title: Use of supervised injection facilities and injection risk behaviours among young drug injectors.
abstract: OBJECTIVE
  To study the use of supervised injection facilities (SIFs) as a predictor of safer injecting practices.
  
  
  METHODS
  Cross-sectional study conducted with face-to-face interview using a structured questionnaire with computer-assisted personal interviewing. Dried blood spot samples were collected for human immunodeficiency virus (HIV) and hepatitis C virus (HCV) antibody testing.
  
  
  METHODS
  All participants were street-recruited by chain referral methods in Madrid and Barcelona.
  
  
  METHODS
  A total of 249 young heroin drug injectors recruited by the ITINERE cohort study in two Spanish cities with SIFs.
  
  
  METHODS
  The main outcome measures were self-reported injecting behaviours and SIFs attendance.
  
  
  RESULTS
  SIF users were more marginalized socially than non-users. They were also more often regular injectors (weekly or more versus sporadic) [odds ratio (OR) = 4.9, 95% confidence interval (CI): 2.7-8.8], speedball users (OR = 2.5, 95% CI: 1.5-4.3) and anti-HCV-positive (OR = 3.1, 95% CI: 1.4-7.1). In the logistic regression analysis, using SIFs was associated independently with not borrowing used syringes (OR = 3.3, 95% CI: 1.4-7.7). However, no significant association was found between SIF use and not sharing injection equipment indirectly (OR = 1.1, 95% CI: 0.5-2.2).
  
  
  CONCLUSIONS
  SIFs attract highly disadvantaged drug injectors who engage none the less in less borrowing of used syringes than non-users of these facilities. The risks of indirect sharing should be emphasized when counselling SIF attendees.
authors.affiliation: Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain. mbravop@isciii.es
authors.forename: María J
authors.initials: MJ
authors.lastname: Bravo
authors.forename: Luis
authors.initials: L
authors.lastname: Royuela
authors.forename: Luis
authors.initials: L
authors.lastname: De la Fuente
authors.forename: María T
authors.initials: MT
authors.lastname: Brugal
authors.forename: Gregorio
authors.initials: G
authors.lastname: Barrio
authors.forename: Antonia
authors.initials: A
authors.lastname: Domingo-Salvany
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000517:prevention & control*; D015497:HIV-1; D006556:Heroin Dependence / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D018671:Needle-Exchange Programs / Q000458:organization & administration*; D015397:Program Evaluation; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D055815:Young Adult