Lower-risk consumption rooms, where users can inject drugs in a supervised setting, are effective in limiting practices that pose a risk of HIV and hepatitis C infection.
- One of the main risk factors for transmission of HIV and hepatitis C viruses is the sharing of equipment such as needles or syringes.
- A 90% reduction in the risk of sharing equipment is observed in “shooting rooms”, where drug users can inject in better hygienic conditions.
- No significant difference between patients having access to “shooting rooms” and those benefiting from other risk reduction programs was visible in the screening for hepatitis C or in the follow-up of opioid agonist treatment.
In Switzerland, Canada and the United States, “shooting rooms” are part of the landscape. These lower-risk consumption rooms (SCMR) are spaces where people who consume substances intravenously can inject in good conditions. The objective of these structures? Reduce the risks of transmission of HIV and hepatitis C viruses by providing easy access to sterile single-use injection equipment under the supervision of trained staff. As a reminder, “sharing equipment such as needles or syringes is one of the main risk factors for virus transmission”, according to researchers from Inserm, CNRS, EHESS, the universities of Strasbourg, Aix-Marseille and Bordeaux.
A 90% reduction in the risk of sharing equipment in “shooting rooms”
In France, lower-risk consumption rooms are currently being tested in Paris and Strasbourg. Other cities, such as Nancy, are also working on projects to open such structures. As part of a new study, the team of scientists wanted to examine the impact of lower-risk consumption rooms on the sharing of injection equipment and access to hepatitis C screening and so-called treatments. “by opioid agonist” (TAO). To do this, they followed 665 users of substances by injection in four large French cities, Bordeaux, Marseille, Paris and Strasbourg. The authors used data from face-to-face interviews at enrollment and at 6- and 12-month visits. Then, a comparison was made between the information of volunteers having access to a SCMR and that of adults benefiting from other types of structures or risk reduction programs.
The research, published in the journal Addictionshowed a significant 90% reduction in the risk of material sharing among people with access to a SCMR compared to those who had access to other risk reduction structures. “While more than 25% of participants reported being infected with hepatitis C, the results of this study show that 1% of participants with access to consumption rooms reported being likely to share their injection equipment compared to 11% of those not having access to these places. (…) In the French healthcare context, these places would have a positive impact on practices with an infectious risk of HIV and hepatitis C”, declared Marie Jauffret-Roustide, Inserm researcher and co-author of this work, in a statement.
“Shooting rooms”: no impact on hepatitis C screening
However, no significant difference was observed between adults having access to lower-risk consumption rooms and those having access to other structures with regard to hepatitis C screening and follow-up of treatment with opioid agonist. “This can be explained by the fact that the French care model now makes it possible to systematically offer hepatitis C screening in risk reduction places. In addition, if there is wide access to OAT in our country , according to our study, many people who access consumption rooms in Paris use morphine sulfates without a prescription, which is not yet officially considered as an OAT: this could give an underestimated result for consumption rooms”specified Perrine Roux, Marc Auriacombe and Laurence Lalanne, co-authors of the study.
Faced with these results, researchers insist on the need to put in place “actions complementary to those already existing”in order to better combat viral transmission among people who consume substances by injection. “In particular, develop addiction treatment centers but also facilitate access to more diversified opioid agonist treatments and offer comprehensive care.”
