HIV among injecting drug users: current epidemiology, biologic markers, respondent-driven sampling, and supervised-injection facilities

North America is currently experiencing an opioid crisis. One proposed solution to combat problems associated with injection drug use is the use of supervised injection facilities. These facilities provide drug users a space to inject pre-obtained drugs without any legal repercussions. Research on these facilities has focused on public health outcomes, and generally found positive results. Far fewer studies have investigated the impact supervised injection facilities have on crime. The current study provides an interrupted time-series analysis on the impact of North America’s only supervised injection facility on crime. Analyses of city wide crime data evidence no impact of the supervised injection facility on crime. Disaggregated analyses indicate a significant decrease in crimes in the district where the supervised injection facility is located. Implications of the findings are discussed.

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P03-257 - Psychotic symptoms in cocaine injecting drug users, report of healthcare professionals working in a medically supervised injection clinic (MSICS)

European Psychiatry ◽

10.1016/s0924-9338(10)71311-0 ◽

2010 ◽

Vol 25 ◽

pp. 1324

Author(s):

C. Roncero ◽

N. Martínez-Luna ◽

B. Gonzalvo ◽

C. Daigre ◽

M. Comin ◽

...

Keyword(s):

Drug Users ◽

Healthcare Professionals ◽

Injecting Drug Users ◽

Psychotic Symptoms ◽

Supervised Injection

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Evaluating Recruitment among Female Sex Workers and Injecting Drug Users at Risk for HIV Using Respondent-driven Sampling in Estonia

Journal of Urban Health ◽

10.1007/s11524-009-9427-7 ◽

2010 ◽

Vol 87 (2) ◽

pp. 304-317 ◽

Cited By ~ 37

Author(s):

Anneli Uusküla ◽

Lisa G. Johnston ◽

Mait Raag ◽

Aire Trummal ◽

Ave Talu ◽

...

Keyword(s):

At Risk ◽

Sex Workers ◽

Drug Users ◽

Female Sex Workers ◽

Injecting Drug Users ◽

Respondent Driven Sampling ◽

Female Sex

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Evaluation of supervised injection facilities as an ethically sound approach to treatment of injection drug abuse

University of Western Ontario Medical Journal ◽

10.5206/uwomj.v86i2.2051 ◽

2017 ◽

Vol 86 (2) ◽

pp. 67-69

Author(s):

Katherine Fleshner ◽

Matthew Greenacre

Keyword(s):

Drug Use ◽

Injection Drug Use ◽

Drug Users ◽

Active Drug ◽

Categorical Imperative ◽

Injection Drug ◽

Negative Consequences ◽

Drug Paraphernalia ◽

Supervised Injection ◽

Supervised Injection Facilities

Novel approaches are needed to address the issue of injection drug use in Canada, which can have negative consequences for drug users and society. Supervised injection facilities (SIFs) are legally sanctioned facilities in Canada where drug users can receive sterile drug paraphernalia, referral to cessation programs and timely medical care if necessary. SIFs operate under the principle of harm reduction, which aims to reduce rates of infection and death due to overdose among drug users. SIFs are largely driven by the utilitarian ideal of maximizing benefit for the greatest number of people, through supervision of active drug users and appropriate referral for those wishing to quit. Deontological theory may support SIFs depending on how one applies the categorical imperative. Studies of the first SIF in North America, Insite, have shown demonstrable reductions in adverse health and societal consequences of injection drug use, rationalizing their implementation under consequentialism. SIFs are, therefore, suitable for greater adoption by the healthcare system.

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An analysis of respondent-driven sampling with injecting drug users in a high HIV prevalent state of India

Harm Reduction Journal ◽

10.1186/s12954-017-0171-0 ◽

2017 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Sanjib Kumar Phukan ◽

Gajendra Kumar Medhi ◽

Jagadish Mahanta ◽

Rajatashuvra Adhikary ◽

Gay Thongamba ◽

...

Keyword(s):

Drug Users ◽

Injecting Drug Users ◽

Respondent Driven Sampling

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Rapid Assessment of Injecting Drug Users (IDUs) in Nairobi and Mombasa counties, Kenya: A Respondent Driven Sampling Survey

10.21203/rs.3.rs-44785/v1 ◽

2020 ◽

Author(s):

Gabriel O Dida ◽

Francis Oguya ◽

Patrick Kenya ◽

Francisca Ongecha ◽

Patrick Mureithi ◽

...

