Prevalence and factors related to syringe sharing behaviours among female injecting drug users who are also sex workers in China.

BACKGROUND

Female injecting drug users who are sex workers (IDUFSWs) are at high risk of contracting HIV. They may bridge HIV transmissions from injecting drug users to clients of female sex workers.

METHODS

A total of 216 non-institutionalised IDUFSWs were recruited by snowball sampling methods. Anonymous face-to-face interviews were conducted to collect data. Univariate, multivariate and hierarchical logistic regression models were fitted to investigate the associations between background characteristics, cognitive variables, psychological stress and syringe sharing behaviours among IDUFSWs.

RESULTS

Respectively 33.8% and 27.8% of the respondents injected drugs with others' used syringes and gave used syringes to others for drug injection in the last month. These two syringe sharing behaviours were significantly associated with inconsistent condom use during commercial sex (OR=5.00 and 1.92, p<0.05). Over 90% of the respondents reported at least one type(s) of psychological distress included in this study. Adjusting for significant background variables, all variables that are related to the Theory of Planned Behaviour (attitude, norm, perceived control and behavioural intention) and psychological distress (except for depression) were significantly associated with injecting drugs with others' used syringes (adjusted OR=2.08-6.25, p<0.05), whilst variables related to perceived control, behavioural intention and insomnia were significantly associated with providing used syringes to others for injection (adjusted OR=2.00-3.56, p<0.05). In two separate summary multivariate models, variables related to the Theory of Planned Behaviours and psychological distress were independently associated with injecting drugs with others' used syringes (OR=1.98-4.02, p<0.05) and giving used syringes to others for injection (OR=2.06-3.59, p<0.05).

CONCLUSIONS

Syringe sharing behaviours were prevalent among IDUFSWs and were associated with cognitive and psychological factors. Effective integrative intervention programmes targeting IDUFSWs are warranted.