Client-Level Coverage of Needle and Syringe Program and High-Risk ‎Injection Behaviors: A Case Study of People Who Inject Drugs in ‎Kermanshah, Iran

Document Type : Original Article(s)

Authors

1 PhD Candidate, Department of Epidemiology, School of Public Health, Shahid Beheshti ‎University of Medical Sciences, Tehran, Iran

2 Assistant Professor, Global Health Sciences, University of California, San Francisco, CA, USA ‎AND Regional Knowledge Hub and WHO Collaborating Centre for HIV Surveillance, Institute ‎for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran

3 Psychiatrist, Iranian National Center for Addiction Studies (INCAS), Iranian Institute for ‎Reduction of High-Risk Behaviors AND School of Advanced Technologies in Medicine, Tehran ‎University of Medical Sciences, Tehran, Iran‎

4 Professor, Department of Epidemiology, School of Public Health, Shahid Beheshti University of ‎Medical Sciences, Tehran, Iran

5 Associate Professor, Mental Health Research Center AND Department of Community ‎Psychiatry, School of Behavioral Sciences and Mental Health, Tehran Institute of Psychiatry, ‎Iran University of Medical Sciences, Tehran, Iran

6 Assistant Professor, Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland

7 Assistant Professor, Regional Knowledge Hub and WHO Collaborating Centre for HIV ‎Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, ‎Kerman, Iran

8 Senior Fellow, National Drug Research Institute, Faculty of Health Sciences, Curtin University, ‎Melbourne, Australia

9 Professor, Safety Promotion and Injury Prevention Research Center AND Department of ‎Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, ‎Iran

Abstract

Background: Needle-syringe programs (NSP) have been running in Iran since 2002. However, the coverage of such program among the NSP clients at the individual level was not studies yet. This study aimed to determine the client coverage of NSP and its correlation with high injection-related risk behaviors. Methods: A cross-sectional survey was conducted in Kermanshah province, Iran, in 2014. 230 people who inject drugs (PWID) recruited from two drop-in centers (DICs) from April to September 2014, participated in a face-to-face interview to provide information related individual coverage of NSP, demographic characteristics, and injecting behaviors 30 days prior to the interview. Findings: Overall, the average of syringe coverage was 158% [95% confidence interval (CI) = 65.7-205.5], while 56% (95% CI = 40-97) have individual converge less than 100%. Needle/syringe sharing was significantly higher among individual with low NSP coverage [adjusted odds ratio (AOR) = 2.6, 95% CI = 1.3-6.2]. About 85% participants with coverage of less than 100% reported reuse of syringe within the last 30 days (AOR = 3.2, 95% CI = 1.4-7.7). Conclusion: PWID are different regarding their NSP individual-level converges. There are certain clusters of PWID, who do not receive sufficient number of syringes. Given that insufficient individual syringe coverage level is highly associated with injection risk behaviors, reasons for such low converge need to be assessed and addressed carefully.

Keywords

Addiction & Health
Volume 7, 3-4 - Serial Number 3
15
August 2015
Pages 164-173

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