Keyword(s):

Drug Use ◽

Risk Behaviors ◽

Drug Users ◽

Injecting Drug Users ◽

Injecting Drug Use ◽

Hiv Prevalence ◽

Injection Drug ◽

Respondent Driven Sampling ◽

Cross Sectional ◽

Situational Assessment

Abstract Background: A Cross-sectional Rapid Situational Assessment of Injecting Drug Users (IDUs) applying Respondent Driven sampling techniques (RDS) was used to recruit subjects/participants in a study aimed at assessing HIV prevalence and risk behaviors among injection drug users in Nairobi and Mombasa counties of Kenya. The study sought to establish HIV prevalence and document risk behaviors among IDUs in the two regions, as well as assess their spatial distribution and size estimates in the general population. Methods: A cross-sectional study design was adopted in which a set of initial subjects referred to as ‘seeds’ were first identified from which an expanding chain of referrals was obtained, with subjects from each wave referring subjects of subsequent wave. The seeds were drawn randomly from the population and interviewed to pick the one with the largest network and other unique characteristics. A maximum of twelve seeds were recruited. The second stage involved conducting assessment visits to the sites to identify potential collaborators that included non-governmental organizations (NGOs), drug treatment centres, health facilities, Community based organizations (CBO's), among others. Three NGOs located in the Mombasa county and one in Nairobi county were identified to assist in identifying drug injection locations and potential participants. Key informant interviews (KIIs) and Focus Group Discussions (FGDs) were also conducted using interview guides. Results: A total of 646 individuals (344 in Nairobi and 302 at the coast) were recruited for the study between January and March 2010. Of these 590 (91%) were males and 56 (9%) were female. Findings showed that most IDUs initiated injecting drug use between the ages of 20-29 years, with the youngest age of initiation being 11 years and oldest age being 53 years. Most commonly injected drug was heroin (98%), with a small (2%) percentage injecting cocaine. Other non-injecting methods such as smoking or combining these two drugs with other drugs such as cannabis or rohypnol were also common. Most IDUs used other substances (cigarettes, alcohol, and cannabis) before initiating injecting drug use. While all IDUs continue to be at risk in the two regions, those from the Western parts of Nairobi were at a relatively higher risk given their higher rate of sharing injecting equipment and solutions. Conclusions: Given that initiation of injection drug use begins early and peaks mainly after formal school years (20-29 years), preventive programmes should be targeted at secondary school, college and out of school youth. Further, to protect People who inject drugs (PWIDs) from HIV infection, the country should introduce free Needle Syringe Programs with provision of condoms and Methadone Assisted Therapy as a substitute for drug use.

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Supervised Injection Facilities and International Law

Journal of Drug Issues ◽

10.1177/002204260303300302 ◽

2003 ◽

Vol 33 (3) ◽

pp. 539-578 ◽

Cited By ~ 8

Author(s):

Ian Malkin ◽

Richard Elliott ◽

Rowan McRae

Keyword(s):

Drug Users ◽

Health It ◽

Health Crisis ◽

Public Health Crisis ◽

Legal Obligations ◽

Legal Implications ◽

International Obligations ◽

Supervised Injection ◽

Supervised Injection Facilities ◽

The Right

The ongoing public health crisis associated with injection drug use highlights the failure of prohibitionist policies. In contrast, harm reduction approaches aim to protect and promote the health of drug users. Supervised injection facilities (SIFs) are one important component of this approach. This article considers the international legal implications of establishing SIFs. It argues that implementing trials of SIFs is an appropriate measure that states should take pursuant to their international legal obligations to realize progressively the right of their nationals to the highest attainable standard of health. It argues that international drug control treaties do not prevent such measures, as is commonly claimed. The authors conclude that successful trials in Europe and Australia should be emulated elsewhere, in accordance with states' international obligations.

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French People’s positions on supervised injection facilities for drug users

Substance Abuse Treatment Prevention and Policy ◽

10.1186/s13011-020-00321-2 ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Maria Teresa Munoz Sastre ◽

Lonzozou Kpanake ◽

Etienne Mullet

Keyword(s):

Health Professionals ◽

Drug Users ◽

Political Orientation ◽

Staff Members ◽

Rehabilitation Programs ◽

Supervised Injection ◽

Safe Injection ◽

Supervised Injection Facilities ◽

Set Up ◽

Unsafe Injection

Abstract Background Supervised injection facilities have been set-up in many countries to curb the health risks associated with unsafe injection practices. These facilities have, however, been met with vocal opposition, notably in France. As harm reduction policies can only succeed to the extent that people agree with them, this study mapped French people’s opinions regarding the setting-up of these facilities. Method A sample of 318 adults--among them health professionals--were presented with 48 vignettes depicting plans to create a supervised injection facility in their town. Each vignette contained three pieces of information: (a) the type of substance that would be injected in the facility (amphetamines only, amphetamines and cocaine only, or amphetamines, cocaine and heroin), (b) the type of staff who would be working in the facility (physicians and nurses, specially trained former drug users, specially trained current drug users, or trained volunteers recruited by the municipality), and (c) the staff members’ mission (to be present and observe only, technical counselling about safe injection, counselling about safe injection and hygiene, or counselling and encouragement to follow a detoxification program). Results Through cluster analysis, three qualitatively different positions were found: Not very acceptable (20%), Depends on staff and mission (49%), and Always acceptable (31%). These positions were associated with demographic characteristics--namely gender, age and political orientation. Conclusion French people’s positions regarding supervised injection facilities were extremely diverse. One type of facility would, however, be accepted by a large majority of people: supervised injection facilities run by health professionals whose mission would be, in addition to technical and hygienic counselling, to encourage patrons to enter detoxification or rehabilitation programs.

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