An analysis of 15-19-year-old first attenders at the Dublin needle exchange, 1990-97

FRANÇAIS :
Etude rétrospective à partir de données collectées dans 11 sites d'un programme d'échange de seringues de Dublin auprès de 1224 participants sur les facteurs associés à la probabilité de partage de seringues et d'usage de préservatifs. Sur les 8 années de l'étude, à la fois le nombre et la proportion des jeunes injecteurs ont augmenté, notamment ceux des jeunes femmes. Dans l'année précédant l'entrée dans le programme, la prévalence du partage de seringues était de 39% et celle de l'usage de préservatifs de 61%.
ENGLISH:
Aims. Identification of characteristics and trends over time in young injecting drug users at first attendance at needle exchange. Design. Retrospective cross-sectional survey of routinely collected data. Setting. Dublin needle exchange programme which consists of 11 sites in the greater Dublin area. Participants. First-time attenders (n = 1224) at the needle exchange from 1990 to 1997, between the ages of 15 and 19. Measurement. Factors associated with a likelihood of needle sharing and condonm use were tested using logistic regression. Findings. Increases in both the number and proportion of young injectors, particularly young female injectors, have occurred over the 8 years. Forty-eight per cent of the young injectors were injecting for less than 1 year. Needle sharing prevalence in the year previous to first attendance was 39% and condom use was 61%. The proportion of females not using a condom during sexual relationships was significantly higher than males. Very few of the young attenders had received any treatment for drug dependence. Conclusions. After the first year of injecting drug use the likelihood of needle sharing increased and we recommend that interventions occur early on and are targeted to the needs of young injecting drug users, in particular young females. It is essential that services are accessible to the young injecting drug user and that barriers to contact with services are minimized or eliminated. Some high-risk behaviours are occurring in the context of the sexual relationship and this should be taken into account when designing prevention programmes, especially for young females. (Author' s abstract)