Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #101079

Gregory Scott, PhD, Department of Sociology, DePaul University, 990 W. Fullerton Ave., Ste. 1100, Chicago, IL 60614, Lauretta E. Grau, PhD, Department of Epidemiology and Public Health, Yale University, P. O. Box 208034, 60 College St, New Haven, CT 06520-8034, 203.785.2904, lauretta.grau@yale.edu, and Robert Heimer, PhD, Epidemiology and Public Health, Yale University, 60 College St., P.O Box 208034, New Haven, CT 06511.

Practices surrounding the intravenous injection of illicit drugs often contribute to the onset of preventable skin pathologies and to the proliferation of opportunistic viral infections (e.g., hepatitis B). Efforts to train injection drug users (IDUs) on safer injection abound but rarely undergo systematic evaluation. Moreover, prevailing interventions tend to require prohibitive investments of IDUs' time, making them inconvenient, underutilized, and costly. Embedded in an ongoing three-year randomized controlled trial of syringe exchange-based hepatitis B vaccination program in Chicago, Illinois the authors collaborated with IDUs to develop a protocol for teaching safer injection in the context of a typical venipuncture (blood draw) session. Prior to venipuncture participants respond to a self-report survey regarding knowledge of injection-associated hygiene, risk for hepatitis B infection, motivation to alter injection practices, and injection behaviors. Two weeks later participants return for serologic test results and complete a post-test. Survey and observational data (including videotaped “live” injections) accrue through ethnographic fieldwork. Analysis examines the degree to which phlebotomy-based instruction yields cost-effective improvements in injectors' knowledge and practice of safe injection. Variation in knowledge and behavioral change (reported/actual) is assessed in relation to frequency of injection, type of drug injected, participation in syringe exchange, motivation to change, serostatus, and demographics. Results of self-report surveys are compared to videotaped in situ injection practices. Changes in knowledge and behavior merit critical scrutiny. The paper considers opportunities for and obstacles to practicing safe injection as well as programmatic, health service, and public policy implications concerning safer injection.

Learning Objectives:

• Articulate the connections between typical illicit drug injection procedures and the most serious consequent adverse health outcomes such as tissue pathologies and bacterial and viral infections.
• Identify the most common errors that injection drug users make when self-administering injections.
• Assess the evaluative and ethnographic research literature concerning interventions to improve injection procedures and recognize these interventions' deficiencies.
• Develop an understanding of how his particular intervention constitutes a cost-effective measure for altering drug injection procedures with a net result of improved vein and skin health.
• Identify the effective and ineffective components of this particular intervention.
• Discuss opportunities for and obstacles to practicing safe injection.
• Consider programmatic, health service, public policy, and ethnographic research implications concerning safer injection education among injection drug users.

Keywords: Injecting Drug Use, Evidence Based Practice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.