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At least 19 recordsLinked to original sources
PubMed1985

Intravenous drug abusers and the acquired immunodeficiency syndrome (AIDS). Demographic, drug use, and needle-sharing patterns.

We studied the demographic characteristics, drug use patterns, and sexual habits of intravenous (IV) drug abusers to further define this population at risk for acquired immunodeficiency syndrome (AIDS). Sixteen IV drug abuser patients with AIDS, 24 IV drug abuser patients with AIDS-related complex (ARC), and 14 IV drug abuser controls without evidence of AIDS or ARC were evaluated. The subjects in each group were similar demographically, in drug use practice, and in sexual orientation and experience. Of the AIDS and ARC patients, 34 (88%) of 40, including all seven homosexual men, shared needles, as did all drug abusers without AIDS or ARC. Seventy-four percent of patients, including all homosexual men, attended "shooting galleries," where anonymous multiple-partner needle sharing took place. Needle sharing supports the hypothesis of AIDS transmission by a blood-borne route, can explain the spread of AIDS and the high rate of seropositivity to the putative AIDS agent among IV drug abusers, and is a logical link between IV drug abusers and male homosexuals, the two largest groups with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Risk factors for needle sharing among methadone-treated patients.

OBJECTIVE: This paper examines the sociodemographic and psychiatric characteristics of patients taking methadone who continue to share needles. METHOD: Three hundred twenty-three patients were recruited from four methadone programs. Data were collected by using questionnaires and interviews. Psychiatric symptoms were measured with the SCL-90, the Beck Depression Inventory, and the Addiction Severity Index. RESULTS: Twenty percent of these subjects reported sharing needles within the previous 6 months. Those who shared reported greater difficulty in acquiring new needles, more legal difficulties, more severe drug problems, and higher levels of psychiatric symptoms. CONCLUSIONS: These data suggest that patients who continue to share needles are a more disturbed subgroup of the methadone maintenance population. Efforts designed to reduce needle sharing may need to be more sharply focused on patients who are at greatest risk of infection, and these patients may require more intensive psychiatric services.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Reliability and construct validity of the needle sharing inventory.

The Needle Sharing Inventory (NSI) is a 59-item test developed to specify and assess behavior patterns associated with drug use and needle sharing. In order to determine its reliability and construct validity, the NSI was administered to 80 intravenous drug users (IVDUs) recruited from a methadone maintenance program in New York City. Patients were included in the study if they reported using intravenous drugs during the previous month. Factor analysis was performed indicating that 31 of the items loaded onto 6 factors similar to those hypothesized: four dealing with the social context of needle sharing - indiscriminate sharing, social sharing, intimate sharing, and use of shooting galleries; and two dealing with the emotional context of intravenous drug use negative affect states and positive affect states. These variables accounted for 71% of the total variance, suggesting internal consistency of these items. Factor scores significantly correlated to subjects' self-reported estimates of time using nonsterile needles and sharing needles. These data suggest that the NSI is both a reliable and a valid measure which may be used in future studies of intravenous drug use and needle sharing behavior patterns. The NSI may prove useful for the purpose of developing and evaluating interventions aimed at preventing or reducing the spread of HIV through needle sharing.

Adult↗
PubMed1996

People and places: behavioral settings and personal network characteristics as correlates of needle sharing.

Sharing of contaminated needles constitutes one of the primary modes of HIV transmission in the U.S. This study examined social and environmental factors as possible correlates of needle sharing in a sample of inner-city drug users in Baltimore, Maryland. Drug users' social context was assessed through an analysis of personal networks, and the environmental context of drug use was assessed through a delineation of injection settings. The 330 respondents participating in an HIV prevention study were administered two surveys an average of 5.2 months apart. An examination of the association of network characteristics at baseline and needle sharing at followup revealed that the factors of higher total network density, larger drug network size, and injecting at friends' residences were positively associated with reports of sharing needles that had been cleaned with bleach. Sharing of needles that had not been disinfected with bleach was positively associated with reports of injecting in semipublic areas (streets, rooftops, parks, cars, public bathrooms, and abandoned buildings). These data support ecological and resource models of needle sharing and suggest the potential utility of network-oriented strategies for reducing needle sharing among injecting drug users.

Adult↗
PubMed1990

Needle-sharing practices and risk for AIDS transmission among intravenous drug users in Seattle.

