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Significant decrease in injection risk behaviours among participants in a needle exchange programme.

Martin Kåberg1,2, Niklas Karlsson3,4, Andrea Discacciati5

  • 1Department of Medicine Huddinge, Division of Infection and Dermatology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden.

Infectious Diseases (London, England)
|February 20, 2020
PubMed
Summary
This summary is machine-generated.

Needle exchange programs (NEP) significantly reduced injection risk behaviors among people who inject drugs (PWID) in Stockholm. Participation in NEP led to decreased sharing of needles and syringes, lowering risks of HCV and HIV transmission.

Keywords:
HIVInjection risk behaviourharm reductionhepatitis Cneedle exchange programmepeople who inject drugs

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Area of Science:

  • Public Health
  • Infectious Disease Epidemiology
  • Harm Reduction

Background:

  • Sharing of unsterile injection equipment among people who inject drugs (PWID) is a primary driver for transmitting hepatitis C virus (HCV), HIV, and hepatitis B virus (HBV).
  • Sweden's delayed implementation of needle exchange programs (NEP) resulted in high HCV and HIV prevalence among PWID.
  • NEP are crucial interventions for preventing viral transmission in this population.

Purpose of the Study:

  • To examine demographic and drug-related factors influencing injection risk behaviors and equipment sharing among PWID.
  • To analyze changes in these risk behaviors over time within subgroups of PWID enrolled in the Stockholm NEP.
  • To assess the effectiveness of NEP in reducing transmission risks.

Main Methods:

  • A prospective open cohort study involving 2860 PWID participating in the Stockholm NEP, established in 2013.
  • Data collection occurred at baseline and at 6, 12, 24, 36, and 48 months post-enrollment.
  • Statistical analysis identified associations between demographic/drug-related factors and injection risk behaviors, and tracked changes over time.

Main Results:

  • Factors associated with higher baseline injection risk behaviors included female gender, homelessness, low education, younger age, amphetamine use, not being in opioid substitution therapy (OST), being HIV negative, and being HCV positive.
  • A significant overall decrease in injection risk behaviors was observed among participants over the 4-year study period.
  • Women demonstrated a faster reduction in injection risk behaviors compared to men; OST enrollment, HIV positivity, and age under 25 did not correlate with decreased risk behaviors over time.

Conclusions:

  • Participation in the Stockholm Needle Exchange Program (NEP) was strongly associated with a significant reduction in injection risk behaviors over a 4-year period.
  • The study highlights variations in risk behavior reduction among different PWID subgroups, with women showing more rapid decreases.
  • Findings underscore the critical role of NEP in harm reduction strategies for preventing viral infections among people who inject drugs.