Examining the potential role of a supervised injection facility in Saskatoon, Saskatchewan, to avert HIV among people who inject drugs.

Ehsan Jozaghi,Asheka Jackson

doi:10.15171/ijhpm.2015.73

Abstract

Research predicting the public health and fiscal impact of Supervised Injection Facilities (SIFs), across different cities in Canada, has reported positive results on the reduction of HIV cases among People Who Inject Drugs (PWID). Most of the existing studies have focused on the outcomes of Insite, located in the Vancouver Downtown Eastside (DTES). Previous attention has not been afforded to other affected areas of Canada. The current study seeks to address this deficiency by assessing the cost-effectiveness of opening a SIF in Saskatoon, Saskatchewan. We used two different mathematical models commonly used in the literature, including sensitivity analyses, to estimate the number of HIV infections averted due to the establishment of a SIF in the city of Saskatoon, Saskatchewan. Based on cumulative cost-effectiveness results, SIF establishment is cost-effective. The benefit to cost ratio was conservatively estimated to be 1.35 for the first two potential facilities. The study relied on 34% and 14% needle sharing rates for sensitivity analyses. The result for both sensitivity analyses and the base line estimates indicated positive prospects for the establishment of a SIF in Saskatoon. The opening of a SIF in Saskatoon, Saskatchewan is financially prudent in the reduction of tax payers' expenses and averting HIV infection rates among PWID.

Highlights

The contraction and spread of HIV via People Who Inject Drugs (PWID) is not a problem exclusive to large cities and urban areas as small and medium sized towns have reported an increase in HIV infection [1]
Has been positively transformed as a result of long standing harm reduction programs that have addressed an array of PWID needs, the establishment of Insite, North America’s only lawfully operated Supervised Injection Facility (SIF) [5,6,7,8,9,10]
Sensitivity analyses conducted at different baseline sharing rates demonstrated that establishing SIF based on HIV averted may save tax payers’ dollars

Summary

Introduction

The contraction and spread of HIV via People Who Inject Drugs (PWID) is not a problem exclusive to large cities and urban areas as small and medium sized towns have reported an increase in HIV infection [1]. The Downtown Eastside (DTES) of Vancouver has historical shared similarities with many small cities in Canada in terms of HIV prevalence. Since early 2000, the DTES has been positively transformed as a result of long standing harm reduction programs that have addressed an array of PWID needs, the establishment of Insite, North America’s only lawfully operated Supervised Injection Facility (SIF) [5,6,7,8,9,10]. Insite, located in the DTES of Vancouver, is a small injection facility with twelve individual booths that afford PWID with free sterile injection supplies to inject illicit drugs under the supervision of a registered nurse [11] (Figure 1).

Methods

Results

Conclusion