Safer Injecting

The most commonly reported risk exposure for HIV in Saskatchewan is injection drug use. In two thirds of new cases of HIV (67%, 118 cases) people self-reported injection drug use as their main exposure to the virus, with ages ranging from early teens to over 80 years of age (HIV and AIDS in Saskatchewan, 2013).

One of the best ways to avoid infection by HIV or Hepatitis C is to use new, sterile (clean) equipment every time. We operate a needle exchange¬† in the 601 Outreach Centre, and there are others available throughout the city so that people can access new equipment. This lowers the risk for transmission of blood borne diseases and other health complications caused from reusing equipment (such as abscesses, blood clots, Endocarditis and infections). New needles are sharper and less likely to damage veins. If you cannot get new needles find a way to mark yours so that you don’t accidentally share (use a pen or nail polish).

Use new materials for injection:Newneedle

  • needles
  • syringes
  • tourniquets

Use new materials for drug preparation:

  • cookers and spoons
  • filters
  • water
  • alcohol swabs

Steps to Safer Injecting

  1. To inject safely it helps to have a safe place to prepare your equipment where you will not be disturbed, preferably with running water and good light. Cleaning the injection site with soap and water or alcohol swabs will prevent dirt or other germs on the skin from getting pushed into the vein by the needle. Wipe in one direction – a circular or back and forth motion will just move dirt and germs around and they will stay on the skin.
  2. Finding a vein is the next step. Rotating injection sites allows time for the vein to heal after being used and will help stop them from collapsing or becoming infected. Typically the veins in the hands and arms are the best sites to use. Some areas of the body are very dangerous to use – avoid using the neck, groin, penis, eyes, feet and breasts – see diagram.

saferinjection-web-en3. With the opening of the needle (bevel) facing up the needle is slowly inserted into the vein. Insert at a 35 degree angle and in the direction of the heart to reduce vein damage. ‘Fishing around’ for a vein will cause bruising and damage the veins. Instead remove the needle and try again – make sure to clean the site again.

4. Flagging will make sure that the needle has hit a vein. Flagging is when the plunger is pulled back slowly until a little blood flows into the syringe. If the blood is frothy or brighter red than usual this can mean that the syringe has hit an artery – this is very painful and can cause swelling and blood loss, as well as wasting the drug and its desired effects. Slowly remove the needle and put pressure on the site if you have hit an artery. If the bleeding continues and there is pain and swelling after 10 minutes medical attention is needed – get to the hospital or medical clinic.

5. Once the syringe is in the vein, the tourniquet should be released and the plunger pushed down slowly to release the drug. Releasing the tourniquet as quickly as possible is important to avoid vein ruptures.

6.Slowly remove the needle at the same angle it was inserted. Apply pressure to the site for a few minutes with a clean, dry cotton ball or tissue to stop the bleeding. Using an alcohol swab for this will actually cause more bleeding as the alcohol prevents the blood from clotting.

7. Clean up all of your equipment to protect others from coming into contact with contaminated supplies. Sharps containers are available from the needle exchange programs. If you do not have a sharps container you can use an empty plastic bottle with a lid (like a pop bottle or bleach container). It is important to put all the equipment in the sharps container (filters, tourniquet, tissues and wrappers) to protect others from possible exposure to HIV and Hep C. Because the Hep C virus can live on surfaces for many days the final step is to wash the work surface and hands with soap and water.



This page is a shortened version of an article that appears on the CATIE website. You can view the full length piece here.

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