Edinburgh drug users : are they injecting and sharing less ?

To describe epidemiological trends in injecting and equipment sharing among a sample drawn from a drug-using population with a high rate of HIV infection. A structured interview was administered prior to treatment to cross-sectional samples of drug users over the period 1988-1991. Reports of injecting, sharing and HIV infection were compared annually. Lothian Health Board's Community Drug Problems Service is a secondary level service offering harm reduction and treatment of dependency. A total of 734 consecutively referred drug users resident in Edinburgh. Re-referrals in the same calendar year were excluded. History of injecting and sharing, recent injecting and sharing, HIV testing history, drugs used in previous month and substitute prescription status. Large reductions in the frequency of injecting were found over the 4 years even among those who were not receiving oral substitutes. More participants in latter years were receiving prescriptions combining opioids and benzodiazepines. Fewer of those interviewed latterly had ever shared injecting equipment. Among recent injectors just as many share equipment as previously. HIV prevalence did not vary significantly over the period. An HIV prevalence of 19% was reported among recent injectors. Edinburgh's drug users are engaging in far safer drug-taking behaviour than previously. Levels of HIV in this population suggest that the epidemic is being contained. A small number persist in high risk drug-related activities. Further investigation of the characteristics of these individuals and the need to develop novel methods of influencing their behaviour are recommended.