title: HIV seroprevalence among participants at a Supervised Injection Facility in Vancouver, Canada: implications for prevention, care and treatment.
abstract: North America's first government sanctioned medically supervised injection facility (SIF) was opened during September 2003 in Vancouver, Canada. This was in response to a large open public drug scene, high rates of HIV and hepatitis C transmission, fatal drug overdoses, and poor health outcomes among the city's injection drug users. Between December 2003 and April 2005, a representative sample of 1,035 SIF participants were enrolled in a prospective cohort that required completing an interviewer-administered questionnaire and providing a blood sample for HIV testing. HIV infection was detected in 170/1007 (17%) participants and was associated with Aboriginal ethnicity (adjusted Odds Ratio [aOR], 2.70, 95% Confidence Interval [95% CI], 1.84-3.97), a history of borrowing used needles/syringes (aOR, 2.0, 95% CI, 1.37-2.93), previous incarceration (aOR, 1.87, 95% CI, 1.11-3.14), and daily injection cocaine use (aOR, 1.42, 95% CI, 1.00-2.03). The SIF has attracted a large number of marginalized injection drug users and presents an excellent opportunity to enhance HIV prevention through education, the provision of sterile injecting equipment, and a supervised environment to self-inject. In addition, the SIF is an important point of contact for HIV positive individuals who may not be participating in HIV care and treatment.
authors.affiliation: Department of Medicine, University of British Columbia, Vancouver Hospital, 2775 Laurel Street, Vancouver, V5Z 1M9, Canada. mtyndall@cfenet.ubc.ca
authors.forename: Mark W
authors.initials: MW
authors.lastname: Tyndall
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Ruth
authors.initials: R
authors.lastname: Zhang
authors.forename: Calvin
authors.initials: C
authors.lastname: Lai
authors.forename: Julio S G
authors.initials: JS
authors.lastname: Montaner
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr