Options for reducing HIV transmission related to the dead space in needles and syringes

• Published in: Harm reduction journal Vol. 15; no. 1; pp. 3 - 10
• Main Authors: Zule, William A, Pande, Poonam G, Otiashvili, David, Bobashev, Georgiy V, Friedman, Samuel R, Gyarmathy, V Anna, Des Jarlais, Don C
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 15.01.2018; BioMed Central; BMC
• Subjects: Analysis; Asia; Dead space; Disease transmission; Equipment Design; Europe; Harm Reduction; Health aspects; Hepatitis C virus; HIV; HIV infections; HIV Infections - complications; HIV Infections - prevention & control; Humans; Needle exchange programs; Needle Sharing - adverse effects; Needles; Needles - statistics & numerical data; Patient outcomes; People who inject drugs; Planning; Prevention; Risk factors; Sharing; Substance Abuse, Intravenous - complications; Syringes; Syringes - statistics & numerical data; Asia; Europe; Needle and syringe programs; Syringes; HIV; Needles; People who inject drugs; Hepatitis C virus; Dead space
• ISSN: 1477-7517; 1477-7517
• DOI: 10.1186/s12954-017-0207-5

When shared by people who inject drugs, needles and syringes with different dead space may affect the probability of HIV and hepatitis C virus (HCV) transmission differently. We measured dead space in 56 needle and syringe combinations obtained from needle and syringe programs across 17 countries in Europe and Asia. We also calculated the amounts of blood and HIV that would remain in different combinations following injection and rinsing. Syringe barrel capacities ranged from 0.5 to 20 mL. Needles ranged in length from 8 to 38 mm. The average dead space was 3 μL in low dead space syringes with permanently attached needles, 13 μL in high dead space syringes with low dead space needles, 45 μL in low dead space syringes with high dead space needles, and 99 μL in high dead space syringes with high dead space needles. Among low dead space designs, calculated volumes of blood and HIV viral burden were lowest for low dead space syringes with permanently attached needles and highest for low dead space syringes with high dead space needles. The dead space in different low dead space needle and syringe combinations varied substantially. To reduce HIV transmission related to syringe sharing, needle and syringe programs need to combine this knowledge with the needs of their clients.