COMPLIANCE TO BLEACH DISINFECTION PROTOCOLS AMONG INJECTING DRUG-USERS IN MIAMI

Bleach cleansing of injection equipment has been recommended to reduce the risk of human immunodeficiency virus (HIV) transmission associate d with the reuse of injection equipment by injecting drug users (IDUs) . We evaluated the recall and performance of the most commonly recomme nded bleach cleansing procedure of two complete fillings of the syring e with bleach, followed by two complete fillings with rinse water, and not putting used bleach and water back into source containers. IDUs w ere taught this procedure on enrollment in an HIV prevention demonstra tion project in Dade County, Florida, During follow-up session 6-12 mo nths after initial training, the knowledge and ability of IDUs to perf orm bleach cleansing were assessed by trained observers using a standa rdized method. In 1988-90, we assessed the knowledge and ability of 45 0 IDUs to perform the bleach cleansing procedure taught at enrollment. More than 90% of IDUs assessed performed the basic steps. However, on ly 43.1% completely filled the syringe with bleach and only 35.8% comp letely filled the syringe with bleach at least twice. Substantial prop ortions of IDUs did not perform all the steps of the previously taught breach cleansing procedure. Compliance decreased as the number of ste ps required was increased. This limited compliance may make bleach cle ansing less effective and suggests that some IDUs may fail to adequate ly disinfect injection equipment and therefore sterile needles and syr inges are safer than bleach-cleansed ones. Compliance testing can help assess the effectiveness of HIV prevention programs.