title: Patterns of drug use and associated harms among rural injecting drug users: comparisons with metropolitan injecting drug users.
abstract: OBJECTIVE
  Given the harms associated with injecting drug use to both individuals and community and the paucity of such data from rural areas, the study aimed to compare: patterns of drug use, harms, and service access and utilisation among rural and metropolitan injecting drug users (IDU).
  
  
  METHODS
  Cross-sectional survey, using interviewer-administered structured questionnaire.
  
  
  METHODS
  One hundred and sixty-four rural and 96 metropolitan IDU from seven different New South Wales Area Health Services, recruited through needle and syringe programs (NSPs), snowballing techniques and advertisement.
  
  
  RESULTS
  Age, gender, education and employment were similar for rural and metropolitan participants. Both samples reported use of a range of drugs, but rural participants were less likely than metropolitan participants to report daily heroin use (2% vs 10%), but more likely to report having injected morphine (50% vs 21%) in the last six months. Similar proportions reported using a needle/syringe after another person. Rural participants were less likely to report use of NSPs (36% vs 80%) and reported a number of barriers to NSP access and also to drug treatment services. Rural participants reported a significantly longer period of time between blood-borne virus testing.
  
  
  CONCLUSIONS
  Samples of rural IDU are similar to metropolitan, although report some differences in patterns of drug use. Service provision, including access to new injecting equipment, blood-borne virus testing and drug treatment was found to cause considerable problems for rural IDU. These issues warrant further consideration.
authors.affiliation: National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Darlinghurst, New South Wales, Australia. cday@nchecr.unsw.edu.au
authors.forename: Carolyn
authors.initials: C
authors.lastname: Day
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Conroy
authors.forename: Julia
authors.initials: J
authors.lastname: Lowe
authors.forename: Jude
authors.initials: J
authors.lastname: Page
authors.forename: Kate
authors.initials: K
authors.lastname: Dolan
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D019969:Amphetamine-Related Disorders / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006505:Hepatitis / Q000175:diagnosis / Q000453:epidemiology; D006556:Heroin Dependence / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009021:Morphine Dependence / Q000453:epidemiology; D016485:Needle Sharing / Q000706:statistics & numerical data; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data; D009517:New South Wales / Q000453:epidemiology; D012309:Risk-Taking; D012424:Rural Population / Q000706:statistics & numerical data*; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D015819:Substance Abuse, Intravenous / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D014505:Urban Population / Q000706:statistics & numerical data*