Risk factors associated with higher injection drug use and HIV rates: Findings from Saskatchewan, Canada

Background: Over the last decade, the incidence of positive HIV test reports within the Saskatoon Health Region (SHR), Saskatchewan, and Canada has been rapidly rising. Injection drug use (IDU) has been widely recognized as the major etiological factor for this increase. This study sought to assess the prevalence, characteristics, and risk indicators of higher risk injection drug use (HR IDUs) in comparison to lower risk injection drug use (LR IDUs) within the SHR, Saskatchewan, and Canada. Methods: This is a cross sectional study. Study participants were selected over an eight month period spanning from 2009 to 2010. During that time period current IDUs (n = 603) were interviewed and stratified into either the HR IDUs (n = 182) or LR IDUs (n = 421) categories depending on their drug use behaviours and needle and paraphernalia sharing practices. Results: This study found that HR IDUs were more often engaged in giving sex to get drugs and giving drugs to get sex than LR IDUs. HR IDUs also had significantly more sexual partners and a higher frequency of injection than LR IDUs. Logistic regression analysis, determined three covariates that independently predicted being a HR IDU including homelessness, having experienced sexual assault as a child, and lack of knowledge related to HIV/AIDS. Conclusions: The findings of the present study provide valuable information to health care professionals and a useful context based on which public health initiatives can be designed to specifically target IDUs, who are most at risk in developing HIV and subsequently transmitting the disease.