Behavioural Surveillance Surveys - The Wisdom of Whores

Injecting Drug User Indicator 4
Injecting drug users never
sharing equipment in the last
month
Definition
Numerator :
Number of respondents who
report never sharing injecting
equipment during any episode
of injection in the last month.
Denominator : Total number of respondents
surveyed.
Measurement tools
Injecting drug user questionnaire
Q307
What it measures
Sharing of injecting equipment between
HIV-infected and uninfected drug injectors is
an extremely efficient pathway for the spread
of HIV. Because the risk of contracting
infection per single act of risky injection is
so high, programs must aim not just for a
reduction in the sharing of equipment
between drug users, but for a complete halt
to this behavior.
Injecting Drug User Indicator 3 uses a robust
methodology that will give a good picture of
rising safe injecting behavior, but will not
capture entirely the rises in consistently safe
behavior for which prevention programs
among drug injectors strive.
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 at any time in the last
month are excluded from the numerator,
which includes only people who report not
having shared equipment during any episode
of drug injecting over the last month.
The denominator is all respondents.
As with the previous indicator, the questionnaire
should prompt for sharing situations
such as injecting in shooting galleries or
through professional injectors.
Strengths and limitations
This indicator shares the strengths and
limitations of Injecting Drug User Indicator 3.
In addition, it is likely to suffer more from
recall bias. Depending on the local drug
scene, drug users may be injecting several
times each day. Recalling the circumstances
of every act of injection over the past 30 days
may be problematic.
Trends measured by this indicator should
confirm changes registered in the indicator that
looks only at behavior at last injection. The
difference between the two indicators may be
used to pinpoint areas of program weakness.
This indicator measures trends in consistent
safe behavior among drug users who continue
to inject drugs.
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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