title: Assisted injection among people who inject drugs in Thailand.
abstract: BACKGROUND
  Assisted injection is common among people who inject drugs (IDU), and has been associated with elevated risk for HIV infection and overdose. However, this practice has not been explored in the Asian context, including in Thailand, where HIV prevalence among IDU remains high.
  
  
  METHODS
  Using multivariate logistic regression, we examined the prevalence and correlates of assisted injecting among IDU participating in the Mitsampan Community Research Project in Bangkok. We also sought to identify reasons for engaging in assisted injecting and those who provide this form of assistance.
  
  
  RESULTS
  In total, 430 IDU participated in this study, including 376 (87.5%) who reported having ever required assistance injecting, and 81 (18.8%) who reported assisted injecting in the previous six months. In multivariate analyses, assisted injecting in the previous six months was independently and positively associated with being female (adjusted odds ratio [AOR] = 2.42; 95% confidence interval [CI]: 1.40 - 4.18), being a weekly heroin injector (AOR = 1.78; 95% CI: 0.99 - 3.20), syringe sharing (AOR = 2.08; 95% CI: 1.18 - 3.68) and soft-tissue infection (AOR = 3.51; 95% CI: 1.43 - 2.53). Having a longer injecting career (AOR = 0.96; 95% CI: 0.94 - 0.99) was negatively associated with assisted injecting. Primary reasons given for engaging in assisted injecting included being new to injecting and lacking knowledge on how to inject. The most common providers of assistance with injecting were close friends.
  
  
  CONCLUSIONS
  We found a high prevalence of assisted injecting among IDU in Bangkok, with females, frequent heroin injectors, those with shorter injecting careers being more likely to engage in this practice. Those who require help with the injecting process are more likely to share syringes, and have skin infections. These findings indicate the need for interventions focused on promoting safer and self-administered injections.
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, V6Z 1Y6, Vancouver, BC, Canada. uhri-tk@cfenet.ubc.ca.
authors.forename: William K
authors.initials: WK
authors.lastname: Lee
authors.forename: Lianping
authors.initials: L
authors.lastname: Ti
authors.forename: Kanna
authors.initials: K
authors.lastname: Hayashi
authors.forename: Karyn
authors.initials: K
authors.lastname: Kaplan
authors.forename: Paisan
authors.initials: P
authors.lastname: Suwannawong
authors.forename: Evan
authors.initials: E
authors.lastname: Wood
authors.forename: Thomas
authors.initials: T
authors.lastname: Kerr
mesh_terms: D000328:Adult; D003299:Cooperative Behavior; D055030:Drug Users / Q000523:psychology; D005260:Female; D015658:HIV Infections / Q000150:complications; D006801:Humans; D007267:Injections / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016485:Needle Sharing / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012309:Risk-Taking; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D013785:Thailand / Q000453:epidemiology
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