Factors associated with injecting risk behaviour among serial community-wide samples of injecting drug users in Glasgow 1990-94: implications for control and prevention of blood-borne viruses

Aims. To examine the association between recipient-sharing of needles and s yringes and demographic characteristics, injecting behaviour and needle and syringe Exchange utilisation. Design. Self-report data from serial cross-s ectional surveys. Setting. Multiple street, needle and syringe exchange and drug treatment sites throughout Glasgow. Participants. 2576 current inject ing drug users (IDUs) recruited during 1990-94. Findings. In the multiple l ogistic regression analysis, a significantly lower level of recipient-shari ng was associated with respondents who resided within 1 mile of a needle an d syringe exchange compared to those who lived further away (adjusted OR 1. 3; 95% CI 1.0-1.6), and by IDUs who reported obtaining either 6-15, 16-30, or > 30 sterile needles and syringes in an average week from a needle excha nge and/or pharmacist (adjusted ORs 0.55, 0.34, 0.25; 95% CIs 0.3-0.9, 0.2- 0.6 and 0.2-0.4, respectively) compared to those who obtained no sterile eq uipment from these sources. Recipient-sharing of needles and syringes in th e previous 6 months reduced significantly between 1990 (43%) and 1991-94 (2 7-33%) (p < 0.0001); this decline was not explained by needle and syringe e xchange utilization, suggesting that additional factors were influencing be havioural change at that time. Conclusion. Our data indicate that improving injectors' convenience of access to exchange facilities and increasing the numbers of sterile needles and syringes available to them is likely to res ult in further reductions in recipient-sharing, and thus the potential for blood-borne virus transmission, among IDUs.