Abstract

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.