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People who inject drugs: Safe Injecting Practices

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Percentage of people who inject drugs reporting the use of sterile injecting equipment the last time they injected

ID: 
853
What it measures: 

It measures progress in preventing injecting drug use-associated HIV transmission

Safer injecting and sexual practices among people who inject drugs are essential, even in countries where other modes of HIV transmission predominate, because: (i) the risk of HIV transmission from contaminated injecting equipment is extremely high; and (ii) people who inject drugs can spread HIV (e.g., through sexual transmission) to the wider population.

Note: Countries with generalized epidemics may also have a concentrated sub-epidemic among people who inject drugs. If so, it would be valuable for them to calculate and report on this indicator for this population.

Numerator: 

Number of respondents who report using sterile injecting equipment the last time they injected drugs.

Denominator: 

Number of respondents who report injecting drugs in the last month.

Data Type: 
Percent
Calculation: 
Numerator / Denominator
Method of measurement: 
Special surveys including the Family Health International Behaviour Surveillance Survey for people who inject drugs. Respondents are asked the following questions: 1. Have you injected drugs at any time in the last month? 2. If yes: The last time you injected drugs, did you use a sterile needle and syringe ? This question may need to be modified in certain local contexts. In certain drug injecting cultures, for example, needles and syringes may be exposed to HIV without being shared between users (e.g. through shared drug solutions). The questions used must ascertain that the needle and syringe used were actually sterile. Whenever possible, data for people who inject drugs should be collected through civil society organizations that have worked closely with this population in the field. Access to survey respondents as well as the data collected from them must remain confidential. For further information, please consult the following references: o WHO/UNODC/UNAIDS (2009). Technical Guide for Countries to set Targets for Universal Access to HIV Prevention, Treatment and Care for Injecting Drug Users. Geneva: WHO. o UNAIDS (2007). A Framework for Monitoring and Evaluating HIV Prevention Programmes for Most-At- Risk Populations. Geneva: UNAIDS. o UNAIDS (2007). Practical Guidelines for Intensifying HIV Prevention: Towards Universal Access. Geneva:UNAIDS
Data Collection
Data Collection Method: 
Survey: most-at-risk population
Data Collection Tools: 
Behavioural Surveillance Survey (BSS)
Measurement Frequency: 
Biennial
Epidemic Type: 
Concentrated/low level
Generalized
Indicator Type: 
Behavioral Outcome
Indicator Level: 
National
Disaggregations
Age-group: 
< (less than) 25 years
> (greater than) 25 years
Gender: 
Female
Male
Strengths and weaknesses: 

Surveying people who inject drugs can be challenging. Consequently, data obtained may not be based on a representative sample of the national injecting drug user population being surveyed. If there are concerns that the data are not based on a representative sample, these concerns should be reflected in the interpretation of the survey data. Where different sources of data exist, the best available estimate should be used. Information on the sample size, the quality and reliability of the data, and any related issues should be included in the report submitted with this indicator.

The extent of injecting drug use-associated HIV transmission within a country depends on four factors: (i) the size, stage and pattern of dissemination of the national AIDS epidemic; (ii) the extent of injecting drug use; (iii) the degree to which people who inject drugs use contaminated injecting equipment; and (iv) the patterns of sexual mixing and condom use among people who inject drugs and between people who inject drugs and the wider population. This indicator provides information on the third factor.

To maximize the utility of these data, it is recommended that the same sample used for the calculation of this indicator be used for the calculation of the other indicators related to these populations.

Preferred Indicator: 
Global AIDS Progress Reporting 2012
Agency: 
European Centre for Disease Prevention and Control (ECDC)
Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM)
Joint United Nations Programme on HIV/AIDS (UNAIDS)
Relevance: 
Dublin Declaration Monitoring
Global AIDS Progress Reporting 2012
Global AIDS Response Progress Reporting (GARPR) 2013
Universal Access (UA)
Status: 
Active
Document link: 
GFATM. 2011. (165.44 KB)
Harm Reduction
UNAIDS. Global AIDS Response Progress Reporting 2013: Construction of Core Indicators for monitoring the 2011 UN Political Declaration on HIV/AIDS. 2013. (1.85 MB)
Indicator 2.3, page 54
Keywords
Programme Focus General: 
Prevention
Programme Focus Specific: 
Injecting Behaviour
Target Population: 
Age: Adults
Age: Young People
Most-at-Risk: Injecting Drug Users
Sex: All
Goal - Initiative or Country: 
Initiative