Canadian Journal of Public Health

, Volume 94, Issue 5, pp 355–359 | Cite as

Requiring Help Injecting as a Risk Factor for HIV Infection in the Vancouver Epidemic

Implications for HIV Prevention
  • Evan WoodEmail author
  • Patricia M. Spittal
  • Thomas Kerr
  • Will Small
  • Mark W. Tyndall
  • Michael V. O’Shaughnessy
  • Martin T. Schechter



Requiring help injecting was recently associated with syringe sharing, and later HIV-1 and HCV seroconversion among injection drug users (IDU) in Vancouver. This risk factor remains poorly understood. The present study investigates this risk factor among Vancouver IDUs.


We evaluated factors associated with requiring help injecting among participants enrolled in the Vancouver Injection Drug User Study (VIDUS) using univariate and logistic regression analyses. VIDUS participants who were followed-up during the period December 2000 to December 2001 were eligible for the present analyses. We also evaluated self-reported reasons for requiring help injecting.


Overall, 661 active injection drug users were interviewed during the study period. Among this population, 151 (22.8%) had required help injecting during the last six months, whereas 510 (77.2%) indicated that they had not. Variables that were independently associated with requiring help injecting included borrowing a used syringe (adjusted odds ratio [AOR] = 2.18), frequent cocaine injection (AOR = 1.57), and female gender (AOR = 2.29). Among males, the most common reasons for requiring help injecting were: having no viable veins (77.1%), and anxiousness or being drug sick (42.9%). Among females, the most common reasons reported were: having no viable veins (71.6%), jugular injection or ‘jugging’ (45.7%), and being anxious or drug sick (27.2%). Almost twice as many females (13.6% vs 7.1%) reported not knowing how to inject as their reason for requiring help injecting.


Although current public health approaches, such as needle exchange, are unable to address the concerns associated with requiring help injecting, available evidence suggests that safer injecting facilities have the potential to substantially mitigate this risk behaviour.



On a récemment associé le fait d’avoir besoin d’aide pour se piquer au partage des seringues, et plus tard à la séroconversion VIH-1 et VHC chez les utilisateurs de drogues injectables (UDI) de Vancouver. Nous avons voulu étudier ce facteur de risque, encore mal compris, chez les UDI de Vancouver.


À l’aide d’analyses univariées et de régression logistique, nous avons évalué les facteurs associés au fait d’avoir besoin d’aide pour se piquer chez les participants de la VIDUS (enquête vancouveroise auprès des utilisateurs de drogues injectables). Les analyses portaient sur les participants à la VIDUS ayant fait l’objet d’un suivi entre décembre 2000 et décembre 2001. Nous avons également évalué les motifs pour lesquels les intéressés déclaraient avoir besoin d’aide pour se piquer.


Dans l’ensemble, 661 utilisateurs actifs de drogues injectables ont été interviewés durant la période de référence. De ce nombre, 151 (22,8 %) avaient eu besoin d’aide pour se piquer au cours des six mois précédents, et 510 (77,2 %) n’en avaient pas eu besoin. Certaines variables présentaient une corrélation indépendante avec le fait d’avoir besoin d’aide pour se piquer: l’emprunt d’une seringue usagée (rapport de cotes ajusté [RCA] = 2,18), l’injection fréquente de cocaïne (RCA=1,57) et le fait d’être une femme (RCA=2,29). Chez les hommes, les raisons le plus souvent déclarées d’avoir besoin d’aide pour se piquer étaient l’absence de veines adéquates (77,1 %) et l’anxiété ou l’état de manque (42,9 %). Chez les femmes, les raisons le plus souvent déclarées étaient l’absence de veines adéquates (71,6 %), l’injection dans une veine jugulaire (45,7 %) et l’anxiété ou l’état de manque (27,2 %). Les femmes étaient près de deux fois plus nombreuses que les hommes (13,6 % contre 7,1 %) à déclarer avoir besoin d’aide parce qu’elles ne savaient pas comment s’y prendre.


Bien que les approches actuelles de santé publique, comme l’échange de seringues, ne répondent pas aux préoccupations liées au fait d’avoir besoin d’aide pour se piquer, les données disponibles donnent à penser que des piqueries plus sûres pourraient peut-être atténuer considérablement ce comportement à risque.


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Copyright information

© The Canadian Public Health Association 2003

Authors and Affiliations

  • Evan Wood
    • 1
    • 2
    Email author
  • Patricia M. Spittal
    • 1
    • 2
  • Thomas Kerr
    • 1
    • 3
  • Will Small
    • 1
  • Mark W. Tyndall
    • 1
    • 2
  • Michael V. O’Shaughnessy
    • 1
    • 4
  • Martin T. Schechter
    • 1
    • 2
  1. 1.BC Centre for Excellence in HIV/AIDSSt. Paul’s HospitalVancouverCanada
  2. 2.Department of Health Care and EpidemiologyUniversity of British ColumbiaCanada
  3. 3.Department of Educational PsychologyUniversity of VictoriaCanada
  4. 4.Department of Pathology and Laboratory MedicineUBCCanada

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