Factors associated with primary source of sterile syringes among injecting drug users

Latvia has the highest HIV incidence rate in the EU, and injecting drug use is the second main mode of HIV transmission. Needle-syringe exchange program (NSP) is a harm reduction to prevent blood transmitted infections. However, Latvia has insufficient coverage of sterile syringes through NSP, some people who inject drugs (PWID) are not informed about NSP services and availability of NSP services is limited, consequently, it increases injecting risk behaviour and spread of infectious diseases. Aim of the analysis is to identify factors associated with the primary source of sterile syringes among PWID. Data from the 11th phase of Drug User’s Cohort Study (2018, Latvia) was used. The research was held by the Centre for Disease Prevention and Control and NGO “DIA+LOGS”. Of the 478 respondents, 431 PWID provided information about the primary source of sterile syringes in the last 30 days. Multiple logistic regression models were adjusted for age, gender, income, duration of injection, the intensity of injection, by using IBM SPSS 24.0 software. There were 92.8% (n = 400/431) PWID obtaining sterile syringes mainly from NSP and 7.2% - at the pharmacy stores (n = 31/431). PWID obtaining syringes from NSP have higher odds of polydrug use (aOR 16.3; 95%CI 2.0-134.9) and injecting at least two times per day (aOR 7.0; 95%CI 1.9-26.0) than PWID obtaining syringes at the pharmacy stores. Clients of NSP services are more likely to use previously used syringes (aOR 6.0; 95%CI 1.1-32.9) and overdose (aOR 3.8; 95%CI 1.1-12.6) than PWID obtaining syringes at the pharmacy stores. PWID obtaining syringes from NSP have higher odds of injecting risk behaviour, which indicates insufficient coverage of sterile syringes and needs to improve the availability of NSP services. Also, pharmacy stores could provide NSP services, like a possibility to utilize syringes and distribute sterile syringes for free.