title: Parenteral transmission of HIV among injection drug users: assessing the frequency of multiperson use of needles, syringes, cookers, cotton, and water.
abstract: OBJECTIVE
  To describe and estimate the frequency of different types of drug preparation and injection practices that could result in the transfer of blood and blood-borne infections among injection drug users (IDUs).
  
  
  METHODS
  We analyzed data from interviews administered to 12,323 active IDUs recruited from 19 sites in the United States. The interviews ascertained drug-related behaviors during the previous 30 days.
  
  
  RESULTS
  31.9% of IDUs reported that they engaged in the use of both needle/syringes and cookers/cotton/water previously used by another IDU; 8.6% engaged only in the use of needle/syringes previously used by another IDU; 17.5% engaged only in the use of cookers/cotton/water previously used by another IDU; and 42.0% reported using neither needle/syringes nor cookers/cotton/water previously used by another IDU. Only 12.6% reported use of new (never-used) needle/syringes. The 3935 IDUs who used both needle/syringes and cookers/cotton/water that had been previously used by another IDU had more than 311.000 potential exposures to blood-borne infections from these high-risk practices in 30 days; about 64% of these exposures were from multiperson use of cookers/cotton/water.
  
  
  CONCLUSIONS
  Programs to limit parenteral transmission of HIV and other blood-borne infections among IDUs must consider all drug preparation and injection practices that could allow transfer of blood and blood-borne infections among IDUs.
authors.affiliation: Department of Epidemiology and Public Health and Comprehensive Drug Research Center, University of Miami, Florida 33136, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: McCoy
authors.forename: L R
authors.initials: LR
authors.lastname: Metsch
authors.forename: D D
authors.initials: DD
authors.lastname: Chitwood
authors.forename: P
authors.initials: P
authors.lastname: Shapshak
authors.forename: S T
authors.initials: ST
authors.lastname: Comerford
mesh_terms: D017848:Blood-Borne Pathogens; D004339:Drug Compounding; D017743:Equipment Reuse; D015658:HIV Infections / Q000635:transmission*; D015528:HIV Seroprevalence; D006801:Humans; D007407:Interviews as Topic; D016485:Needle Sharing / Q000706:statistics & numerical data*; D009339:Needles; D015819:Substance Abuse, Intravenous; D013594:Syringes; D014481:United States; D014867:Water
chemical_list: D014867:Water