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. 2016 Feb;106(2):301-7.
doi: 10.2105/AJPH.2015.302959. Epub 2015 Dec 21.

Reduction in Needle Sharing Among Seattle-Area Injection Drug Users Across 4 Surveys, 1994-2013

Richard D Burt  1 , Hanne Thiede  1
Affiliations

Reduction in Needle Sharing Among Seattle-Area Injection Drug Users Across 4 Surveys, 1994-2013

Richard D Burt et al. Am J Public Health. 2016 Feb.

Abstract

Objectives: We evaluated time trends in sharing needles and other injection equipment from 1994 to 2013 among injection drug users in the Seattle, Washington area.

Methods: We combined data from 4 sources: the Risk Activity Variables, Epidemiology, and Network (RAVEN) study, recruited from institutional settings; the Kiwi study, recruited from jails; National HIV Behavioral Surveillance system (NHBS) surveys, which used respondent-driven sampling; and surveys at needle-exchange sites.

Results: Levels of needle sharing were higher in the earlier studies: RAVEN, 1994 to 1997 (43%) and Kiwi, 1998 to 2002 (61%). In the NHBS surveys, the initial level of 44% in 2005 declined to 31% in the period 2009 to 2012. Across needle-exchange surveys (2009-2013) the level was 21%. There was a parallel reduction in sharing other injection equipment. These trends persisted after control for sociodemographic and risk-associated variables. There was a contemporaneous increase in the number of needles distributed by local needle exchanges and a decline in the number of reported HIV cases among injection drug users.

Conclusions: The apparent long-term reduction in sharing injection equipment suggests substantial success in public health efforts to reduce the sharing of injection equipment.

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Figures

FIGURE 1—
FIGURE 1—
Time Trends in the Proportion of Participants Reporting Sharing Needles Across Seattle-Area Surveys of Injection Drug Users: 1994–2013 Note. NHBS = National HIV Behavioral Surveillance system; RAVEN = Risk Activity Variables, Epidemiology, and Network study.
FIGURE 2—
FIGURE 2—
Time Trends in the Proportion of Participants Reporting Sharing Injection Equipment Other Than Needles Across Seattle-Area Surveys of Injection Drug Users: 1994–2013 Note. NHBS = National HIV Behavioral Surveillance system; RAVEN = Risk Activity Variables, Epidemiology, and Network study.
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