• drug misuse
• injecting behaviour

In 1988, the UK Departments of Health gave approval for sterile needles and syringes to be made available to injecting drug users, thus obviating their need to inject with used equipment.1 Since then, several hundred needle/syringe exchange schemes have been established, the incidence of HIV among injectors has been extremely low,2 and exchange attenders have been shown to share needles/syringes less frequently than non-attenders.1During the mid-1990s to late 1990s, however, several observations suggested that injecting risk behaviours might be increasing; between 1997 and 1998, reports of acute hepatitis B infections in injectors throughout the UK increased by 50%,2 hepatitis C (HCV) infections were prevalent in young injectors3 and data from Scotland's Drug Misuse Database and England and Wales's unlinked anonymous surveys of injectors showed high rates of needle/syringe sharing.2 We set out to determine the authenticity of these observations by …