• Open Access

Healthcare utilisation and disclosure of injecting drug use among clients of Australia's needle and syringe programs

Authors

  • M. Mofizul Islam,

    1. Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales; School of Public Health and Community Medicine, University of New South Wales; Drug Health Service, Royal Prince Alfred Hospital, New South Wales
    Search for more papers by this author
  • Libby Topp,

    1. Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales
    Search for more papers by this author
  • Jenny Iversen,

    1. Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales
    Search for more papers by this author
  • Carolyn Day,

    1. Drug Health Service, Royal Prince Alfred Hospital, New South Wales; Sydney Medical School, University of Sydney, New South Wales
    Search for more papers by this author
  • Katherine M. Conigrave,

    1. Drug Health Service, Royal Prince Alfred Hospital, New South Wales; Sydney Medical School, University of Sydney, New South Wales; National Drug and Alcohol Research Centre, University of New South Wales
    Search for more papers by this author
  • Lisa Maher

    1. Viral Hepatitis Epidemiology and Prevention Program, The Kirby Institute, University of New South Wales; School of Public Health and Community Medicine, University of New South Wales
    Search for more papers by this author

Correspondence to: Professor Lisa Maher, The Kirby Institute, University of New South Wales, CFI Building, Corner Boundary and West Streets, Darlinghurst, NSW 2010, e-mail: L.Maher@kirby.unsw.edu.au

Abstract

Background : People who inject drugs (PWID) report limited access to healthcare, and may avoid disclosing drug use. Health service utilisation was examined among participants in the Australian Needle and Syringe Program Survey (ANSPS), an annual cross-sectional sero-survey of needle syringe program (NSP) attendees.

Methods : An anonymous questionnaire was self-completed by 2,395 NSP clients throughout Australia. Multivariable logistic regressions identified variables independently associated with (i) disclosure of injecting to the most recent healthcare provider; and (ii) recent presentation to emergency departments.

Results : Seventy-eight percent of participants reported accessing healthcare in the preceding 12 months. Reasons for presentation included general health issues (46%); medication seeking (17%); and both (37%). Participants who recently accessed healthcare or had previously visited their most recent provider were more likely to disclose injecting drug use. Participants presenting to a GP or medical centre were less likely than others to disclose injecting. Those accessing emergency departments were more likely to report recent imprisonment.

Conclusions : Despite Australia's universal healthcare system and harm reduction policies, NSP-participants remain reluctant to disclose injecting, potentially hindering appropriate care and highlighting the need for multiple entry points to the healthcare system, including NSPs and opioid substitution therapy clinics.

Ancillary