Injecting drug users (IDU)

toolkit material

Main specific indicators: these are included in the EMCDDA Drug related infectious disease DRID indicator. In the DRID, they are collected in the Standard table 9 through Fonte, and the recall period is not fixed, options are possible and have to be mentioned by the time of reporting.

Title and definition: Reported needles & syringe sharing in the last four weeks among current* IDU** i.e. have they injected with the same needles and syringes as any of their injecting partners during the last four weeks Includes borrowing and lending

 

Purpose and rationale To measure the extent of re-use of needles and syringes – principal route of HIV (and other blood borne viruses BBV) transmission - among IDU
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Difficulties in measurement due to social responsibility reporting bias
Additional sources of information  Used in several EU countriesSee also EMCDDA's 'Drug-related infectious diseases' indicators 

 

*  current IDU = having injected in the last 12 months or in the last four weeks**  the same question can be asked regarding the sharing of other material serving to prepare injection such as spoon, water cotton, pipe, etc.

Title and definition: Reported injecting frequency in last four weeks among current IDUi.e. how many times have they injected during the last four weeks (Could ask about times injected last full day or on a typical day, and number of days injected during last four weeks)

 

Purpose and rationale  To measure the frequency of injection among IDU, frequent injection has been associated with higher risk, such as the injection of crack-cocaine.  Can be related to the needles and syringes obtained indicator to assess individual level coverage of needle and syringe supply
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses  Recall issues may lead to estimates where injection is very frequent
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

 

Title and definition: The number of new needles and syringes obtained for personal use from all sources in last four weeks among current IDUi.e. how many new needles/syringes have you obtained from any source for your own use during the last four weeks (Could ask about last week and how many of the last four weeks they had injected)

 

Purpose and rationale  To measure the amount of clean needles and syringes obtained, to assess intervention uptake among IDU.  Access to sufficient clean needles and syringes has been associated with lower levels of risk. Can be related to the reported injecting frequency indicator to assess individual level coverage of needle and syringe supply
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Recall issues may lead to estimates, where large amounts of injecting equipment are being obtained
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

 

Title and definition: Having received a substitute drug in last four weeks among current IDUi.e. have they been prescribed and taken a subsitute drug, such as methadone or bupronorphine or heroin, during the last four weeks

 

Purpose and rationale To measure the uptake of a key intervention among IDU that has been shown to reduce infection risk
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Possible confusion over treatment types, not suited to those injecting drugs where substitution therapy not available. A simple question, easy to ask
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

Title and definition: HCV testing: having been tested for HCV a) everb) in the last 12 months

 

Purpose and rationale  To assess the coverage of HCV testing in IDU
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Possible confusion with other virus types (HBV, HIV)
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

Title and definition: Years since first injected among current IDU

 

Purpose and rationale To assess potential exposure period for HIV and other BBVs
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Recall when initiation to injection was many years ago
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

 

 

Title and definition: Having been paid for sex

 

Purpose and rationale  To assess this specific sexual risk, not uncommon among IDU
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Possible declaration bias
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

Title and definition: Number of sharing partners in last four weeks among current IDU

 

Purpose and rationale  To measure the extent of re-use of needles and syringes – principal route of HIV (and other BBV) transmission - among IDU
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Difficulties in measuring due to social responsibility reporting bias
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators 

 

 

Title and definition: Injection in prison

a)  ever injected in prison among current IDU having ever been in prison (option: injection  in prison in a defined time period (last 12 months)

b) syringe sharing in this situation

 

Purpose and rationale  Imprisonment among IDU is common, but service provision in prison often limited and injection here likely to be high-risk
Measurement frequency

Where possible should be measured annually

Strengths and weaknesses Possible small samples with shorter time periods
Additional sources of information  See also EMCDDA's 'Drug-related infectious diseases' indicators