Theme: Epidemiology & Public Health Research Year: 2024
Background: As part of the World Health Organization (WHO) Global Health Sector Strategy on Viral Hepatitis, countries must evidence the distribution of 300 needles per person who injects drugs (PWID) per year as a programmatic target. In England, there is currently no national surveillance of needle and syringe provision (NSP). We used biobehavioural survey data to estimate progress towards this target.
Methods: England data were extracted from the 2022 Unlinked Anonymous Monitoring (UAM) Survey, an annual cross-sectional biobehavioural survey. Data on NSP use in the last year, visits per month, number of needles collected per visit and how many of these were for others were extrapolated to number collected per year, excluding collection for others. The analysis population (N=904) consisted of those who have injected in the last year who either: collected 0 needles (reported no NSP use in the last year or collection only for others) or collected needles. 421 individuals were excluded due to not providing enough data for extrapolation.
Results: 82.1% of participants reported accessing NSP in the last year. The median visits per month was 3. Of those reporting collection, 68.0% collected >300 needles per year. Overall, the median number of needles collected per year was 360. 21.2% of individuals collected no needles. Those who did collected a median of 600 needles (inter-quartile range: 240–1392). There was no significant difference between males and females (median 480 vs 240 respectively, p=0.06) or across regions (p=0.45), however cocaine users collected more than non-cocaine users (median 480 vs 336 respectively, p=0.005).
Conclusion: The data shows that UAM participants are exceeding the WHO target. However, UAM participants are engaged with services, so may not represent the entire PWID population. This measure also doesn’t account for adequacy. Therefore, efforts should be made to numerate NSP activity at a population level.
Download abstract Download poster