Prevalence and correlates of jugular injections among injection drug users

Background. Jugular injection of drugs has been reported, although little is known about the prevalence of and risk factors associated with this behaviour. We evaluated factors associated with jugular injection among a cohort of injection drug users (IDU) in Vancouver, Canada. Methods. We used univariate statistics and logistic regression to examine factors associated with jugular injection among participants in the Vancouver Injecting Drug Users Study (VIDUS), a large prospective cohort study of IDU recruited through snowball sampling methods in Vancouver, Canada. Findings. Between December 2004 and November 2005, 780 IDU were followed up as part of VIDUS and 198 (25%) reported jugular injection in the previous 6 months. In multivariate analyses, factors associated independently with jugular injection included: being of the female gender [adjusted odds ratio (aOR)=1.72, 95% confidence interval (CI): 1.14-2.59; p=0.010], daily heroin use (aOR=2.89, 95% CI: 1.93-4.34; p < 0.001), daily cocaine use (aOR=1.76, 95% CI: 1.12-2.76; p=0.014], requiring help injecting (aOR=4.44, 95% CI: 2.64-7.46; p < 0.001), and involvement in the sex-trade (aOR=2.71, 95% CI: 1.6-4.55; p < 0.001). Interpretation. Reporting a history of jugular injecting was alarmingly high in the cohort and was associated with several identifiable demographic and drug-using characteristics. Given previous reports demonstrating the risk of infection and vascular trauma due to this behaviour, these populations should be considered seriously as a target for safer injecting education.