Behavioural Surveillance Surveys - The Wisdom of Whores

Some education programs have focused on
sterilizing needles between users. Users may
continue to inject drugs and even share needles,
but may sterilize in between uses. It is,
however, difficult to know the success of
individual efforts to sterilize equipment.
Experience in some settings has demonstrated
that inadequate cleaning of equipment is
common, and many programs have ceased to
promote equipment cleaning as a prevention
method, preferring to concentrate efforts on
putting an end to the sharing of injecting
equipment. This indicator includes in its
numerator of those with risky behavior,
injecting drug users who sterilize, but still
share their equipment.
Because those included in the survey have
by definition injected recently, the indicator is
very sensitive to recent time trends in injecting
practice. Countries with inconsistent policies
supporting safe drug injection may see large
variations in this indicator. Police crackdowns
on users, distributors or support services such
as needle exchange centers may lead to
dramatic changes in injecting practices over
a very short period of time.
The indicator does not attempt to look at
consistency in avoiding needle sharing. It asks
only about a single recent act of injection.
This method minimizes recall bias and has
proved very robust in other areas such as
condom use at last sex. Consistency is covered
in the IDU indicator 4.
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C H A PTER 9 B EHAV I OR A L S U R V EI L L A NC E S U R V EY S