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Examining unmet needs: a cross-sectional study exploring knowledge, attitudes and sexually transmitted infection screening preferences among persons who inject drugs in Camden, New Jersey
  1. Alexis Roth1,
  2. Nguyen Khai Tran2,
  3. Martha Chavis3,
  4. Barbara Van Der Pol4
  1. 1 Department of Community Health and Prevention, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
  2. 2 Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
  3. 3 Camden Area Health Education Center, Camden, NJ, USA
  4. 4 Division of Infectious Diseases, University of Alabama at Birmingham School of Medicine, Birmingham, Alabama, USA
  1. Correspondence to Dr Alexis Roth, Department of Community Health and Prevention, Dornsife School of Public Health, Philadelphia, PA 19104, USA; alexisroth{at}


Objectives To inform the development of targeted sexually transmitted infection (STI) control programmes for persons who inject drugs (PWID).

Methods We recruited 116 PWID (aged ≥ 18 years) from a community-based syringe exchange programme (SEP) and assessed their STI knowledge and screening preferences via technology assisted self-interview. We estimated prevalence of STI transmission knowledge, attitudes and screening preferences as well as the association between reported sexual behaviours (past 6 months) and willingness to self-collect specimens.

Results Participants were white (77%), female (51%) and heterosexual (77%). STI knowledge regarding transmission and testing was high among the sample. More than 70% of participants were aware extragenital infections were possible and were least likely to know urine tests do not detect rectal infections (40.9%). Site-specific specimen collection was highly reflective of reported sexual behaviour. PWID who reported receptive sex (36% vs 5%, p<0.01) and insertive anal sex (31% vs 6%, p=0.01) were more likely to collect rectal specimens than those who did not. A similar trend was seen for oral sex performance on men and self-collection of oropharyngeal swabs (15% vs 3%, p=0.04). In addition, participants preferred collecting their own sample to having a clinician collect it for them (69% vs 31%, p<0.01) and testing at the SEP compared with a STI clinic (86% vs 14%, p<0.01).

Conclusion Our findings suggest site-specific specimen collection may be a proxy for risk behaviour engagement in this fairly knowledgeable high-risk population. To increase case finding, STI control programmes should educate patients about site-specific screening and pair outreach with the infrastructure provided by SEPs, in settings where these programmes exist.

  • injecting drug use
  • screening
  • infection control
  • attitudes

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  • Handling editor Adam Huw Bourne

  • Contributors AR designed the study and oversaw all aspects of the project from data collection through dissemination. NKT performed the statistical analyses. AR and NKT wrote the manuscript. BVDP contributed to study design and provided extensive comments and revision for the manuscript. MC contributed to study design, data collection and provided comments on the manuscript.

  • Funding This study was sponsored by New Jersey Department of Health, Division of HIV/AIDS, TB and STD Services as well as Community Driven Research Day; a joint effort of Drexel University, the University of Pennsylvania, Temple University and The Children’s Hospital of Philadelphia.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval Drexel University Institutional Review Board and the Camden Area Health Education Center Executive Director.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement There are no unpublished data available.