Prevalence and Correlates of Indirect Sharing Practices Among Young Adult Injection Drug Users in Five U.S. Cities

"Sharing of drug paraphernalia to prepare, measure, and divide drugs for injection remains an important residual risk factor for hepatitis C and other blood-borne infections among injection drug users (IDUs), especially as sharing of syringes for injection decreases," explained the study authors.

Data from five US cities were analyzed to assess the prevalence and independent correlates of non-syringe paraphernalia-sharing (NSPS) and syringe-mediated drug-splitting (SMDS) among IDUs ages 15-30 who reported not injecting with others' used syringes (receptive syringe-sharing, RSS).

Fifty-four percent of IDUs who did not practice RSS reported NSPS, which was independently associated (p<0.05) with having five or more injection partners, injecting with sex partners or regular injection partners, injecting in shooting galleries, the sharing behaviors of peers, lower self-efficacy for avoiding NSPS, and less knowledge of HIV and hepatitis C transmission. Twenty-six percent of IDUs who did not practice RSS reported SMDS, which was independently associated with having five or more injection partners and injecting in shooting galleries; SMDS was inversely associated with unknown HIV status.

NSPS and SMDS were common among IDUs in the current study, the researchers concluded. "Increased efforts to prevent these risky practices should address social and environmental contexts of injection and incorporate knowledge and skills building, self-efficacy, and peer norms," they suggested.

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