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A Profile of People Who Inject Drugs in London, Ontario Report on the Public Health Agency of Canada I-Track Survey, Phase 3 Canadian Public Health Association May 28, 2014. Authors: Hilary Caldarelli BSc MPH Alison Locker BSc MSc Bryna Warshawsky MDCM MHSc CCFP FRCPC.

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authors hilary caldarelli bsc mph alison locker bsc msc bryna warshawsky mdcm mhsc ccfp frcpc

A Profile of People Who InjectDrugs in London, OntarioReport on the Public Health Agency of CanadaI-Track Survey, Phase 3Canadian Public Health AssociationMay 28, 2014

Authors:

Hilary Caldarelli BSc MPH

Alison Locker BSc MSc

Bryna Warshawsky MDCM MHSc CCFP FRCPC

overview
Overview
  • Background
  • Methods
  • Selected results
  • Limitations
  • Summary and local next steps
  • Acknowledgements
the middlesex london region
The Middlesex-London Region
  • Population 439,151 (2011 Census)
    • City of London: 366,151
    • Remainder of Middlesex County: 73,000
  • SW Ontario along the Windsor-Quebec City corridor
    • Approximately 2 hour drive from Windsor and Toronto
what is the i track survey
What is the I-Track Survey?
  • Survey of people who inject drugs developed and led by Public Health Agency of Canada (PHAC)
    • Behavioural and biological surveillance
  • Occurs regularly at sentinel sites
    • Middlesex-London Health Unit participated for first time in 2012, during Phase 3 (2010-2012)
why is i track important
Why is I-Track Important?
  • Injection drug use is an important risk factor in acquiring hepatitis C and HIV
  • People who use injection drugs are a vulnerable population
  • Middlesex-London had a significantly higher incidence of hepatitis C compared to Ontario
    • 2010: 53.4 per 100,000 population vs. 33.1 per 100,000 in ON
how were i track survey participants interviewed
How were I-Track Survey Participants Interviewed?
  • The Health Unit partnered with Regional HIV/AIDS Connection (RHAC)
  • Face to face interview
    • Participants recruited and interviewed through RHAC needle and syringe exchange program (NEP) in January to February 2012
    • Approximately 80 questionsin 6 topic areas
who was eligible to participate
Who Was Eligible to Participate?
  • Had injected drugs in the past 6 months
  • ≥ 16 years of age
  • Able to provide informed consent
  • Able to speak English or French
  • Had not already participated in Phase 3 of the I-Track survey
demographics cont d
Demographics (cont’d)
  • Unstable housing and recent incarceration higher in London sample than national sample
injection risk behaviours
Injection Risk Behaviours
  • Borrowing and lending needles and equipment higher in London sample than national sample
hepatitis c and hiv prevalence
Hepatitis C and HIV Prevalence
  • London sample has higher hepatitis C prevalence rates, but lower HIV prevalence rates compared to the national sample
limitations
Limitations
  • Non-random convenience sample
    • Hard to reach population
  • Self-reported
    • Leveraged existing relationships between interviewers and participants to minimize social desirability bias
  • Other potential biases
    • Recall, selection
summary
Summary
  • Active local population of people who inject drugs with a high prevalence of hepatitis C and HIV
  • Opioid drugs were most commonly injected
  • Higher prevalence of injection risk behaviours compared to national sample
local next steps
Local Next Steps
  • Overview of local withdrawal management services and needle disposal and recovery
    • Assess NEP services in County area
  • Additional reporting on impacts of drug use in Middlesex-London
  • Collaborate with municipal and community partners to develop a comprehensive community drug strategy
acknowledgements
Acknowledgements
  • Survey participants
  • Regional HIV/AIDS Connection (RHAC)
  • Public Health Agency of Canada (PHAC)
authors hilary caldarelli bsc mph alison locker bsc msc bryna warshawsky mdcm mhsc ccfp frcpc1

A Profile of People Who InjectDrugs in London, OntarioReport on the Public Health Agency of CanadaI-Track Survey, Phase 3Canadian Public Health AssociationMay 28, 2014

Authors:

Hilary Caldarelli, BSc MPH

Alison Locker, BSc MSc

Bryna Warshawsky, MDCM MHSc CCFP FRCPC