HIV prevalence and risk behaviour in needle exchange attenders - a national study

Abstract

Objective: To determine whether needle and syringe exchange programs represent feasible sites to describe the prevalence of HIV and related risk behaviour among injecting drug usersDesign: Cross-sectional surveySetting: 21 needle and syringe exchange programs in all Australian jurisdictionsParticipants: All persons attendgin the needle and syringe exchange programs over one week in March 1995 were eligible to participate in the study once.Intervention: Needle and syringe exchange attenders were asked to complete a brief, self-administered questionnaire and provide a finger-prick blood sample.Main outcome measures: Prevalence of HIV antibody,drug rejecting and sexual behaviour, and survey costResults: Completed questionnaires with blood samples suitable for testing were provided by 1005 (42%)of 2373 individuals who attended the needle and syringe exchange programs during the survey week. Women were more likely than men to participate in the survey but there was no difference in the response rate by age group. The HIV prevalence was 2.1% and was significantly higher in men who described themselves as homosexual, compared to men who described themselves as heterosexual (22.5% v. 0.7%;P<0.001). Thirty-one per cent of respondents reported using a syringe after someone else in the preceding month.Conclusion: Cross-sectional surveys of needle exchange clients offer a practical method for monitoring risk behaviour and seroprevalence of bloodborne viral infections.