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Physical and geographical injecting sites among injecting drug users

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Author: Shane Darke, Joanne Ross, Sharlene Kaye

Resource Type: Technical Reports

NDARC Technical Report No. 77 (1999)

EXECUTIVE SUMMARY

A sample of 200 injecting drug users were interviewed about their physical injection sites (body parts) and the geographical locations in which they injected. The use of multiple physical injection sites was common. The mean number of injection sites that had been used by subjects was 3.1, and 2.0 sites had been used in the previous six months. Sixteen percent of subjects had injected in five or more sites. Almost all (99%) had injected in the cubital fossa (crook of the arm). The next most popular site was the forearm (71%). Other sites included the hand (53%), foot (19%), leg (18%), neck (10%) and groin (6%). There was a clear progression in sites used, from the cubital fossa at initial injection to the use of sites such as the groin after 10 years of injecting. Compared to the initial injection, the most recent injection was significantly more likely to be in a site other than the cubital fossa (27% v 6%).

Females had used significantly more injection sites than males. There were significant correlations between the number of injection sites ever used and: length of injecting career, number of injection related problems experienced, number of drug classes ever used and number of drug classes ever injected. Linear multiple regressions revealed that a greater number of injection-related problems and a greater number of drug classes ever injected were independently associated with the use of more injection sites.

Nearly all subjects (96%) had injected in a public place, and 89% had done so in the preceding six months. Large proportions had injected in all locations studied, including cars (90%), public toilets (81%), the street (80%) and trains (55%). Injecting in public places also occurred frequently. Twenty seven percent had injected often in the street over the preceding six months, 22% had injected often in cars and 17% had injected often in public toilets. Overall, 53% of subjects had injected often in at least one public location during the preceding six months.

Frequent injectors in public places were more likely to be male, and to have overdosed in the preceding six months. They had injected significantly more drug classes in the preceding six months, had injected in more physical injecting sites in that period and had more current injection-related problems. Logistic regressions indicated that, after controlling for the effects of other variables, being male and having a greater number of injection-related problems were independently associated with frequent public injections.