Needle sharing in regular sexual relationships: An examination of serodiscordance, drug using practices, and the gendered character of injecting

Background: This paper examines correlates of needle and other equipment sharing among injecting drug users (IDU) in regular heterosexual relationships. Methods: A cross-sectional survey collected data from people obtaining sterile needles and syringes from pharmacies in New South Wales, Australia. 181 IDU in regular heterosexual relationships provided information about their own drug and injecting practices and those of their partners. Results: Compared to female partners, male partners reported more frequent injecting, more commonly injected their partners, scored and prepared the drugs, and obtained the needles. Couples were less likely to share needles with each other if they reported a low-to-moderate connection with drug using networks compared to a moderate-to-high connection (AOR 0.4, 95% Cl 0.19-0.95) or if the respondent partner reported sharing injecting equipment (needles and/or ancillary equipment) with friends in the last 6 months (AOR 3.2, 95% CI 1.34-7.86). Couples were more likely to share ancillary equipment with each other if they spent most or all of their injecting time together (ACR 4.1, 95% CI 1.40-11.31) or if the respondent reported sharing injecting equipment with friends (AOR 5.3, 95% CI 1.73-16.37). Couples with discordant hepatitis C status were no more or less likely than those with concordant status to share needles or ancillary injecting equipment. Conclusions: Injecting practices in regular heterosexual relationships do not appear to be organised around hepatitis C status but are influenced by gender, the couples' connection with other IDU, and extent to which they share the equipment with those outside of their relationship. (C) 2009 Elsevier Ireland Ltd. All rights reserved.