Trends in sources and sharing of needles among people who inject drugs, San Francisco, 2005-2012

Nathan J Kim, Harry Jin, Willi McFarland, Henry F Raymond
International Journal on Drug Policy 2015, 26 (12): 1238-43

BACKGROUND: Globally, people who inject drugs (PWID) are disproportionately at risk for HIV and HCV due to risky injection drug use behaviors, such as sharing used needles and injection kits. In response, San Francisco, one of several cities with a sizable PWID population that had quickly committed to stopping the spread of HIV/HCV, have expanded needle access, including in pharmacies and hospitals, in order to ensure that PWID inject with clean needles. However, there was no current research on whether each source of needles is equally associated with always using new sterile needles in San Francisco. Furthermore, no research in San Francisco had examined behavioral trends in needle-sharing practices, the relationship between PWID and their injection partners, and knowledge of their injection partners' HIV or HCV status.

METHODS: Therefore, we analyzed data from three cycles of the National HIV Behavioral Surveillance studies from 2005 to 2012 in San Francisco among PWID.

RESULTS: The results from our analysis suggest that overall risky drug injection practices, such as injecting with used needles, sharing used cookers or water, and dividing drugs with a used syringe, among PWID in San Francisco has decreased from 2005 to 2012. An increasing proportion of PWID are injecting with their friend/acquaintance than with their sex partner. Also, a declining portion of PWID report knowing their last injection partner's HIV-positive or HCV-positive status. In terms of sources of needles, less PWID are getting their needles from friends and drug dealers while a greater proportion are using pharmacies and needle exchanges. However, pharmacies as a source of needles are negatively associated with always using new sterile needles.

CONCLUSION: From 2005 to 2012, overall high-risk injection behavior among PWID in SF has decreased including PWID that are injecting with others. However, our results suggest caution over the expansion of pharmacies as a source of needles in San Francisco and in similar cities due to their negative association with always using a new sterile needle. Since more PWID are injecting with their friend/acquaintance, interventions at needle access programs at pharmacies, hospitals, and needle exchanges should stress the potential to transmit HIV and HCV even in one-on-one sharing situations. Furthermore, since a decreasing percentage of PWID know about their injection partner's HIV/HCV status, such interventions should also highlight the importance of having a conversation about HIV and HCV status with one's injecting partner.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"