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Abstract

LITERATURE REVIEW
The sharing and lending of injecting equipment amongst the injecting drug
user (IDU) population has been identified as a leading cause of the transmission of
blood-borne viruses such as hepatitis B (HBV), hepatitis C (HCV), and human
immunodeficiency virus (HIV). A large body of research exists which has attempted
to identify those IDU who are at elevated risk for engaging in behaviours known to
be associated with BBV transmission. Primary amongst these identified factors are
those relating to impulsivity traits, psychological distress including anxiety and
depression, and pharmacological effects of drug use. Also, a number of demographic
and drug use variables also are routinely investigated in the literatures as possible
risk factors, and typically include factors of sex, age, duration of injecting history,
frequency of injecting, preferred drug of choice, sexual orientation, drug treatment
status, accommodation status, education level, ethnicity, and the presence or absence
of prison history.
The following literature review describes the existing research into each of
these key variables, elucidating those which present as the clear risk factors for BBV
transmission risk behaviours, and those which are somewhat ambivalent in the
prediction of risk behaviours and BBV transmission rates. Further, the review
discusses the need for comprehensive research to be conducted, identifying the
variables that are most predictive of BBV risk behaviours amongst this population.
EMPIRICAL STUDY
Incidence of blood-borne viruses such as Hepatitis B, Hepatitis C, and HIV have
begun to rise in recent years, with Hepatitis C now being the most communicable
disease in Australia. Spread by blood-to-blood contact, it is now recognised that by
far the majority of new cases of blood-borne viruses are transmitted during the
process of injecting illicit drugs, through behaviours such as the sharing of injecting
equipment. Previous studies have identified a number of factors that independently
predict the risk of injecting drug users (rpm engaging in these risk behaviours.
These factors include demographic, drug use and injection variables, psychological
distress factors (i.e. anxiety and depression), and impulsivity factors, however to date
no research has comprehensively examined these risk factors in a combined sense in
order to establish which IDU are at a heightened risk for engaging in risky injection
episodes. The current study sought to address this, and utilised a multivariate
regression modelling approach with a sample of 269 regular IDU in Tasmania to
examine the contribution of the above factors to the prediction of the engagement in
various injecting risk behaviours. The study details factors which emerged as
significant predictors to transmission through needle and syringe contamination,
other equipment contamination, contamination from injecting others, exposure from
being injected by others, needlestick contamination, as well as overall risk. While the
factors which significantly contribute to risk in the various aspects of transmission
behaviours vary, the factors of unstable accommodation status, amphetamine use,
alcohol use, less occasions of self-injection, higher symptoms of anxiety, and a desire
to seek out novel stimulation emerged as the most significant contributors to overall
risk. Of these, elevated anxiety symptoms and reduced episodes of self-injection were clearly the most important factors as identified in a multivariate model for
overall risk of engaging in blood-borne virus risk behaviours. This finding suggests
that while there is value in delivering blood-borne virus transmission intervention
efforts to all IDU, particular attention and emphasis should be paid to those IDU
exhibiting the above risk factors. Specific strategies for intervention is discussed in
the below report.

Item Type:	Thesis - Coursework Master
Authors/Creators:	Antel, Elizabeth
Keywords:	Intravenous drug abuse, Needle sharing, Intravenous drug abusers
Copyright Holders:	The Author
Copyright Information:	Copyright 2010 the Author - The University is continuing to endeavour to trace the copyright owner(s) and in the meantime this item has been reproduced here in good faith. We would be pleased to hear from the copyright owner(s).
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