Sharing of needles by intravenous drug users is known to be one of the major means for the transmission of the HIV virus into the general population. In Seattle, where liberal laws make acquisition of needles relatively easy, it has been assumed that needle sharing is not a significant problem. Results of a survey of 212 methadone maintenance clients demonstrated that needle sharing is quite prevalent among intravenous drug users in this area and that addicts fail to sterilize their needles between uses. Because the rate of HIV infection among Seattle's intravenous drug users is relatively low, immediate intervention efforts by public health authorities can prevent a rapid acceleration of the infection rate.

Acquired Immunodeficiency Syndrome↗
PubMed2003

A meta-analysis of needle sharing, lending, and borrowing behaviors of needle exchange program attenders.

This study used meta-analysis to examine cumulatively needle exchange program (NEP) change/comparison data from 47 studies between 1988 and 2001, based on data collected between 1986 and 1997. The research question posed was: Is NEP attendance associated with reductions in risky needle-related behaviors? Results indicated that needle sharing (r = -.189), variations on the outcome measure of needle sharing (r = -.161), and needle lending/borrowing (r = -.194) consistently declined among NEP attenders, suggesting the NEPs are effective in reducing risky needle-related behaviors of IDUs. The meta-analytic results lend support to the harm-reduction philosophy often used as the rationale for the establishment and maintenance of NEPs.

Female↗
PubMed2006

Needle-sharing among young IV drug users and their social network members: The influence of the injection partner's characteristics on HIV risk behavior.

Injection drug use is a risk factor for HIV among adolescents and young adults, yet the interpersonal dynamics of needle-sharing among young injectors remain poorly understood. Research has focused on identifying the characteristics of individual IV drug users (IVDUs) that increase their risk of needle-sharing. Most studies have not taken into consideration IVDUs' decisions to share needles with certain partners but not with other partners. This study examined partner characteristics associated with needle-sharing among 96 male and 77 female young adult IV drug users who had shared needles previously. Men were most likely to share needles with partners who gave them emotional support, partners who they injected or who injected them, and partners with whom they had had sex. Women were most likely to share needles with partners who they injected or who injected them, partners with whom they had discussed HIV risk, and partners with whom they had had sex. Results indicate that needle-sharing occurs within the context of mutual injection rituals and close emotional and sexual relationships. Public health interventions are needed to help young IVDUs to avoid needle-sharing with intimate partners.

Adolescent↗
PubMedDate not supplied

Needle sharing behaviour among injection drug users (IDUs) in treatment in Montreal and Toronto, 1988-1989.

Injection drug users (IDUs) entering treatment programs in Montreal and Toronto were recruited for a study of drug using behaviour and risk of HIV infection. Only those who had injected within 6 months of entering their treatment program were eligible for participation. 183 subjects were recruited in Montreal and 167 in Toronto between November, 1988 and October, 1989. Each participant completed a standardized interviewer-administered questionnaire which focussed on, among other things, drug history and needle sharing behaviour. Approximately three-quarters of respondents in both cities reported sharing needles and syringes within the 6-month period prior to their entry into treatment. Our analysis, which focussed on variables associated with needle sharing revealed that having a sexual partner who injected, trouble obtaining sterile needles and syringes and cocaine injection were significantly and independently associated with needle sharing in a logistic regression model which also controlled for city of recruitment.

AIDS Serodiagnosis↗
PubMed2003

Needle sharing among southern Thai drug injectors.

AIM: To examine factors associated with needle sharing among injecting drug users (IDU) in southern Thailand. DESIGN: Using a cross-sectional survey, 272 active IDU were interviewed about their socio-economic background, needle sharing and drug use patterns at six drug-treatment clinics in southern Thailand. FINDINGS: Ninety-one per cent of IDU gave a past history of ever sharing injecting equipment: of these, 23% currently injected but did not share and 68% still shared. Only 5% of participants knew that bleaching needles could reduce HIV transmission risks. Recent needle sharing was correlated with number of IDU friends (OR 12.23; CI, 5.24-28.51), engaging in illegal jobs (OR 2.74; CI, 1.13-6.67), being unable to use new needles at all times (OR 2.89; CI, 1.17-7.14) and believing that cleaning contaminated shared needles with at least plain water could reduce HIV transmission (OR 3.32; CI, 1.16-6.68). CONCLUSIONS: Our data suggest that AIDS prevention efforts should focus on approaches to reduce needle sharing. Needle exchange programs, HIV counseling and testing and bleach distribution may reduce levels of needle-sharing risks.

