An external evaluation of a peer-run outreach-based syringe exchange in Vancouver,Canada |
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| Authors: | Kanna Hayashi Evan Wood Lee Wiebe Jiezhi Qi Thomas Kerr |
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| Affiliation: | 1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul''s Hospital, Vancouver, Canada;2. Interdisciplinary Studies Graduate Program, University of British Columbia, Vancouver, Canada;3. Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada;4. Vancouver Area Network of Drug Users, Vancouver, Canada;1. British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, Vancouver, Canada;2. Department of Medicine, University of British Columbia, Vancouver, Canada;1. Harm Reduction Victoria, P.O. Box 12720, A’Beckett Street, Melbourne, Victoria 8006, Australia;2. Centre for Social Research in Health (CSRH), University of New South Wales (NSW), Sydney, Australia;1. Australian Research Centre in Sex, Health and Society, La Trobe University, Bundoora, 3086, Victoria, Australia;2. Peer-based Harm Reduction WA, PO Box 8003, Perth WA 6849, Australia;3. Australian Injecting & Illicit Drug Users League, GPO Box 1555, Canberra ACT 2601, Australia;4. Harm Reduction Victoria, PO Box 12720 A’Beckett Street, Melbourne, Australia;5. New South Wales Users and AIDS Association, PO Box 350, Strawberry Hills, NSW 2012, Australia;6. Centre for Social Research in Health, University of New South Wales, UNSW Sydney, NSW 2052, Australia;7. STI and BBV Applied Research and Evaluation Network, School of Public Health, Curtin University, GPO Box U1987, Perth WA 6845, Australia;8. School of Regulation and Global Governance, Australian National University, Canberra ACT 2600, Australia;1. BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada;2. Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada;3. Vancouver Area Network of Drug Users, Vancouver, British Columbia, Canada;4. Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada;1. Department of Medicine, University of Miami, 1120 NW 14thSt., Miami, FL, 33136, USA;2. RTI International, 351 California Street, Suite 500, San Francisco, CA, 94104, USA;3. Department of Sociomedical Sciences, Columbia University, 2970 Broadway, New York, NY, 10027, USA;4. Bureau of Communicable Diseases, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL, 32399, USA |
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| Abstract: | ObjectiveVancouver, Canada has been the site of an epidemic of human immunodeficiency virus (HIV) amongst injection drug users (IDU). In response, the Vancouver Area Network of Drug Users (VANDU) initiated a peer-run outreach-based syringe exchange programme (SEP) called the Alley Patrol. We conducted an external evaluation of this programme, using data obtained from the Vancouver Injection Drug Users Study (VIDUS).MethodsUsing generalised estimating equations (GEE) we examined the prevalence and correlates of use of the SEP amongst VIDUS participants followed from 1 December 2000 to 30 November 2003.ResultsOf 854 IDU, 233 (27.3%) participants reported use of the SEP during the study period. In multivariate GEE analyses, service use was positively associated with living in unstable housing (adjusted odds ratio [AOR] = 1.83, 95% confidence interval [CI]: 1.39–2.40), daily heroin injection (AOR = 1.31, 95% CI: 1.01–1.70), daily cocaine injection (AOR = 1.34, 95% CI: 1.03–1.73), injecting in public (AOR = 3.07, 95% CI: 2.32–4.06), and negatively associated with needle reuse (AOR = 0.65, 95% CI: 0.46–0.92).ConclusionThe VANDU Alley Patrol SEP succeeded in reaching a group of IDU at heightened risk for adverse health outcomes. Importantly, access to this service was associated with lower levels of needle reuse. This form of peer-based SEP may extend the reach of HIV prevention programmes by contacting IDU traditionally underserved by conventional syringe exchange programmes. |
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