Risks incurred by first-injection intravenous drug users.

Aims. - The objectives of the study were to describe the circumstances surr ounding the intiation of intravenous drug use, the role of the introducer a nd to evaluate intravenous drug users risk behaviors at the first injection of drug. Design. - In 1997, we conducted a cross-sectional survey using a structured questionnaire concerning the initiation process into intravenous drug abus e, IDUs were interviewed in four treatment drug abuse and psychosocial cent ers in Paris and in one prison, Participants. - Of the 152 consecutive IDUs interviewed, 143 completed the questionnaire, 83 were male. Findings. - The mean age at first opiate use and at first injection were 19 years (SD: 4.3) and 20 years (SD: 4.3), At first injection, heroin was the main used drug (91 %), the subject was with others persons (91 %), asked h imself for injection (70 %) albeit had not planned this injection (40 %). T he subject injected at a friend's home (31 %), The introducer was an IDU (9 3 %), mean age 23.4 (SD: 5.2). He or she was a friend (61 %) or a sexual pa rtner (140/0). The preparation of the first injection and the injection wer e made by the introducer in 72 % and 74 % of cases. The injecting equipment had been borrowed (22 %) from an IDU whose HIV status and HCV status were unknown in 83 % and 85 % of cases. Conclusion. - Our study shows novel results about the first injection, they are of prime importance for harm reduction. The introducer plays a major r ole in preventing risk-behavior at the first injection and for education ab out safe injecting practices.