EDINBURGH DRUG-USERS - ARE THEY INJECTING AND SHARING LESS

Objective: To describe epidemiological trends in injecting and equipme nt sharing among a sample drawn from a drug-using population with a hi gh rate of HIV infection. Design: A structured interview was administe red prior to treatment to cross-sectional samples of drug users over t he period 1988-1991. Reports of injecting, sharing and HIV infection w ere compared annually. Setting: Lothian Health Board's Community Drug Problems Service is a secondary level service offering harm reduction and treatment of dependency. Participants: A total of 734 consecutivel y referred drug users resident in Edinburgh. Re-referrals in the same calendar year were excluded. Measures: History of injecting and sharin g, recent injecting and sharing, HIV testing history, drugs used in pr evious month and substitute prescription status. Results: Large reduct ions in the frequency of injecting were found over the 4 years even am ong those who were not receiving oral substitutes. More participants i n latter years were receiving prescriptions combining opioids and benz odiazepines. Fewer of those interviewed latterly had ever shared injec ting equipment. Among recent injectors just as many share equipment as previously. HIV prevalence did not vary significantly over the period . An HIV prevalence of 19% was reported among recent injectors. Conclu sions: Edinburgh's drug users are engaging in far safer drug-taking be haviour than previously. Levels of HIV in this population suggest that the epidemic is being contained. A small number persist in high risk drug-related activities. Further investigation of the characteristics of these individuals and the need to develop novel methods of influenc ing their behaviour are recommended.