Individual-level syringe coverage among Needle and Syringe Program attendees in Australia

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Harm Reduction

Background:

• Injecting drug use causes significant morbidity and mortality globally, including millions infected with HIV and Hepatitis C virus (HCV).
• Needle and Syringe Programs (NSPs) are critical interventions for HIV prevention, with program coverage estimates vital for assessing effectiveness.

Purpose of the Study:

• To estimate individual-level syringe coverage among Australian NSP attendees.
• To identify factors associated with insufficient syringe coverage and syringe reuse.

Main Methods:

• A national cross-sectional study of NSP attendees in Australia was conducted.
• Individual-level syringe coverage was calculated as the proportion of monthly injections covered by new syringes.
• Logistic regression analyses examined associations between demographics, risk behaviors, HIV/HCV prevalence, and syringe coverage.

Main Results:

• Twenty percent of participants reported insufficient new syringes for all injections.
• Syringe reuse was independently associated with less than 100% syringe coverage.
• Procurement from NSPs, especially when combined with opiate substitution therapy, was linked to adequate or greater syringe coverage (≥100%).

Conclusions:

• Australian NSP attendees generally report high syringe coverage by international standards.
• Syringe reuse can serve as a proxy indicator for insufficient individual-level syringe coverage.
• Prevention efforts, particularly ensuring access to sterile syringes through NSPs, could be further enhanced to reduce harm associated with injecting drug use.