Ireland, particularly Dublin, has a higher incidence of HIV transmission due to injecting drug use than many other European countries. Over 40% of AIDS cases in Ireland are associated with intravenous drug use. In 1989, the Eastern Health Board set up a needle-exchange programme in order to address this problem. Response to the clinic was good and by the end of 1990 630 individuals had attended the exchange. At this stage it was decided to evaluate the service in a more formal way. The aim of the study is to measure prevalence of HIV infection and assess the level of equipment sharing and unsafe sex among attendees of the needle exchange. In a six-week period from February to March 1992, attendees were asked to provide a sample of saliva for HIV testing and to complete a brief self-administered questionnaire, in accordance with a protocol devised by the Public Health Laboratory Service AIDS Centre, Colindale, London. Participation was on a voluntary basis, and questionnaires were anonymous.

106 individuals responded to the survey: 80 males with a median age of 28 years and 24 females with a median age of 27 years responded. The median age of starting drug use was 19, and the most common drug used in the previous 28 days was morphine sulphate, which had been used by 48.1% of respondents. 76 respondents answered the question on needle sharing, and of these nearly half did not share their needles with anyone else in the previous month. Over one third shared with two or more people. A usable sample of saliva was obtained from 81 respondents, of whom 12 were HIV positive.

The results suggest that approximately one person in six attending the needle exchange clinic is HIV positive. However, the finding should be treated with some caution, as it is possible that attendees who knew they were HIV positive may have been less likely to participate in the study. The fact that individuals both HIV positive or negative reported recent unsafe behaviour in relation to needle and sexual practices is cause for consideration. However, despite its limitations, the study does provide a valuable snapshot of the level of HIV infection and risk behaviour among attendees, and it provides a baseline against which future studies can compare.