"High Dead-Space Syringes and the Risk of HIV and HCV Infection Among
Injecting Drug Users"
Drug and Alcohol Dependence Vol. 100; No. 3: P. 187-284
(03.01.09)::William A. Zule; Georgiy Bobashev

High dead-space syringes (HDSSs) retain more than 1,000 times
more blood after rinsing than do low dead-space syringes (LDSSs). The
current study examines the association between using and sharing
HDSSs and prevalent HIV and hepatitis C virus (HCV) infections among
injecting drug users (IDUs).
In Raleigh-Durham, N.C., a sample of 851 out-of-treatment IDUs
was recruited between 2003 and 2005. The participants were tested for
HIV and HCV antibodies. Via interviews, information was collected on
demographics, drug use, and injection practice. Multiple logistic
regression analysis was employed to analyze data. The mean age of the
sample was 40; 74 percent were male; 63 percent were
African-American; 29 percent were non-Hispanic white; and 8 percent
were of another race/ethnicity.
A total of 42 percent of participants reported having ever used
an HDSS; 12 percent reported sharing an HDSS. Among IDUs who reported
sharing an HDSS, HIV prevalence was 16 percent, compared with 5
percent among IDUs who had never used an HDSS. The HIV model used a
propensity score approach to adjust for differences between IDUs who
had used an HDSS and those who had never used one. The HCV models
included all potential confounders as covariates.
"A history of sharing HDSSs was associated with prevalent HIV
(odds ratio=2.50; 95 percent confidence interval=1.01-6.15). Use and
sharing of HDSSs were also associated with increased odds of HCV
infection," concluded the authors, who called for prospective studies
to determine if sharing HDSSs is associated with increased HIV and
HCV incidence among IDUs.