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Public injecting among a cohort of injection drug users in Vancouver, Canada
  1. Kora DeBeck1,
  2. Will Small1,
  3. Evan Wood2,
  4. Kathy Li1,
  5. Julio Montaner3,
  6. Thomas Kerr3
  1. 1 BC Centre for Excellence in HIV/AIDS, Canada;
  2. 2 BC Centre for Excellence in HIV/AIDS; Department of Medicine, University of British Columbia, Canada;
  3. 3 BC Centre for Excellence in HIV/AIDS; 2. Department of Medicine, University of British Columbia, Canada
  1. E-mail: uhri{at}


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 injection drug users (IDU) in Vancouver.

Methods: We prospectively examined the prevalence and correlates of recent public injecting among participants enrolled in the Vancouver Injection Drug User Study during the period of December 1, 2003 to November 30, 2005 using generalized estimating equations (GEE).

Results: Among our sample of 620 active IDU, at some point during the study period, 142 (22.9%) individuals reported 'usually' or 'always' injecting in public in the six 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 odds ratio [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: Our findings indicate that a substantial proportion of local IDU 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 IDU in this setting and significantly decrease the prevalence of public injecting. In addition, our 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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