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Sharing of Injection Drug Preparation Equipment is Associated with HIV Infection

A Cross Sectional Study

Ball, Laura J. MPH1; Puka, Klajdi MSc2; Speechley, Mark PhD2; Wong, Ryan BMSc1; Hallam, Brian MSc2; Wiener, Joshua C. BHSc2; Koivu, Sharon MD3; Silverman, Michael S. MD, FRCP, FACP1

JAIDS Journal of Acquired Immune Deficiency Syndromes: April 19, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/QAI.0000000000002062
Original Article: PDF Only

Background. Sharing needles/syringes is an important means of HIV transmission amongst persons who inject drugs (PWIDs). London, Canada is experiencing an outbreak of HIV amongst PWIDs, despite a large needle/syringe distribution program and low rates of needle/syringe sharing.

Objective. To determine whether sharing of injection drug preparation equipment (IDPE) is associated with HIV infection.

Methods. Between August 2016 and June 2017, individuals with a history of injection drug use and residence in London were recruited to complete a comprehensive questionnaire and HIV testing. We conducted a cross sectional study to examine the risk factors associated with the HIV outbreak.

Results. A total of 127 participants were recruited; 8 were excluded due to failure to complete HIV testing. The remaining 35 HIV infected (cases) and 84 HIV uninfected (controls) participants were assessed. Regression analysis found that sharing IDPE, without sharing needles/syringes, was strongly associated with HIV infection (Adjusted Odds Ratio: 22.1, 95% Confidence Interval: 4.51-108.6, p<0.001).

Conclusions. Sharing of IDPE is a risk factor for HIV infection among PWIDs, even in the absence of needle/syringe sharing. Harm reduction interventions to reduce HIV transmission associated with this practice are urgently needed.

This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

1Department of Medicine, Western University, B3 414, St. Joseph’s Health Care London, PO Box 5777, Stn B, London, Ontario, Canada N6A 4V2

2Department of Epidemiology and Biostatistics, Western University, Kresge Building, Room K201B, London, Ontario, Canada N6A 5C1

3Department of Family Medicine, Western University, The Western Centre for Public Health and Family Medicine, 1st floor, Schulich School of Medicine & Dentistry, Western University,1465 Richmond St., London, ON, Canada N6G 2M1

Corresponding Author: Laura Jane Ball, MPH Schulich School of Medicine and Dentistry London, Ontario CANADA

Conflicts of Interest and Sources of Funding: The authors have no relevant conflicts of interest. This research was supported by unrestricted grants from the Ontario HIV Treatment Network, and St Joseph’s Hospital Foundation. This research was presented at the Canadian Society of Addiction Medicine Conference in Vancouver 2018.

Contact Information: Dr. Michael Silverman, MD, FACP, FRCP 268 Grosvenor St. London, ON N6A 4V2 Ph: 519-646-6311 Fx: 519-646-6328

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