HIV This Week

Tyndall MW, Wood E, Zhang R, Lai C, Montaner JS, Kerr T. HIV seroprevalence among participants at a medically supervised injection facility in Vancouver, Canada: implications for prevention, care and treatment. Harm Reduct J 2006;3:36.http://www.harmreductionjournal.com/content/3/1/36

North America’s first government sanctioned medically supervised injection facility was opened during September 2003 in Vancouver, Canada. This was in response to a large open public drug scene, high rates of HIV and hepatitis C transmission, fatal drug overdoses, and poor health outcomes among the city’s injection drug users. Between December 2003 and April 2005, a representative sample of 1,035 supervised injection facility participants were enrolled in a prospective cohort that required completing an interviewer-administered questionnaire and providing a blood sample for HIV testing. HIV infection was detected in 170/1007 (17%) participants and was associated with Aboriginal ethnicity (OR 2.70, 95% CI 1.84-3.97), a history of borrowing used needles/syringes (OR 2.0, 95% CI 1.37-2.93), previous incarceration (OR 1.87, 95% CI 1.11-3.14), and daily injection cocaine use (OR 1.42, 95% CI 1.00-2.03). The supervised injection facility has attracted a large number of marginalized injection drug users and presents an excellent opportunity to enhance HIV prevention through education, the provision of sterile injecting equipment, and a supervised environment to self-inject. In addition, the supervised injection facility is an important point of contact for HIV positive individuals who may not be participating in HIV care and treatment.

Editors’ note: This supervised injecting facility is attracting a clientele which often has poor contact with health and social services. Increased safer injecting, lowered morbidity and mortality and lower HIV incidence are the end results to be achieved and documented, as they have in been in Switzerland.