HIV-infection rate nearly double for drug users receiving injection help from peers: study

published on September 1, 2005

(Vancouver) – Drug users who receive help injecting illicit drugs from their peers are twice as likely to become HIV infected, reveals a new study by the B.C. Centre for Excellence in HIV/AIDS.

The Centre study, published in-print today in the Journal of AIDS, is the first involving a cohort of injection drug users (IDUs) examining the risk factor of requiring help injecting from other IDUs and its relation to rates of HIV infection. The findings confirm the relationship between this practice and the HIV epidemic that has occurred in Vancouver’s Downtown Eastside.

Of those who received help injecting at the beginning of the study period, 16.1% became HIV infected after three years, compared to 8.8% among those who did not require help injecting.

A total of 1,013 HIV-negative participants were recruited from the Centre’s ongoing Vancouver Injection Drug Users Study. Within this population, 418 (41.3%) participants had required help injecting during the six months since the initial interview. Participants requiring help injecting were more likely to be female and have fewer years of experience injecting drugs. Those who became HIV infected were more likely to be female and require help injecting.

“Assisted injection among drug users is a very dangerous practice that is common in Vancouver” says Dr. Thomas Kerr, one of the study’s senior authors. “These findings help shed light on why Vancouver has had such an explosive outbreak of HIV among injection drug users.”

The findings also underline recently reported statistics highlighting elevated incidence of HIV infection among women, including female IDUs. According to Kerr, “women were overrepresented among those who need help injecting in this study.”

Insite, Vancouver’s pilot supervised injection site, may provide some benefit to this high-risk group, reveals additional Centre research published in the current issue of The International Journal of Drug Policy. Of Insite users surveyed, nearly one-third received information relating to safer injecting practices. Importantly, those who received help injecting from fellow IDUs on the streets were more than twice as likely to have received safer injecting education at Insite (Note: under Health Canada guidelines, Insite staff cannot directly inject clients). Further study is necessary to examine if receiving safer injecting education reduces the practice of assisted injection by IDUs on the streets or rates of HIV and hepatitis C infection.

The Journal of AIDS study suggests an education campaign is required in IDU communities to inform illicit drug users of the specific risk of being an assisted injection recipient. Peer-run initiatives have recently been shown to play a major role in reducing harm among Vancouver IDUs by reaching highest risk drug users with harm-reduction services. As well, the findings of this study indicate a need to revisit Health Canada’s guidelines that prohibit assisted injection within Insite.

BC Centre for Excellence in HIV/AIDS

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HIV-infection rate nearly double for drug users receiving injection help from peers: study

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