'Single-Use' Needles and Syringes for the Prevention of HIV Infection Among Intravenous Drug Users

Important note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.

'Single-Use' Needles and Syringes for the Prevention of HIV Infection Among Intravenous Drug Users

Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology (07/98) Vol. 18, Supplement 1, P. S52
Des Jarlais, Don C.

Don C. Des Jarlais of Beth Israel Medical Center in New York interviewed manufacturers, syringe exchange program staff, and intravenous drug users in an investigation of the possible use of single-use or difficult-to-reuse (DTR) syringes. DTR syringes use a number of methods to try and prevent multiple use, including the deactivation of the plunder following initial use, the use of hydrophilic gels to block the syringe passageway after a set time, and valves which prevent reloading. Des Jarlais found a number of objections to this equipment by IDUs. Many practice booting--the partial injection of drugs followed by the refilling of the syringe with blood and drug solution, coupled with re-injection--or aspiration of syringes in order to determine if a vein has been successfully located. Booting may give the effect of multiple injections, while aspiration can help IDUs with collapsed veins locate an injecting site. DTR syringes would not be usable for either of these practices, making them undesirable to many IDUs. Additionally, DTR syringes make drug recovery difficult or impossible if something goes wrong during injection. The author argues that it would only take an IDU a few losses of expensive drugs to bias the person against DTR syringes. DTR equipment could also increase the chance that IDUs would be without injecting equipment when they have drugs available, a situation which could actually lead to increased sharing of needles. Des Jarlais suggests that other options be assessed, such as the use of needles that can be disabled by the user or DTR syringes that must be disinfected to be activated for a second use. The author also recommends that needles be designed to protect against needle- stick accidents in case the equipment is discarded in public. He concludes that the introduction of DTR syringes may have an effect in reducing the spread of HIV in shooting galleries, where sharing is more common, but may have multiple problems for widespread use by IDUs.

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