Prevalence and predictors of injecting-related injury and disease among clients of Australia's needle and syringe programs

Authors

  • Libby Topp,

    1. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales
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  • Jenny Iversen,

    1. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales
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  • Andrew Conroy,

    1. Queensland Needle and Syringe Program, Queensland Health
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  • Allison M. Salmon,

    1. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales
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  • Lisa Maher,

    1. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales
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  • on behalf of the Collaboration of Australian NSPs

    1. Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, Faculty of Medicine, University of New South Wales
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  • *

    Directions ACT; AIDS Council of NSW; First Step Program, Port Kembla & Nowra; Health ConneXions, Liverpool; Hunter Harm Minimisation Team, Newcastle; Kirketon Road Centre and K2, Kings Cross; NSW Users and AIDS Association (NUAA), Surry Hills; Northern Rivers Area Health Service, Ballina, Byron Bay, Lismore, Murwillumbah, Nimbin, and Tweed Heads; Resource and Education Program for IDUs (REPIDU), Redfern and Canterbury; Responsive User Services in Health (RUSH), Manly, Ryde and St Leonards; St George NSP, Kogarah; Southcourt Primary Care NSP, Nepean; Sydney West Area Health Service HIV/Hepatitis C Prevention Service, Blacktown, Merrylands and Parramatta; Northern Territory AIDS Council, Alice Springs, Darwin and Palmerston, NT; Biala Community Alcohol and Drug Services, Brisbane; Cairns Base Hospital NSP, Cairns; QUIHN, Brisbane, Gold Coast and Sunshine Coast; Kobi House, Toowoomba; West Moreton Sexual Health Service, Ipswich; Drug and Alcohol Services South Australia, Adelaide; Hindmarsh Centre, Hindmarsh; South Australia Voice for Intravenous Education (SAVIVE): AIDS Council South Australia, Norwood; Parks Community Health Service, Adelaide; Port Adelaide Community Health Service, Port Adelaide; Noarlunga Community Health Service, Adelaide; Northern Metropolitan Community Health Service NSP and Shopfront, Salisbury; Tasmanian Council on AIDS, Hepatitis & Related Diseases (TasCAHRD), Hobart and Glenorchy; Melbourne Inner Needle Exchange, Collingwood; South East Alcohol and Drug Service, Dandenong; St Kilda NSP; Southern Hepatitis/HIV/AIDS Resource and Prevention Service (SHARPS), Melbourne; WA AIDS Council Mobile Exchange, Perth; Western Australia Substance Users Association (WASUA), Northbridge and Bunbury.

Correspondence to:
Dr Libby Topp, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Level 2, 376 Victoria Street, Darlinghurst, New South Wales 2010. Fax: (02) 9385 0920; e-mail: LTopp@nchecr.unsw.edu.au

Abstract

Objective: To identify lifetime prevalence and predictors of self-reported injecting-related injuries and diseases (IRID) and/or injecting-related problems (IRP) among a national cross-sectional sample of injecting drug users.

Methods: 1,961 clients of 45 needle and syringe programs (NSPs) who participated in the 2006 Australian NSP Survey self-completed an item regarding lifetime experience of eight separate IRIDs and IRPs.

Results: Sixty-nine per cent of participants reported a history of IRID/IRP, with a mean of 1.9 injuries/problems (range 0-8). Lifetime prevalence of specific injuries/problems ranged from problems finding a vein (43%) to endocarditis (4%). Factors independently associated with IRID/IRP included bisexual identity; daily or more frequent injecting; injection of pharmaceutical preparations; female gender; longer injecting history; and hepatitis C antibody-positive serostatus.

Conclusions: Consistent with existing literature, results suggest that vascular injury and localised infections are common among IDUs; and that treatment-seeking is often delayed until serious complications arise.

Implications: Findings support the imperative for co-ordinated and timely treatment and prevention activities to reduce the severity and burden of these prevalent injecting outcomes.

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