Behavioural Surveillance Surveys - The Wisdom of Whores

Injecting Drug User Indicator 3
Injecting equipment sharing
at last injection
Definition
Numerator :
Number of respondents
who report sharing injecting
equipment the last time they
injected drugs.
Denominator : Total number of respondents
surveyed.
Measurement tools
Injecting drug user questionnaire
Q301
What it measures
Sharing of injecting equipment is both the
biggest risk factor for HIV transmission among
drug injectors, and the most common focus of
interventions. While equipment sharing is
now relatively uncommon in industrialized
countries with long histories of preventative
interventions among drug injectors, the same
is not true of many of the countries in which
drug injecting populations are exploding.
This indicator measures progress in program
efforts to reduce the most risky practice,
the sharing of injecting equipment among
people who continue to inject drugs. It is
especially valuable for tracking trends over
time for programs that support needle-exchange
initiatives, or that work to improve easy access
to safe injecting equipment.
How to measure it
In a behavioral survey among injecting
drug users, respondents are asked about
their injecting habits. Those that report
sharing needles or syringes (other injecting
equipment such as cookers, spoons and
vials, etc. are not included) the last time
they injected drugs form the numerator.
The denominator is all respondents.
Some respondents may not automatically
think of injecting in shooting galleries or
receiving an injection from a dealer or
professional injector as sharing. Rather, they
think of sharing as something that happens
with a group of known friends. However,
since shooting gallery and similar injecting
circumstances do not use new equipment for
every user, they do qualify as sharing situations.
The questionnaire therefore prompts for these
situations. If anyone responds that they have
injected in any of these situations in the past
month, they automatically enter the numerator
for this indicator.
Strengths and limitations
The indicator does not specify a time frame
within which the last injecting episode must
have taken place. BSS among injecting drug
users by definition includes only those who
are active injectors. In most cases, the inclusion
criteria for potential respondents to the survey
will be drug injection in the last month.
It is assumed that these surveys take place
among people identified as members of a
community of drug injectors. It is possible
that in response to HIV-related interventions,
some injectors stop taking drugs entirely
or switch to non-injected drugs. Since the
indicator is designed to track changes in risky
injecting practices over time among people
who continue to inject drugs, people who
cease to inject will not be included in the
denominator for the indicator.
B EHAV I OR A L S U R V EI L L A NC E SURV EY S CHAPTER 9
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