Factors that Influence the Characteristics of Needles and Syringes Used by People Who Inject Drugs in Tajikistan

“Low dead space” syringes with permanently attached needles retain less fluid, blood, and HIV after use than standard “high dead space” syringes. This reduces the probability of HIV transmission if they are shared by people who inject drugs (PWID). The World Health Organization recently recommended that needle and syringe programs (NSP) offer clients low dead space syringes. The success of this recommendation will depend on PWID switching to low dead space needles and syringes. This paper examines the needles and syringes that PWID in Tajikistan use and factors that influence their choices.

In May 2014, we conducted six focus groups in Kulob and six in Khorog, Tajikistan, with a total of 100 participants. NSP staff members recruited participants. Focus group topics included the needles and syringes used and factors that influence choice of needles and syringes. Focus groups were conducted in Russian and Tajik, audio recorded, transcribed, and translated into English. The translated files were imported into NVivo 10 for coding and analysis.

All participants in both cities were male and reported injecting heroin. Everyone also reported using syringes with detachable needles almost exclusively. The most popular syringe sizes were 2 and 5 ml. Needles ranged in gauge from 25 to 21 g. Needle gauge was influenced by the size of the vein, the viscosity of drug solution to be injected, and problems with blood clotting. Needles ranged in length from 12 to 38 mm, with 25 and 32 mm being the most popular. Needle length was influenced by the depth of the vein being used. Many PWID inject volumes of fluid greater than 1 ml into deep veins that require needles at least 25 mm long and 25 g in diameter.

Most low dead space syringes are 1-ml insulin syringes with 12 mm 28 g permanently attached needles. Findings from this project suggest that these will not be acceptable to PWID who need larger syringes and longer and thicker needles that are detachable. Low dead space detachable needles appear to be an acceptable option that could overcome barriers to the widespread use of low dead space equipment for reducing HIV and HCV transmission.

Below:  Cross-sectional view illustrating dead space in standard needles and syringes and low dead space options. a Standard needle on standard syringe; b Low dead space syringe with permanently attached needle; c Standard needle on low dead space syringe; d Low dead space needle on standard syringe

Full article at: http://goo.gl/Q3h3JU

By: William A. Zule^1*, Alisher Latypov², David Otiashvili³, Irma Kirtadze³⁴, Umedjon Ibragimov⁵ and Georgiy V. Bobashev¹

¹RTI International, 3040 Cornwallis Road, Research Triangle, Park 27709-2194, NC, USA

²Management Sciences for Health, Leadership, Management and Governance, Kiev, Ukraine

³Addiction Research Center, Alternative Georgia, Tbilisi, Republic of Georgia

⁴Business School, Ilia State University, Tbilisi, Republic of Georgia

⁵Behavioral Sciences and Health Education Department, Emory University, Rollins School of Public Health, Atlanta, Georgia, USA

  

More at:  https://twitter.com/hiv_insight