Public drug injecting in London, Ontario: a cross-sectional survey

Ayden Scheim; Beth Rachlis; Geoff Bardwell; Sanjana Mitra; Thomas Kerr

doi:10.9778/cmajo.20160163

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Table 1: Characteristics of Ontario Integrated Supervised Injection Services Feasibility Study participants in London, Ontario stratified by recent regular public injecting and bivariate associations

Characteristic	No. (%) of participants*†			OR (95% CI)
	Full sample n = 196	Recent regular public injecting‡
	Full sample n = 196	Yes n = 91	No n = 105
Age, median (IQR), yr	39 (33-50)	36 (30-46)	43 (37-51)
Per 1-yr increase				0.94 (0.91-0.97)
Gender
Female	75 (38.3)	29 (31.9)	46 (43.8)	0.60 (0.33-1.08)
Male	121 (61.7)	62 (68.1)	59 (56.2)
Ethnicity
White	146 (74.5)	68 (74.7)	78 (74.3)	1.12 (0.58-2.16)
Indigenous/person of colour	48 (24.5)	21 (23.1)	27 (25.7)
Homeless/unstably housed§
Yes	111 (56.6)	64 (70.3)	47 (44.8)	2.93 (1.62-5.29)
No	85 (43.4)	27 (29.7)	58 (55.2)
Recent incarceration§
Yes	24 (12.2)	16 (17.6)	8 (7.6)	2.59 (1.05-6.37)
No	172 (87.8)	75 (82.4)	97 (92.4)
Sold drugs‡
Yes	63 (32.1)	30 (33.0)	33 (31.4)	1.07 (0.59-1.96)
No	133 (67.8)	61 (67.0)	72 (68.6)
Engaged in sex work§
Yes	38 (19.4)	16 (17.6)	22 (21.0)	0.81 (0.39-1.65)
No	158 (80.6)	75 (82.4)	83 (79.0)
Usually injected downtown§
Yes	51 (26.0)	32 (35.2)	19 (18.1)	2.46 (1.27-4.74)
No	145 (74.0)	59 (64.8)	86 (81.9)
Usually injected in Old East§
Yes	105 (53.6)	47 (51.6)	58 (55.2)	0.87 (0.49-1.52)
No	91 (46.4)	44 (48.4)	47 (44.8)
Frequent opioid injection§
Yes	104 (53.1)	62 (68.1)	42 (40.0)	3.21 (1.78-5.78)
No	92 (46.9)	29 (31.9)	63 (60.0)
Frequent crystal methamphetamine injection§
Yes	70 (35.7)	47 (51.6)	23 (21.9)	3.80 (2.05-7.07)
No	126 (64.3)	44 (48.4)	82 (78.1)
Usually injected alone§
Yes	106 (54.1)	54 (59.3)	52 (49.5)	1.49 (0.84-2.62)
No	90 (45.9)	37 (40.6)	53 (50.5)
Needed help injecting§
Yes	63 (32.1)	31 (34.1)	32 (30.5)	1.18 (0.65-2.15)
No	133 (67.8)	60 (65.9)	73 (69.5)
Shared syringe§
Yes	44 (22.4)	30 (33.0)	14 (13.3)	3.25 (1.59-6.63)
No	151 (77.0)	60 (65.9)	91 (86.7)
Ever overdosed unintentionally
Yes	48 (24.5)	28 (30.8)	20 (19.0)	1.87 (0.97-3.63)
No	145 (74.0)	62 (68.1)	83 (79.0)
Any substance use treatment
Yes	83 (42.3)	41 (45.0)	42 (40.0)	1.26 (0.71-2.23)
No	110 (56.1)	48 (52.7)	62 (59.0)

Note: IQR = interquartile range, OR = odds ratio.

*Except where noted otherwise.

†Columns not adding to total are due to missing values.

‡Includes "sometimes," "usually" or "always" injecting in public in the previous 6 months.

§Over the previous 6 months.

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Table 2: Multivariable logistic regression predicting recent regular public injecting in London (n = 194)

Variable	Adjusted OR (95% CI)
Older age (1-yr increase)	0.97 (0.94-1.00)
Homeless/unstably housed (yes v. no)*	2.04 (1.01-4.12)
Recent incarceration (yes v. no)*	1.26 (0.45-3.54)
Usually injected downtown (yes v. no)*	1.68 (0.79-3.61)
Frequent opioid injection (yes v. no)*	2.27 (1.17-4.42)
Frequent crystal methamphetamine injection (yes v. no)*	2.38 (1.18-4.79)
Shared syringe (yes v. no)*	1.81 (0.80-4.13)

Note: CI = confidence interval, OR = odds ratio.

*Over the previous 6 months.

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Table 3: Injection behaviours among those who injected in public in the previous 6 months

Characteristic	No. (%) of participants n = 141
Frequency of public injecting
Always (100% of the time)	11 (7.8)
Usually (75%-99%)	37 (26.2)
Sometimes (25%-74%)	43 (30.5)
Occasionally (< 25%)	50 (35.5)
Public places injected*
Public washroom	90 (63.8)
Park	69 (48.9)
Parking lot	66 (46.8)
Alley/laneway	61 (43.3)
Shelter	46 (32.6)
Abandoned building	44 (31.2)
Community organization/service provider	10 (7.1)
Schoolyard	5 (3.5)
*Reason for public injecting†**
Convenient to where I hang out	98 (69.5)
Homeless	56 (39.7)
Too far from home	43 (30.5)
Nowhere to inject safely where I buy drugs	25 (17.7)
Involved in drug selling	19 (13.5)
Engaged in sex work	10 (7.1)
Used outdoor water source to prepare drugs or rinse syringes	61 (43.3)