Hanne Thiede, DVM, MPH¹, Holly Hagan, PhD², Jennifer Vernon Campbell, MSPH¹, Farzana Kapadia, PhD³, Steffanie A. Strathdee, PhD⁴, Susan L. Bailey, PhD⁵, Sharon M. Hudson, PhD⁶, and Richard S. Garfein, PhD, MPH⁷. (1) HIV/AIDS Epidemiology Program, Public Health - Seattle & King County, 106 Prefontaine Place South, Seattle, WA 98104, (206) 296-4318, hanne.thiede@metrokc.gov, (2) NDRI, 71 West 23rd, 8th floor, New York, NY 10010, (3) Center for Urban Epidemiologic Studies, New York Academy of Medicine, 1216 Fifth Ave, New York, NY 10029, (4) Division of International Health and Cross Cultural Medicine, University of California, San Diago, 9500 Gilman Drive, Ash Building, La Jolla, CA 92093-0622, (5) School of Public Health, Division of Epidemiology and Biostatistics, University of Illinois at Chicago (MC 923), 1603 W. Taylor Street, Chicago, IL 60612, (6) Health Research Association, 1111 N. Las Palmas Avenue, Hollywood, CA 90038, (7) Division of HIV/AIDS Prevention, Epidemiology Branch, Centers for Disease Control and Prevention, 1600 Clifton Road, MS E-45, Atlanta, GA 30333

Background: Syringe-sharing is an important route of HIV and hepatitis B and C transmission among injection drug users (IDUs). Sharing of other paraphernalia (cookers/cotton/rinse water) has been associated with hepatitis C transmission and may become increasingly important as syringe-sharing decreases. Methods: We analyzed data from a cross-sectional survey of IDUs aged 15-30 from 5 US cities to determine the prevalence of paraphernalia-sharing. Correlates of receptive paraphernalia-sharing among IDUs who did not report receptive syringe-sharing were assessed using logistic regression. Results: Among 2,693 IDUs, 45% reported recent (last 3 months) receptive syringe-sharing, 72% cooker-sharing, 63% cotton-sharing, and 64% rinse water-sharing. Those who reported receptive syringe-sharing were more likely (97%) to share paraphernalia than those who did not (60%). Among IDUs who did not share syringes and in models including site, sex, race and age, paraphernalia-sharing was more common (p<0.05) among IDUs who were female (adjusted OR [AOR]=1.4), white (AOR=1.9), homeless (AOR=1.4), or had lived in foster care settings (AOR=1.5). It was also associated with daily injection (AOR=1.3), speedball injection (AOR=1.7), having >5 injection partners (AOR=2.5), injection with sex partners (AOR=1.9) or friends (AOR=1.6), and having friends who shared paraphernalia (AOR=6.2). Conclusions: Our findings show that sharing non-syringe paraphernalia is very common among younger IDUs and differs by sociodemographic factors, drug-use practices, and characteristics of injection partners. Increased efforts to prevent sharing of syringes and other paraphernalia among younger IDUs are needed and should address the social context of injection and the influence of friends on sharing behaviors.

Learning Objectives:

• Describe prevalence of sharing of syringes and other drug preparation equipment and recognize correlates of sharing of non-syringe paraphernalia in a research sample of younger injectors in 5 US urban areas.
• Understand the need to improve efforts to prevent sharing of drug use equipment.

Keywords: Risky Behaviors, Injection Drug Users

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.