Use of supervised injection facilities and injection risk behaviours among young drug injectors

Addiction. 2009 Apr;104(4):614-9. doi: 10.1111/j.1360-0443.2008.02474.x. Epub 2009 Feb 10.


Aims: To study the use of supervised injection facilities (SIFs) as a predictor of safer injecting practices.

Design: Cross-sectional study conducted with face-to-face interview using a structured questionnaire with computer-assisted personal interviewing. Dried blood spot samples were collected for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) antibody testing.

Setting: All participants were street-recruited by chain referral methods in Madrid and Barcelona.

Participants: A total of 249 young heroin drug injectors recruited by the ITINERE cohort study in two Spanish cities with SIFs.

Measurements: The main outcome measures were self-reported injecting behaviours and SIFs attendance.

Results: SIF users were more marginalized socially than non-users. They were also more often regular injectors (weekly or more versus sporadic) [odds ratio (OR) = 4.9, 95% confidence interval (CI): 2.7-8.8], speedball users (OR = 2.5, 95% CI: 1.5-4.3) and anti-HCV-positive (OR = 3.1, 95% CI: 1.4-7.1). In the logistic regression analysis, using SIFs was associated independently with not borrowing used syringes (OR = 3.3, 95% CI: 1.4-7.7). However, no significant association was found between SIF use and not sharing injection equipment indirectly (OR = 1.1, 95% CI: 0.5-2.2).

Conclusions: SIFs attract highly disadvantaged drug injectors who engage none the less in less borrowing of used syringes than non-users of these facilities. The risks of indirect sharing should be emphasized when counselling SIF attendees.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • HIV Infections / epidemiology
  • HIV Infections / prevention & control*
  • HIV-1*
  • Heroin Dependence / epidemiology
  • Heroin Dependence / etiology*
  • Humans
  • Male
  • Needle-Exchange Programs / organization & administration*
  • Program Evaluation
  • Risk Factors
  • Spain / epidemiology
  • Substance Abuse, Intravenous / complications*
  • Substance Abuse, Intravenous / epidemiology
  • Surveys and Questionnaires
  • Young Adult