title: Qualitative accounts of needle and syringe cleaning techniques among people who inject drugs in Sydney, Australia.
abstract: OBJECTIVE
  Cleaning needles/syringes is an important second-line harm reduction strategy, yet there is limited information on practices employed by people who inject drugs in Australia. This study attempts to identify and assess cleaning practices in terms of the techniques involved and the social contexts in which cleaning takes place.
  
  
  METHODS
  As part of an exploratory qualitative study in south-west Sydney, in-depth interviews and simulated cleaning exercises were conducted with 12 people who inject drugs. Interviews were digitally recorded and transcribed verbatim. Open coding was used to inductively classify data into themes, and data were examined for patterns and variations in the relationships within and between themes.
  
  
  RESULTS
  Data indicate that cleaning and reuse of needles/syringes was common in this small sample. The most frequently utilised reagent was cool water. While all participants reported cleaning and reusing only their own equipment, none of the techniques demonstrated would have been sufficient to deactivate human immunodeficiency virus or hepatitis C virus.
  
  
  CONCLUSIONS
  Results suggest that even where cleaning of needles and syringes is widespread, people who inject drugs may not engage in efficacious cleaning. The combination of the complexity of current cleaning messages and a lack of accurate information about efficacious techniques are likely to contribute to poor cleaning practice. Australia could benefit from the development of a nationally consistent cleaning message; however, the evidence would suggest that this would need to be accompanied by strategies designed to simplify and disseminate this information in order to increase the uptake of efficacious cleaning methods by people who inject drugs.
authors.affiliation: Viral Hepatitis Epidemiology and Prevention Program, National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2010, Australia.
authors.forename: Jai
authors.initials: J
authors.lastname: Nathani
authors.forename: Jenny
authors.initials: J
authors.lastname: Iversen
authors.forename: Kerri
authors.initials: K
authors.lastname: Shying
authors.forename: Jude
authors.initials: J
authors.lastname: Byrne
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
mesh_terms: D000328:Adult; D003902:Detergents / Q000592:standards*; D004203:Disinfection / Q000379:methods; D005260:Female; D040261:Harm Reduction; D006526:Hepatitis C / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D016485:Needle Sharing / Q000009:adverse effects*; D009339:Needles / Q000592:standards*; D009517:New South Wales / Q000453:epidemiology; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D013594:Syringes / Q000592:standards*; D014867:Water / Q000592:standards; D055815:Young Adult
chemical_list: D003902:Detergents; D014867:Water