Background:
The Community Oriented Substance Use Programme has operated a needle and syringe programme (NSP) in Tshwane (South Africa) since 2016. Some local stakeholders have questioned the benefits of NSP services. We aimed to describe knowledge, attitudes and practices of people who inject drugs (PWID) who access NSP services.
Methods:
We implemented a quantitative cross-sectional survey among PWID accessing NSP services at 12 sites between December 2023 and February 2024. From a population of 2400 PWID, 280 were randomly sampled, stratified by site. An interviewer-assisted survey was used to collect data on demographics and drug use and the influence of NSP services on knowledge around safer injecting, attitudes towards personal health and the sharing of injecting equipment. Data was analysed using descriptive statistics.
Results:
Most participants (n=266, 95.0%) were male, 52.9% (n=148) were aged between 18 – 34 years, 67.9% (n=190) had below grade 12 education and 63.6% (n=178) were unemployed. Half (50%, n=140) had injected for at least six years and 60.7% (n=170) injected four times daily. Overall, 87.5% (n=245) reported to inject more safely and 92.5% (n=259) learnt how to safely discard used needles as a result of the NSP. Overall, 87.9% (n=246) reported to care more about their health, 83.2% (n=233) reported improved quality of life and 84.7% (n=240) knew more about HIV as a result of NSP services. Two-thirds (60.7%, n=170) did not share injecting equipment during their last injection. Around a third (37.9%, n=106) felt that they needed 30 sterile needles per week, and 85.4% (n=239) felt that access to NSP is insufficient.
Conclusion:
PWID who have injected for many years and inject frequently access NSP services. NSP services have improved knowledge around safer injecting and discarding and has supported healthier attitudes among PWID. Sustaining and expanding NSP services in Tshwane could further reduce injecting-related harms. |