Online Program

336902
Injection Drug Use and Syringe Sharing Among Sexually Transmitted Disease Clinic Patients in the U.S


Monday, November 2, 2015

Pedro C. Castellon, MPH, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, Miami, FL
Rui Duan, MPH, Department of Epidemiology and Public Health, University of Miami, Miami, FL
Daniel J. Feaster, PhD, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, FL
Lauren Gooden, PhD, Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University
Tim Matheson, PhD, Center for Public Health Research, San Francisco Department of Public Health, San Francisco, CA
Lisa R. Metsch, PhD, Department of Sociomedical Sciences, Columbia University, New York, NY
Background:  Little is known about the efficacy of risk-reduction counseling at the time of HIV testing in reducing syringe sharing among injection drug users.

Methods:  Project AWARE randomized 5012 participants from 9 STD clinics to receive a rapid HIV test with (1) brief risk-reduction counseling or (2) information only, complete a behavioral risk assessment, and be assessed for STDs at baseline and 6-month follow-up.  A GEE model was used to examine the change of syringe sharing between visits.  Predictors were: treatment group, participant and partner gender, visit and the interaction of treatment group and visit. 

Results:  In the counseling group, 145 (5.79%) and 112 (5.14%) participants reported injection drug use (IDU) at baseline and follow-up, respectively.  In the information only group, 160 (6.38%) and 113 (5.17%) participants reported IDU at baseline and follow-up, respectively.  There was a decrease in the number of injectors across time (χ2=5.33, p=0.0210), but there was no difference in the decrease between groups (χ2=0.56, p=0.4552). Among injectors at baseline, 31 (21.4%) in the counseling group and 28 (17.5%) in the information only group shared syringes; at follow-up, 16 (14.3%) in the counseling group and 6 (5.3%) in the information only group shared syringes. There was a decrease in the rate of syringe sharing across time (χ2=21.45, p<0.0001); the rate in the information group decreased more than in the counseling group (χ2=4.33, p=0.0375).

Discussion: Brief risk-reduction counseling may not be appropriate in addressing IDU and syringe sharing among STD clinic patients at the time of HIV testing.

Learning Areas:

Public health or related research
Social and behavioral sciences

Learning Objectives:
Assess the effect of risk-reduction counseling with a rapid HIV test on injection drug use and syringe sharing among sexually transmitted disease clinic patients

Keyword(s): HIV Risk Behavior, Drug Abuse

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: Over the past 6 years I have served as Project Coordinator or Director on several clinical trials involving: 1) HIV testing among individuals at risk for contracting HIV, 2) linking substance users to substance use disorder (SUD) treatment services, and 3) linking and retaining HIV-infected substance users to HIV care and SUD treatment. Additionally, I have been a co-author on several abstracts and manuscripts involving HIV and/or SUD treatment.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: HIV and Substance Use