2 (4.9) |
Unsure | 4 (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: http://goo.gl/2IuC7S
By: Elizabeth N Kinnard, 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.
More at: https://twitter.com/hiv_insight
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