Background: Despite the implementation of policy interventions to address open drug consumption, public injecting continues to occur in many urban settings. This study sought to examine public injecting among a community-recruited cohort of injecting drug users (IDUs) in Vancouver.
Methods: The prevalence and correlates of recent public injecting among participants enrolled in the Vancouver Injection Drug User Study during the period of 1 December 2003 to 30 November 2005 were examined prospectively using generalised estimating equations (GEEs).
Results: Among the sample of 620 active IDUs, at some point during the study period, 142 (22.9%) individuals reported “usually” or “always” injecting in public in the 6 months prior to their study visit. Factors that were significant and positively associated with recent frequent public injecting in multivariate GEE analysis include homelessness (adjusted OR (AOR) 6.70); frequent crack use (AOR 1.48); and frequent heroin injection (AOR 1.56). Recent frequent public injecting was found to be negatively associated with cooking and filtering drugs prior to injecting (AOR 0.50) and older age (AOR 0.95).
Conclusion: The findings indicate that a substantial proportion of local IDUs frequently inject in public, and those who report recently injecting in public spaces appear to be a vulnerable population facing significant health hazards. The provision of secure housing may have the potential to protect the health of IDUs in this setting and significantly decrease the prevalence of public injecting. In addition, the findings support previous work suggesting that removing barriers to the use of Vancouver’s existing supervised injection site may serve to further reduce public drug use.
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Funding: The study was supported by the US National Institutes of Health (R01 DA011591-04A1) and Canadian Institutes of Health Research grant (MOP-67262). WS and KD are supported by Michael Smith Foundation for Health Research Senior Graduate Trainee Awards and Canadian Institutes of Health Research Doctoral Research Awards. TK is supported by the Michael Smith Fundation for Health Research and the Canadian Institutes for Health Research. Funding agencies had no role in study design, data collection, analysis or writing of the report, nor did they have a role in the decision to submit the paper for publication.
Competing interests: Declared. JM has received grants from, served as an ad hoc advisor to, or spoken at various events sponsored by Abbott, Argos Therapeutics, Bioject Inc, Boehringer Ingelheim, BMS, Gilead Sciences, GlaxoSmithKline, Hoffmann-La Roche, Janssen-Ortho, Merck Frosst, Pfizer, Schering, Serono Inc, TheraTechnologies, Tibotec, Trimeris.
Ethics approval: Ethics approval was obtained.