Adult↗
PubMed2000

Needle sharing in opioid-dependent outpatients: psychological processes underlying risk.

Needle sharing contributes to the spread of the human immunodeficiency virus and other health concerns and remains a persistent problem among injection drug users. We determined whether needle sharing may be related to the discounting of the value of delayed outcomes. Outpatients in treatment for heroin dependence indicated preference for immediate versus delayed hypothetical monetary and heroin outcomes in a titration procedure that determined indifference points at various delays. The degree to which the delayed outcomes lost value was estimated with a nonlinear decay model. Participants who agreed to share a needle in a scenario (N=15) discounted delayed money more steeply than did the nonsharing group (N=17). Both groups discounted delayed heroin more steeply than delayed money. Persistent needle sharing may be related to the relative inability of delayed outcomes to impact current behavior. Training to mitigate the effect of delay on outcome value may offer reductions in needle sharing and drug abuse.

Adult↗
PubMed1991

Needle sharing in The Netherlands: an ethnographic analysis.

BACKGROUND: Needle sharing has been reported to be the main cause of the rapid spread of the human immunodeficiency virus (HIV) among injecting drug users. Risk behaviors such as needle sharing are, however, the end result of complicated interaction patterns in drug user networks, which have their specific rules and rituals, and larger social structures and official drug policy. METHODS: To study these interaction patterns we examined the drug administration rituals of heroin addicts in Rotterdam, The Netherlands. Intensive ethnographic descriptions were collected by participant observation. RESULTS: In less than 10% of the observed self-injections unsafe syringes were used. In 68% of the self-injections new, sterile syringes were used. Needle sharing as a planned sequence was not observed. Sharing was determined primarily by the availability of syringes, experience with the injecting ritual, and drug craving. In all observed needle-sharing events, subjects were aware of the risks involved and undertook efforts to clean the injection equipment. CONCLUSIONS: In contrast to psychological approaches aimed at reducing individual "risk behavior," these findings suggest that HIV prevention can be made more effective if active drug injectors are organized to help themselves and their peers prevent high-risk exchange situations.

Adult↗
PubMed2005

Mental health status, drug treatment use, and needle sharing among injection drug users.

This study examined the relationship among mental health symptoms, drug treatment use, and needle sharing in a sample of 507 injection drug users (IDUs). Mental health symptoms were measured through the ASI psychiatric scale. A logistic regression model identified that some of the ASI items were associated with needle sharing in an opposing direction. Specifically, anxiety was significantly and positively associated with needle sharing. Using psychotropic medication was significantly and negatively associated with sharing needles. Those who had higher levels of drug injecting were more likely to share needles and those with an HIV-positive status were less likely to share needles. Finally, IDUs who reported high levels of drug treatment use (in the 75th percentile in terms of number of treatment admissions) were also more likely to share needles. Results suggest that treating mental health problems in IDUs who are not drug free could reduce HIV risk behaviors. The results also suggest the need to develop new intervention methods for high-level drug treatment users who may be "cycling" through treatment with low levels of treatment completion.

Adult↗
PubMed1999

Depressive symptoms, drug network, and their synergistic effect on needle-sharing behavior among street injection drug users.

In this study, we examined the relationship between depressive symptoms and needle-sharing behavior in a community sample of intravenous drug users (N = 499) in Baltimore, Maryland. Based on the polytomous logistic regression, higher depressive symptoms were positively associated both with needle sharing after cleaning with bleach and with needle sharing without first cleaning with bleach at the bivariate analyses. This relationship remained significant (OR = 1.66) even after adjusting for demographic characteristics, life events, drug use patterns, and social and drug networks. A significant synergistic effect of depressive symptoms and drug network on needle sharing after cleaning with bleach and needle sharing without cleaning was observed. More depressed intravenous drug users who also had a larger drug network were found to be at higher risk of needle sharing after cleaning with bleach, as well as needle sharing without cleaning (OR = 2.59). Depression status is discussed as a predisposing factor and drug network size as a precipitating factor for needle-sharing behavior. Implications for preventing needle-sharing behavior by reducing depressive symptoms are discussed.

