National Amphetamine-Type Stimulant Strategy Background Paper

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ongoing drug use. That is, the exclusive focus was on changing sexual behaviour only.
The study found that those assigned to the safer sex behavioural intervention engaged
in significantly more protected sex acts at both 8-month and 12-month assessment times
(Mausbach et al., 2007). However, in general, there are few HIV prevention interventions
that target drug-using MSM, particularly non-injectors.
Injecting Behaviours
Injecting behaviours are a particular concern in relation to people who are dependent on
ATS (generally, dependent on methamphetamine). In Australia, the majority of dependent
methamphetamine users inject the drug, and methamphetamine accounts for around onethird
of injecting drug use in Australia (Iverson et al., 2006). This has important implications
for the spread of blood-borne viruses, such as HIV and particularly hepatitis C, which is
endemic among injecting drug users in Australia (National Centre in HIV Epidemiology and
Clinical Research, 2007).
While earlier research suggested that those who inject methamphetamine do not appear
to differ in their level of HIV risk behaviour compared to their heroin injecting counterparts
(Hall et al., 1993), some evidence indicates that those who use ATS have a lower perception
of risk. For example, HIV is perceived as a risk for people who inject heroin, as opposed
to a risk for those who inject any drug, including amphetamine (e.g., Vincent et al., 1999).
Consequently, it has been argued that a comprehensive strategy needs to be maintained to
reduce the risk of blood borne virus transmission among all injecting drug users, including
those who inject methamphetamine.
Harm reduction messages warning of the risks of blood-borne viral infections (BBVIs)
associated with injecting drug use are also indicated. These messages should, perhaps,
particularly target young people prior to their uptake of injecting drug use, because much
of the literature indicates that early onset injecting drug users are also higher risk takers in
relation to their health (such as increased risk of sharing needles) (Fennema et al., 1997;
Battjes et al., 1992). Thus, newer and younger initiates to injecting drug use are at greater
risk of contracting and transmitting blood borne viruses.
Commencing in August 2002, AIVL conducted a research project to investigate the
hepatitis C transmission risks amongst methamphetamine injecting drug users that was
completed in March 2003. A questionnaire (the PSU Tool) was developed and 182 injecting
psychostimulant users were interviewed across Australia. The findings were reported in the
‘National Snapshot on Hepatitis C Transmission Risks Amongst Injecting Psychostimulant
Users’ (available from AIVL website). Among the main findings were that, although almost
the entire sample reported seeing hepatitis C information, there were mixed levels of
knowledge about the condition. In addition, approximately 29% were ‘concerned a great
deal’ about contracting hepatitis C, while responses to other items revealed that many
were engaging in unsafe injecting practices. One of the conclusions drawn from the
research is that opiate users may be more aware of the risks associated with injecting
than psychostimulant users, as opiate users have more commonly been the focus of harm
reduction messages associated with blood borne virus transmission.