Background: Programmatic data suggests Australia has high coverage of harm reduction strategies; individual-level data can indicate whether these programs are implemented effectively.
Objective: To determine individual-level harm reduction intervention coverage among people who inject drugs in Australia and compare coverage across intersectional risk factors (gender, housing, main drug injected, and lifetime incarceration).
Methods: We used data from the 2023 Illicit Drug Reporting System, in which 820 people who inject drugs and reside in an Australian capital city were interviewed. Individual-level needle/syringe coverage was defined as the percentage of injecting episodes ‘covered’ by at least one sterile needle/syringe per participant in the past month. Coverage for other harm reduction interventions (opioid agonist treatment [OAT], naloxone) was defined as the percentage of participants who reported recent access.
Results: Most participants had sufficient needle/syringe coverage (90%; 95% confidence interval [CI]: 83-97%). Among those who recently used opioids (n=607), half accessed naloxone during the past year (53%; 47-58%). Among those with possible opioid dependence (n=296), 62% (53-72%) had recently been in OAT. Needle/syringe coverage was lowest among people who predominantly injected methamphetamine (p=0.013). There was no evidence for difference across intervention coverage by gender, housing, or incarceration.
Implications: Individual-level needle/syringe coverage is high in Australia but gaps remain in the implementation of other interventions. Ensuring those who predominantly inject methamphetamine have access to sufficient needles/syringes should be prioritised, especially in the context of increasing use in Australia.