Regional variation in HIV prevalence and risk behaviours in Ontario injection drug users (IDU).
OBJECTIVE
To measure HIV prevalence, risk behaviours, and further service needs in needle exchange programs throughout Ontario, and to conduct regional comparisons.


METHODS
Injection drug users (IDU) recruited through the efforts of needle exchange programme (NEP) staff in 9 Ontario cities during 1997-98 completed questionnaires about their drug use and behaviours and provided saliva and/or dried blood samples for anonymous unlinked HIV testing.


RESULTS
Demographic and drug use characteristics of participants showed great regional variation. HIV prevalence by region ranged from 1.4% to 14.7%. In addition to region, HIV positivity was associated with injecting for more than 5 years, use of (powder) cocaine, use of crack, binge injection (10 or more times per day at least once in the previous 6 months), and being a longer-term NEP user. Sharing of injection equipment, and especially of other drug injection materials such as water and cookers, remain important issues, although much of the sharing reported is with only one other person. Unmet demand for methadone treatment was identified despite changes in regulation of methadone provision designed to make it more accessible.


CONCLUSIONS
This study suggested significant further HIV prevention needs among IDU throughout Ontario. There is also evidence of potential to provide additional services such as methadone at NEPs if the required resources are invested. NEPs that have succeeded in gaining the trust of high-risk IDU offer a means to provide access to needed services.
Millson
Peggy
P
HIV Social, Behavioural and Epidemiological Studies Unit, Faculty of Medicine, University of Toronto, 3rd Floor, 12 Queen's Park Cres. W., Toronto, ON M5S 1A8. p.millson@utoronto.ca
Myers
Ted
T
Calzavara
Liviana
L
Wallace
Evelyn
E
Major
Carol
C
Degani
Naushaba
N
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D017280:Condoms / Q000706:statistics & numerical data; D016001:Confidence Intervals; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology; D006801:Humans; D008297:Male; D016485:Needle Sharing / Q000706:statistics & numerical data; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D012309:Risk-Taking; D017678:Sex Distribution; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires