Abstract

Although public injecting has been studied in large urban centres, little is known about the factors that drive public injecting in remote communities. This study sought to explore public and semi-public injection in Thunder Bay, a remote and mid-sized city in Northwestern Ontario. Peer researchers completed surveys with people who inject drugs. Multivariable logistic regression was used to examine sociodemographic characteristics and behavioural patterns associated with injecting in public or semi-public settings. Among 200 people who inject drugs, 128 (64%) individuals reported engaging in public injection. In multivariable analyses, public injecting was positively associated with age (Adjusted Odds Ratio [AOR], 0.97, 95% Confidence Interval [CI]: 0.97–1.00; p = 0.05), homelessness (AOR 2.34, 95% CI: 1.10–5.02; p = 0.02), sex work (AOR 4.62, 95% CI: 1.37–21.61; p = 0.02), injecting alone (AOR 2.66, 95% CI: 1.19–6.02; p = 0.01), opioid injecting (AOR 3.64, 95% CI: 1.48–9.41; p = 0.05) and cocaine injecting (AOR 4.35, 95% CI: 2.11–9.44). The most frequent reasons for public injecting were proximity to where people buy drugs (59.4%), being too far from home (27.3%), and being homeless (25.8%). Our findings suggest that the scale-up of additional harm reduction programming in Thunder Bay, including supervised injection services, may address public injecting and reduce associated harms in this setting.

摘要

尽管已经在大型城市中心对公共注射进行了研究，但对于驱动偏远社区公共注射的因素知之甚少。本研究旨在探索安大略省西北部偏远中型城市桑德贝的公共和半公共注射。同行研究人员完成了对注射毒品者的调查。多变量逻辑回归用于检查与在公共或半公共场所注射相关的社会人口特征和行为模式。在 200 名注射吸毒者中，有 128 人（64%）报告参与了公共注射。在多变量分析中，公开注射与年龄呈正相关（调整优势比 [AOR], 0.97, 95% 置信区间 [CI]: 0.97–1.00; p = 0.05)、无家可归 (AOR 2.34, 95% CI: 1.10–5.02; p  = 0.02)、性工作 (AOR 4.62, 95% CI: 1.37–21.61; p  = 0.02)、单独注射 (AOR 2.66, 95% CI : 1.19–6.02; p  = 0.01)，阿片类药物注射 (AOR 3.64, 95% CI: 1.48–9.41; p  = 0.05) 和可卡因注射 (AOR 4.35, 95% CI: 2.11–9.44)。公开注射的最常见原因是靠近人们购买毒品的地方（59.4%）、离家太远（27.3%）和无家可归（25.8%）。我们的研究结果表明，在桑德贝扩大额外的减害计划，包括监督注射服务，可能会解决公共注射问题并减少这种情况下的相关危害。