Injecting risk behaviours amongst people who inject drugs: A global multi-stage systematic review and meta-analysis.
HCV
HIV
Injecting drug use
Injectiong risk behaviour
People who inject drugs
Journal
The International journal on drug policy
ISSN: 1873-4758
Titre abrégé: Int J Drug Policy
Pays: Netherlands
ID NLM: 9014759
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
08
01
2020
revised:
10
07
2020
accepted:
10
07
2020
pubmed:
28
7
2020
medline:
29
7
2021
entrez:
27
7
2020
Statut:
ppublish
Résumé
Injecting risk behaviour, such as receptive sharing of injecting equipment and/or re-using one's equipment, is associated with bloodborne virus transmission and infections in people who inject drugs (PWID). We aimed to estimate prevalence and correlates of injecting risk behaviours amongst PWID. We conducted a systematic review and meta-analyses to estimate country, regional, and global prevalences of injecting risk behaviours (including sharing or re-using needle/syringe and sharing other injecting equipment). Using meta-regression analyses, we determined associations between study- and country-level characteristics and receptive needle/syringe sharing. From 61,077 identified papers and reports and 61 studies from expert consutation, evidence on injecting risk behaviours was available for 464 studies from 88 countries. Globally, it is estimated that 17.9% (95%CI: 16.2-19.6%) of PWID engaged in receptive needle/syringe sharing at last injection, 23.9% (95%CI: 21.2-26.5%) in the past month, and 32.8% (95%CI: 28.6-37.0%) in the past 6-12 months. Receptive sharing of other injecting equipment was common. Higher prevalence of receptive needle/syringe sharing in the previous month was associated with samples of PWID with a lower proportion of females, shorter average injecting duration, a higher proportion with ≥daily injecting, and older studies. Countries with lower development index, higher gender inequality and lower NSP coverage had higher proportions reporting receptive needle/syringe sharing. High levels of injecting risk behaviours were observed amongst PWID globally, although estimates were only available for half of the countries with evidence of injecting drug use. There is a need for better capturing of injecting risk behaviours in these countries to inform implementation of harm reduction services and evaluate potential impacts of interventions to reduce risk.
Sections du résumé
BACKGROUND
Injecting risk behaviour, such as receptive sharing of injecting equipment and/or re-using one's equipment, is associated with bloodborne virus transmission and infections in people who inject drugs (PWID). We aimed to estimate prevalence and correlates of injecting risk behaviours amongst PWID.
METHODS
We conducted a systematic review and meta-analyses to estimate country, regional, and global prevalences of injecting risk behaviours (including sharing or re-using needle/syringe and sharing other injecting equipment). Using meta-regression analyses, we determined associations between study- and country-level characteristics and receptive needle/syringe sharing.
RESULTS
From 61,077 identified papers and reports and 61 studies from expert consutation, evidence on injecting risk behaviours was available for 464 studies from 88 countries. Globally, it is estimated that 17.9% (95%CI: 16.2-19.6%) of PWID engaged in receptive needle/syringe sharing at last injection, 23.9% (95%CI: 21.2-26.5%) in the past month, and 32.8% (95%CI: 28.6-37.0%) in the past 6-12 months. Receptive sharing of other injecting equipment was common. Higher prevalence of receptive needle/syringe sharing in the previous month was associated with samples of PWID with a lower proportion of females, shorter average injecting duration, a higher proportion with ≥daily injecting, and older studies. Countries with lower development index, higher gender inequality and lower NSP coverage had higher proportions reporting receptive needle/syringe sharing.
CONCLUSIONS
High levels of injecting risk behaviours were observed amongst PWID globally, although estimates were only available for half of the countries with evidence of injecting drug use. There is a need for better capturing of injecting risk behaviours in these countries to inform implementation of harm reduction services and evaluate potential impacts of interventions to reduce risk.
Identifiants
pubmed: 32712484
pii: S0955-3959(20)30206-1
doi: 10.1016/j.drugpo.2020.102866
pii:
doi:
Substances chimiques
Pharmaceutical Preparations
0
Types de publication
Journal Article
Meta-Analysis
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
102866Subventions
Organisme : Medical Research Council
ID : MR/N00616X/1
Pays : United Kingdom
Organisme : Department of Health
ID : RP-PG-0616-20008
Pays : United Kingdom
Organisme : NIDA NIH HHS
ID : R01 DA037773
Pays : United States
Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Déclaration de conflit d'intérêts
Declaration of Competing Interest In the past three years, LD has received investigator-initiated untied educational grants for studies of opioid medications in Australia from Indivior and Seqirus. SL has received investigator-initiated untied educational grants from Indivior. AP and SM have received investigator-initiated untied educational grants from Seqirus. JG is a consultant/advisor and has received research grants from Abbvie, Cepheid, Gilead Sciences and Merck/MSD. JS reports non-financial support from Gilead Sciences, outside the submitted work. PV has received research support from Gilead Sciences and honoraria from AbbVie and Gilead Sciences, in relation to hepatitis C virus treatment for people who inject drugs. MH has received personal fees from Gilead Sciences, AbbVie, and Merck Sharp & Dohme.These companies/organisations had no knowledge of or role in the design, conduct, interpretation or publication of these findings.