Objectives: Although supervised injecting facility (SIF) use has been associated with reductions in injection-related risk behaviours, the impact of SIFs on the sexual behaviour of injection drug users (IDUs) has not been thoroughly investigated. Therefore, we examined the patterns and predictors of condom use among SIF users in Vancouver, Canada.
Methods: We performed a longitudinal analysis of the factors associated with consistent condom use among IDUs recruited from within a SIF.
Results: Among 1090 individuals, 650 (59.6%) reported a sexual partner in the past 6 months at baseline. Consistent condom use was reported by 108 (25.3%) and 205 (61.6%) individuals reporting regular or casual partners, respectively. After 2 years of observation, these proportions increased to 32.9% and 69.8%, respectively. In multivariate analysis, predictors of consistent condom use with regular partners included HIV positivity (adjusted odds ratio (AOR) 2.23; 95% CI 1.51 to 3.31), injecting with a sex partner (AOR 0.50; 95% CI 0.37 to 0.68), enrollment in addiction treatment (AOR 0.68, 95% CI 0.52 to 0.89) and time since recruitment (AOR 1.29; 95% CI 1.06 to 1.55 per year). Predictors of consistent condom use with casual partners included HIV positivity (AOR 1.70; 95% CI 1.03 to 2.81), syringe borrowing (AOR 0.54; 95% CI 0.32 to 0.91) and syringe lending (AOR 0.52; 95% CI 0.32 to 0.84).
Conclusions: Our results demonstrate that among SIF users, consistent condom use was more frequent among casual sex partners and among HIV positive individuals. Importantly, while the prevalence of consistent condom use was low at baseline, it increased over time. Our findings suggest a possible beneficial effect of the SIF on safer sexual practices.
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Funding: The evaluation is currently supported by the Canadian Institutes of Health Research (CIHR) and Vancouver Coastal Health. TK is supported by the Michael Smith Foundation for Health Research (MSFHR) and CIHR. BM is supported by a Graduate Trainee Award from MSFHR and a Canada Graduate Scholarship from CIHR. The evaluation of the SIF was originally made possible through a financial contribution from Health Canada, although the views expressed herein do not represent the official policies of Health Canada.
Competing interests: None.
Ethics approval: The study has been approved by the University of British Columbia/Providence Healthcare Research Ethics Board.
Contributors: TK had full access to all of the data and takes responsibility for the integrity of the results and the accuracy of the statistical analysis. BM conceived the study concept and design and was responsible for the composition of the manuscript. The statistical analysis was conducted by RZ and the interpretation of the results was performed by BM, EW, MT, JM and TK. The manuscript was edited and revised by BM, EW, MT, JM and TK. The principal investigator of the SEOSI study is TK and the co-investigators are JM, MT and EW.