Unsafe injecting practices among attendees of syringe exchange programmes in France.
OBJECTIVE
To describe syringe exchange programme attendees and their injection practices.


METHODS
Cross-sectional study (one week in 1998). Data were collected through a standardized questionnaire.


METHODS
60/74 syringe exchange programmes (SEPs) in France.


METHODS
Clients requesting syringes in 60 SEPs.


METHODS
Self-reports of drug use, injecting behaviour, sexual behaviour, serological status (HIV, HBV, HCV). Prevalence of unsafe injecting practices in the previous month such as: syringe sharing; and sharing other injection paraphernalia.


RESULTS
1004 questionnaires were collected (response rate: 50%). The mean age of respondents was 30 years, and 70% were males. Among individuals tested, HIV reported prevalence was 19.2%, HCV 58.4% and HBV 20.8%. The mean duration of drug use was 11 years. Eighty-five percent were polydrug users and buprenorphine high-dosage was the substance most used (73%). In the previous month, 45% of the participants had re-used a syringe, 93% injected at least daily (mean 3.6 injections per day), 18% shared a syringe and 71% shared injection paraphernalia. In multivariate analyses, unsafe injecting practices were associated with heroin and cocaine use and with living in a couple. The cluster analysis identified five categories of IDUs: users of buprenorphine-HD (45% of the responders), morphine-sulphate (17%), benzodiazepines and other legal drugs (13%), methadone associated with other legal drugs (13%) and crack-cocaine (13%). The buprenorphine-HD group had better social status and safer injection practices.


CONCLUSIONS
In France, despite an increase in the accessibility to syringes and substitution treatments, unsafe injecting practices persist among SEP attenders. Interventions should stress the importance of using sterile material for each injection, even with a steady sex partner.
Valenciano
M
M
Institut de Veille Sanitaire, St-Maurice, France.
Emmanuelli
J
J
Lert
F
F
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects*; D018671:Needle-Exchange Programs; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D011795:Surveys and Questionnaires