Study: Supervised injection site reduces HIV risk behaviour

published on March 17, 2005

Facility impacts needle-sharing among injection drug users

Vancouver’s pilot supervised injection site has shown to reduce needle sharing among high-risk drug users, reveals a new study authored by the B.C. Centre for Excellence in HIV/AIDS.

The paper, published Friday in the leading international medical journal The Lancet, represents the first published findings on the impact of a supervised injection site on syringe sharing.

Needle sharing among injection users is a practice proven to be one of the highest risk factors for HIV and hepatitis C infection. The supervised injection site, officially known as Insite, attracted high-risk injection drug users with a history of needle-sharing behaviour. Findings from the paper – entitled Safer injection facility use and syringe sharing in injection drug users — reveal Insite positively influenced behaviour, says Thomas Kerr, lead author.

“What’s significant is that Insite attracted people who previously were at high risk of sharing syringes, but after the facility opened we’re seeing reductions in this dangerous behaviour,” says Kerr.

The research results are good news for Vancouver Coastal Health (VCH). “These are the precise outcomes we designed the facility to achieve,” says Dr. David Marsh, Physician Leader, Addiction Medicine, VCH.

Between December 2003 and June 2004, 431 active injection drug users were surveyed. Of those, 90 (20.9%) reported that all, most or some of their injections were at the safer injection facility. Based on an earlier study, site users were shown to be particularly high-risk drug users. Forty-nine individuals reported syringe sharing in the past six months.

“Individuals who used the supervised injection site for some, most or all of their injections were 70% less likely to report syringe sharing,” says Kerr. “Even when all other risk factors were considered, use of the site was independently associated with reduced syringe sharing.”

The study revealed that drug users who need help with injecting and engage in binge drug use were more likely to report syringe sharing.

The paper follows a Centre study published in the Canadian Medical Association Journal last year that revealed Insite’s opening was associated with improved public order by reducing injection drug use and syringe disposal in public spaces. Twelve weeks after Insite opened in September 2003, the study found the average daily number of drug users injecting in public dropped by nearly half, while the average daily number of publicly discarded syringes and injection-related litter also fell significantly.

Insite is the first government sanctioned facility of its kind in North America. The facility was opened by Vancouver Coastal Health (VCH) in partnership with the Portland Hotel Society. The B.C. Centre for Excellence in HIV/AIDS was contracted to conduct an arms-length evaluation of the impact of Insite on public order and public health. The Centre project, formally known as the Scientific Evaluation of Supervised Injecting Study (SEOSI), will evaluate changes in HIV risk behaviour, overdose rates, addiction treatment and public injecting over the duration of the pilot SIS project.