High Dead-Space Syringes and the Risk of HIV and HCV Infection Among Injecting Drug Users

High dead-space syringes (HDSSs) retain more than 1,000 times more blood after rinsing than do low dead-space syringes (LDSSs). The current study examines the association between using and sharing HDSSs and prevalent HIV and hepatitis C virus (HCV) infections among injecting drug users (IDUs).

In Raleigh-Durham, N.C., a sample of 851 out-of-treatment IDUs was recruited between 2003 and 2005. The participants were tested for HIV and HCV antibodies. Via interviews, information was collected on demographics, drug use, and injection practice. Multiple logistic regression analysis was employed to analyze data. The mean age of the sample was 40; 74 percent were male; 63 percent were African-American; 29 percent were non-Hispanic white; and 8 percent were of another race/ethnicity.

A total of 42 percent of participants reported having ever used an HDSS; 12 percent reported sharing an HDSS. Among IDUs who reported sharing an HDSS, HIV prevalence was 16 percent, compared with 5 percent among IDUs who had never used an HDSS. The HIV model used a propensity score approach to adjust for differences between IDUs who had used an HDSS and those who had never used one. The HCV models included all potential confounders as covariates.

"A history of sharing HDSSs was associated with prevalent HIV (odds ratio=2.50; 95 percent confidence interval=1.01-6.15). Use and sharing of HDSSs were also associated with increased odds of HCV infection," concluded the authors, who called for prospective studies to determine if sharing HDSSs is associated with increased HIV and HCV incidence among IDUs.

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