Continuing HIV Risk in New York City Injection Drug Users: The Association of Syringe Source and Syringe Sharing

Abstract

Sterile syringe access is an important means to reduce HIV risk, but many injection drug users (IDU) who obtain syringes from sterile sources continue to share syringes. We examined the factors associated with continuing syringe sharing in New York City. We recruited 500 active IDU in 2005 through respondent-driven sampling. In multiple logistic regression, not obtaining all syringes in the past year exclusively from sterile sources was associated with increased syringe sharing. Ensuring adequate syringe availability as well as engaging and retaining nonusers and inconsistent users in sterile syringe services may increase sterile syringe access and decrease syringe sharing.

Keywords :

• injection drug use
• HIV
• risk behavior
• syringe exchange
• syringe sharing

THE AUTHORS

Samuel M. Jenness, M.P.H., is an epidemiologist with the HIV Epidemiology Program at the New York City Department of Health and Mental Hygiene. In this position, he is the Project Director and data analyst for two national studies concerning HIV behavioral risk and patterns of HIV medical care underutilization. Prior to this position, he was a public health policy analyst at the Massachusetts Department of Public Health. He received his M.P.H. from the Boston University School of Public Health.

Holly Hagan, Ph.D., is a Senior Research Scientist at the New York University College of Nursing. Dr. Hagan holds a Ph.D. in epidemiology from the University of Washington. She has led a number of longitudinal cohort studies examining blood-borne viral transmission in injection drug users, and, in recent years, her research has sought to characterize the etiology, epidemiology, and prevention of hepatitis C virus infections in drug users. She is currently Principal Investigator of a study of sexual health among drug users in Harlem.

Kai-Lih Liu, Ph.D., M.P.H., is currently Associated Director of the Strategic Information Unit at Family Health International Cambodia office in Phnom Penh. During this study, he was a Research Scientist in the HIV Epidemiology Program of the New York City Department of Health and Mental Hygiene. He completed postdoctoral training in behavioral sciences research in HIV infection at the Columbia University, New York, his doctorate in epidemiology at the Yale University, and M.P.H. in epidemiology at the National Taiwan University, Taipei.

Travis Wendel, J.D., has been an Ethnographer working with New York City drug users and distributors since 1996. He is Principal Investigator of a study of the role of social networks in methamphetamine distribution in New York City and Co-Investigator/Ethnographer of the New York City National HIV Behavioral Survey. His research interests center around social networks and the social organization of the distribution and consumption of illegal commodities. Prior to entering upon a research career, he worked as a bicycle messenger, cook, and nightclub bouncer.

Christopher Murrill, Ph.D., was at the time of this study the Director of the HIV Epidemiology Program's Research Unit at the New York City Department of Health and Mental Hygiene. As the Director of this unit, Dr. Murrill serves as the Principal Investigator on a variety of HIV epidemiologic activities conducted among populations at risk for HIV within New York City. Prior to this position, Dr. Murrill was with the Centers for Disease Control and Prevention's Global AIDS Program. He provided technical expertise and guidance for conducting HIV surveillance in a variety of developing countries throughout Africa, Southeast Asia, and the Caribbean. Dr. Murrill received his doctorate in epidemiology at the Tulane University and has worked extensively both domestically and internationally in the field of HIV surveillance and epidemiology.