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Gender differences in syringe exchange program use in Oslo, Norway.

AIMS
To examine gender differences in syringe exchange program (SEP) use, particularly frequent SEP use, within and across survey years.


DESIGN
Three consecutive, anonymous cross-sectional surveys.


SETTING
The SEP in Oslo, Norway.


PARTICIPANTS
Two hundred and eighty-eight, 449 and 523 SEP participants interviewed during comparable 1-week periods in 1992, 1994 and 1997, respectively.


MEASUREMENTS
Brief structured questionnaires assessed SEP use, HIV risk behaviors and self-reported HIV status. Chi square statistics, t-tests and analysis of variance were used to identify gender differences; logistic regression was used to identify independent correlates of frequent SEP use.


FINDINGS
Women reported injecting more frequently than men, but neither reported more frequent SEP use nor acquiring more syringes during an exchange. Although syringe sharing decreased significantly over time, in 1997, 51% of SEP participants continued to share. HIV prevalence remained low (3-5%) over time. After controlling for gender, age and HIV risk factors, frequent SEP use was significantly correlated with frequent injection for both women (OR = 1.4) and men (OR = 1.5). A lack of income or benefits independently increased the likelihood of being a frequent SEP user (OR = 3.0), while having shared a syringe at last injection independently decreased this likelihood (OR = 0.5).


CONCLUSIONS
Gender was not associated with frequent SEP use; rather, the single most important correlate of frequent SEP use was injection frequency. Women's need for sterile syringes may not be fully addressed, despite the existence of a well-established and well-utilized SEP.