Unlinked Anonymous survey of Injecting Drug Users (IDUs)
Aims and Objectives
The Unlinked Anonymous Survey of HIV and Hepatitis in Injecting Drug Users (IDUs) aims to measure the changing prevalence of HIV in current and former IDUs who are in contact with specialist drug agencies (e.g. needle exchange services and treatment centres). The programme also monitors levels of risk and protective behaviours among IDUs, as well as the prevalence of other viral infections. The data are used to assess and develop appropriate preventative and health education campaigns, evaluate the impact of such interventions, and to assist in the provision of services for IDUs in the United Kingdom.
Methodology
Survey data have been collected on an annual basis since the programme was established in 1990. The Health Protection Agency works in partnership with over 70 specialist drug agencies in England, Wales and Northern Ireland to gather the survey data, and provides full training, survey materials, and feedback to each collaborating agency involved. Each year, the agencies are encouraged to ask all eligible clients to participate in the survey - an eligible client being a current or former injecting drug user who has not already participated in the survey in the current calendar year. Each eligible client is asked to complete a short questionnaire and to provide a saliva sample using an OraSure™ device. Identifying information is irreversibly unlinked from all samples before testing, ensuring that both the sample and the questionnaire are completely anonymised. Samples are tested for the presence of HIV and Hepatitis C antibodies (signalling current infection), and also for antibodies developed in response to the Hepatitis B core antigen (which can indicate current or previous infection).
In the questionnaire, participants are asked to provide information regarding their HIV diagnosis status (if known), their patterns of drug use (including treatment for drug abuse and participation in needle exchange services) and their sexual behaviour. This information is used to assess the association between risky activities (such as needle sharing) and the prevalence of HIV among IDUs.
Key Points
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Transmission of HIV and hepatitis C infection through injecting drug use remains higher than in the late 1990s. Overall, around two-fifths of injecting drug users are now infected with hepatitis C and about one in 73 with HIV.
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Injecting site infections are common, with around one-third of injecting drug users reporting an abscess, sore, or open wound at an injecting site in the last year.
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Injecting into the groin and the injection of crack cocaine, which are associated with higher levels of infection and risky injecting, have become more common.
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Needle and syringe sharing has declined in recent years with around a fifth of injecting drug users continuing to share. The sharing of other injecting equipment is more common.
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There has been a marked increase in the number of injecting drug users receiving the hepatitis B vaccine, with over two-thirds now reporting vaccination.
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Services to reduce injecting-related harm and support for those who want to stop injecting should continue to be developed in line with published guidance.
IDU Supplementary Data Set
The following file contains all the tables and figures of the Unlinked Anonymous Prevalence Monitoring Programme of Injecting Drug Users (surveillance update October 2009):
Data tables - Unlinked Anonymous (UA) Prevalence Monitoring Programme of Injecting Drug Users (PDF, 79 KB)Last reviewed: 23 October 2009
