Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada

Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 Janua...

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Bibliographic Details
Published in:Addiction (Abingdon, England) England), 1997-10, Vol.92 (10), p.1339-1347
Main Authors: STRATHDEE, S. A, PATRICK, D. M, ARCHIBALD, C. P, OFNER, M, CORNELISSE, P. G. A, REKART, M, SCHECHTER, M. T, O'SHAUGHNESSY, M. V
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult
Adult and adolescent clinical studies
Biological and medical sciences
British Columbia
Canada
Child
Child Abuse, Sexual
Depression
Depression (Psychology)
Drug abuse
Drug addiction
Drug addicts
Drug Injection
Drug Use
Female
HIV
HIV Seropositivity - psychology
Homosexuality
Humans
Intravenous drug addicts
Male
Medical sciences
Medical supplies
Needle Sharing
Needle Sharing - psychology
Predictors
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Risk-Taking
Sexual Abuse
Sexual Behavior
Sexual behaviour
Sexual Partners
Social Factors
Substance abuse
Substance Abuse, Intravenous - psychology
Vancouver
Vancouver, British Columbia
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Summary:Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had "ever been forced to have sex" as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (AOR = 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of sexual abuse, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.
ISSN:0965-2140
1360-0443
DOI:10.1046/j.1360-0443.1997.9210133910.x