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The Health of the Nation target on syringe sharing: a role for routine surveillance in assessing progress and targeting interventions
Author(s) -
DURANTE AMANDA J.,
HART GRAHAM J.,
BRADY ANTHONY R.,
MADDEN PETER B.,
NOONE AHILYA
Publication year - 1995
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1046/j.1360-0443.1995.9010138910.x
Subject(s) - syringe , psychological intervention , medicine , needle sharing , environmental health , harm reduction , human immunodeficiency virus (hiv) , family medicine , psychiatry , syphilis , condom
The Health of the Nation initiative in the United Kingdom includes a target aimed at reducing the proportion of current injecting drug users who share syringes. The PHLS Collaborative Survey of Salivary Antibodies to HIV and Hepatitis B core in injecting drug users is a comprehensive and national surveillance mechanism which routinely collects data that can be used to monitor progress toward this target. Nineteen per cent of injecting drug users (353/1876) in 1992 and 18% (375/2138) in 1993 shared previously used injecting equipment (difference of ‐ 1.3%, 95% Cl – 3.7%, 1.1%). Only with further years of data collection will it be possible to tell if this decline represents a real change in behaviour. There was a substantial reduction in the proportion of sharers mho received previously used needles and syringes from more than one person, from 45% (138/305) in 1992 to 27% (81/298) in 1993 (fall of 18%, 95% Cl 11%, 26%). This decline could indicate a real reduction in risk behaviour thai is not reflected in the target. Monitoring this aspect of sharing could be an important supplementary measure. Women were more likely to have shared (adjusted OR = 1.87, 95% Cl 1.53, 2.28) and the likelihood of sharing declined with age (adjusted OR of each 5‐year age band = 0.75, 95% Cl 0.72, 0.79). Particular attention should be given to interventions which aim to reduce sharing among women and young people. Clients of agencies at which the main service provided was syringe exchange were less likely to have shared than offenders of other types of agencies (adjusted OR = Q.69y 95% Cl 0.51, 0.93). This suggests that syringe exchange schemes play a role in reducing the transmission of HIV infection.