Adult↗
PubMedDate not supplied

Lifetime needle sharing: a predictive analysis.

Through understanding predictors of needle sharing, it may be possible to design AIDS prevention interventions more effectively. Data were collected from a sample of 416 patients in two New York City methadone programs in 1990. Questions were asked about needle sharing and about a battery of predictors covering 11 psychosocial domains. Based on factor analysis, these were reduced to seven factors: criminal history, antisocial characteristics, social integration, severity of psychiatric problems, current drug involvement, physical health, and personality disorders. Bivariate analyses showed that criminal involvement, antisocial characteristics, social integration, and age were significantly related to needle sharing. With the seven factors, as well as age, gender, and ethnicity simultaneously examined by means of regression analysis, it was found that criminal involvement, severity of psychiatric problems, and age were all positively associated with needle sharing. Implications for treatment are discussed.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The intravenous injection of illicit drugs and needle sharing: an historical perspective.

This study reviewed the literature on the history of needle sharing and intravenous drug abuse. Reports suggest that needle sharing was practiced by drug abusers as early as 1902 in China and 1914 in the United States. Intravenous drug abuse was first mentioned in the literature in 1925. However other references suggest that some opioid users were injecting intravenously prior to 1920. Outbreaks of malaria in Egypt, the United States, and China between 1929 and 1937 were attributed to needle sharing and intravenous injection of opioids. These reports suggest that both needle sharing and intravenous drug use were common by 1937. Factors such as medical use of intravenous injections, enactment and zealous enforcement of antinarcotic laws, and interactions among drug users in institutional settings such as regional hospitals and prisons may have contributed to the spread of both needle sharing and the intravenous technique among drug abusers.

History, 19th Century↗
PubMed1995

Friends and lovers: needle sharing in young people in Western Australia.

The Youth AIDS and Drugs (YAD) Study is a study of young people who inject drugs, and their risk of the transmission of HIV through needle sharing and/or unsafe sex. One hundred and five people, aged less than 21, 75% of whom were current or recent injectors, undertook in-depth interviews which were tape recorded, transcribed and analysed qualitatively. This paper focuses on the ways in which the young people in the group attempted to manage the risk of needle sharing. Needle sharing in the study group was not common behaviour. Almost all injectors employed one of four major Risk Management Strategies some of which included the possibility of sharing unbleached needles with a friend or a lover. These strategies were strongly related to beliefs that such friends and lovers were well enough known by the individual for there to be very little risk. The implications of these findings for health promotion with young people who inject drugs in Perth, a city of low IDU seroprevalence, are outlined.

Acquired Immunodeficiency Syndrome↗
PubMed1993

Psychosocial predictors of needle sharing among intravenous drug users.

This study examined the relationship between health beliefs and needle sharing in a sample of 226 heroin detoxification clients. Zero-order correlations revealed that needle sharing was positively associated with perceived susceptibility and AIDS anxiety, and negatively associated with self-efficacy and communication skill in negotiating safe needle practices. Logistic regression analysis showed that demographic and situational factors also play a role in needle sharing. White race and injection of drugs in shooting galleries or other public places increase the odds of sharing a "dirty" needle, while that probability decreases sharply as a function of drug users' self-efficacy. This last finding suggests that preventive clinical interventions such as counseling or psychoeducational groups maybe needed to help drug users develop confidence in resisting needle sharing.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Correlates of needle sharing among injection drug users.

OBJECTIVES: The sharing of contaminated injection equipment is the primary mode of human immunodeficiency virus (HIV) transmission for injection drug users. This study examined demographic factors, life events, and drug use practices that are potential risk factors for sharing injection equipment. METHODS: Between February 1988 and March 1989, 2921 active injection drug users were interviewed and questioned about their backgrounds, life-styles, and patterns of injection drug use. RESULTS: Of 2524 participants who reported injecting drugs within the 6 months prior to study enrollment, 70.4% reported recent needle sharing. A multivariate analysis found needle sharing to be more frequent among those with a history of arrest and lower socioeconomic status, even after accounting for other demographic and drug use variables. In addition, recent needle sharing was higher in male homosexual or bisexual men than in their heterosexual counterparts. CONCLUSIONS: These data suggest that injection drug users have an economic motive to share needles and that the availability of free and legal needles may reduce levels of needle sharing.

Adult↗