Re-establishing contact: A profile of clients attending the health promotion unit - needle exchange at Merchants Quay Ireland.

Overview of Key Research Findings A total of 338 participants took part in the study. The sample consisted of 290 males(86%) and 48 females (14%). The male to female gender ratio of approximately 6:1 observed in the present study is notably higher than those found in most European and Irish studies. The mean age for males was approximately 34 years and the mean age for females was approximately 32 years. The age distribution found in the present study echoes a general trend identified across drug studies which have observed that the population of Irish opiate users is ageing. Although the majority of participants were Irish nationals (88%), the sample was made up of nineteen different nationalities, which highlights the ethnic diversity in those frequenting the Health Promotion Unit - Needle Exchange at MQI. The results highlighted that the majority of MQI service users are Dublin based. Indeed, only 9% resided outside Dublin, and only 4% resided outside Leinster. Approximately 31% of participants in the present study were residing in categories which were classified as homeless. Heroin was the most prevalently used substance in the past month (86%). Use of prescribed methadone (49%), benzodiazepines (34%; illicit 18%, prescribed 16%), cannabis (24%) and alcohol (22%) was also prevalent. Steroids (7%), cocaine (6%),mephedrone (6%), crack (6%), other (4%), illicit methadone (2%) and amphetamines(1%) were all used by less than 1 in 10 participants within the past month. A large majority of participants were poly-substance users (75%). Approximately 30% of the sample reported use of two substances over the past month, 25% reported use of three substances, 12% reported using four substances and 6% reported using five substances. Less than 2% of participants reported use of more than five substances within the past month. Almost all of the participants attending the Health Promotion Unit - Needle Exchange were injecting drug users (97%). 51% of participants reported injecting 6 or more times in the past week. Approximately three-quarters of the sample reported use of only one main injection site. Almost a third of participants reported injecting in to either the groin or the neck. Overall, approximately 27% of respondents reported incidences of sharing injecting equipment and paraphernalia in the past month. The overall rates of sharing of items were water (13%), tourniquets (12%), cookers (10%), syringes (10%), filters (9%), frontloading (8%), needles (7%) and backloading (5%). During the past week; around 41% reported generally injecting with other people and 59% reported injecting on their own; almost 88% reported generally injecting themselves and just over 12% reported being generally injected by another person/s; almost 86% of respondents had generally been injecting in a private domain and just over 14% had generally been injecting in a public area. Almost four-fifths of participants reported that they had been tested for HIV. The prevalence of HIV reported by those who had been tested was 8.33%. Approximately 55% of the participants who reported being negative for HIV had not been tested within the past year. Uptake of treatment for those who reported being positive for HIV also appears to be a problematic issue. Just over four-fifths of the sample reported being tested for Hepatitis C. The prevalence of Hepatitis C reported by those who had been tested was approximately 45%. Approximately 37% of the participants who reported being negative for Hepatitis C had not been tested within the past year. Another significant concern was the low rate of participants accessing treatment for Hepatitis C. Approximately 78% of participants reported that they had ever been tested for Hepatitis B. The prevalence of Hepatitis B reported by those who had been tested was approximately 5%. Approximately 48% of participants who had previously tested negative for Hepatitis B had not been tested within the past year. The prevalence of Hepatitis C/Hepatitis B co-infection was approximately 3% for those who had been tested for both viruses. The prevalence of HIV and Hepatitis C co-infection was approximately 6% of those who had been tested for both infections. One participant also reported being positive for HIV, Hepatitis B, and Hepatitis C. In combination this indicated that almost 73% of those who were HIV positive were also Hepatitis C positive