Data about the characteristics, behaviours and prevalence of blood borne viruses in people who inject drugs in England, Wales and Northern Ireland

1. Injecting drug users in
England, Wales and Northern
Ireland in 2014
Source:
Public Health England, National Infection Service. Unlinked
Anonymous Monitoring Survey of People Who Inject Drugs: data
tables. July 2015. London, Public Health England

2. Characteristics of people who inject drugs
in England, Wales and Northern Ireland
18%
15%
14%
15%
13% 13%
11%
9% 9%
6% 6%
0%
2%
4%
6%
8%
10%
12%
14%
16%
18%
20%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Proportions under 25 years old

3. Severe and multiple disadvantage

4. Exchanging sex for drugs
“PWID [people who inject
drugs] who exchange sex for
money, goods or drugs may be
particularly vulnerable to harm.
Overall, 12% (95% CI, 11%-
13%) of participants reported
ever having exchanged sex for
money, goods or drugs in
2014.”
14%
13%
12% 12%
0%
2%
4%
6%
8%
10%
12%
14%
16%
2011 2012 2013 2014
Proportion of injecting drug users who
have ever exchanged sex for drugs,
money or goods

5. Direct and indirect sharing of needles and
syringes, by current injectors
28% 28%
23% 23%
19% 19%
21%
17%
14%
16% 17%
54%
50%
46% 45%
40%
36%
39%
35% 34%
39% 38%
0%
10%
20%
30%
40%
50%
60%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Direct sharing:
Sharing of
needles and
syringes
Direct and
indirect sharing:
Sharing of
needles and
syringes, mixing
containers, or
filters.

6. Proportion injecting into riskier sites and
symptoms of of an injection site infection
0%
5%
10%
15%
20%
25%
30%
35%
40%
2006 2007 2008 2009 2010 2011 2012 2013 2014
Groin Hands Legs Feet
35%
38%
34% 35% 35%
28% 29% 28%
31%
0%
5%
10%
15%
20%
25%
30%
35%
40%
2006 2007 2008 2009 2010 2011 2012 2013 2014
Self reports of a swelling containing pus
(abscess), sore, or open wound at an
injection site in preceding year.

7. Proportion injecting stimulants amongst
recent injecting drug users
35% 35% 35%
29% 29%
32%
36% 37%
40%
12% 12% 11%
7.7%
6.6%
8.5% 8.7%
6.9% 7.6%
16%
19% 18% 17% 18%
23% 22% 23% 24%
0%
5%
10%
15%
20%
25%
30%
35%
40%
45%
2006 2007 2008 2009 2010 2011 2012 2013 2014
Crack Cocaine Amphetamine

8. Behaviours amongst those who had
injected in the last four weeks55%
43%
65%
64%
35%
50%
35%
37%
6%
18%
3.60%
31%
34%
37%
36%
31%
42%
41%
44%
38%
39%
23%
15%
12%
18%
23%
15%
14%
13%
14%
22%
22%
17%
32%
31%
37%
55%
37%
38%
36%
32%
43%
41%
30%
LONDON EAST OF
ENGLAND
SOUTH EAST SOUTH WEST WEST
MIDLANDS
NORTH WEST YORKSHIRE
AND THE
HUMBER
EAST
MIDLANDS
NORTH EAST WALES NORTHERN
IRELAND
Injecting Crack Injecting groin Direct sharing Direct and indirect sharing

9. Engagement with treatment or harm
reduction services
88% 90% 91% 92% 91% 92% 91% 92% 91% 91% 89%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
Proportion that had ever used a
needle exchange

10. Anti-hepatitis C prevalence
45% 45% 44% 43% 43%
47% 47%
43%
47%
49% 49%
0%
10%
20%
30%
40%
50%
60%
70%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
60%
39%
58%
51%
36%
66%
52%
47%
29%
50%
23%
0%
10%
20%
30%
40%
50%
60%
70%
London East of
England
South
East
South
West
West
Midlands
North
West
Yorkshire
and the
Humber
East
Midlands
North
East
Wales Northern
Ireland

11. Anti-HIV prevalence
1.40%
1.60%
1.30%
1.10%
1.60%
1.50%
1.10%
1.20%
1.30%
1.10%
1.00%
0.00%
0.20%
0.40%
0.60%
0.80%
1.00%
1.20%
1.40%
1.60%
1.80%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
5 regions reported anti-HIV
prevalence in 2014.
0.25%
0.65%
1.10%
2.50%
4.70%
0.00%
0.50%
1.00%
1.50%
2.00%
2.50%
3.00%
3.50%
4.00%
4.50%
5.00%
Yorkshire
and the
Humber
Northern
Ireland
Wales East
Midlands
London

12. Anti-HBc prevalence
28%
26%
28%
20%
18%
17%
16% 16%
17%
16%
14%
0%
5%
10%
15%
20%
25%
30%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014
25%
13%
20%
12%
5%
27%
9%
12%
8%
11%
7%
0%
5%
10%
15%
20%
25%
30%
London East of
England
South
East
South
West
West
Midlands
North
West
Yorkshire
and the
Humber
East
Midlands
North
East
Wales Northern
Ireland

13. Public Health England’s lessons to learn
These findings indicate that unsafe injecting continues to be a problem and that there is a
need to maintain and strengthen public health interventions that aim to reduce injection
related risk behaviours.
The impact of public health interventions which aim to prevent HIV and hepatitis C infection
through injecting drug use, such as needle and syringe programmes and opiate substitution
therapy, has been shown to be dependent on their coverage.
In addition to these interventions, increasing the treatment of hepatitis C infection in PWID
should also reduce the transmission of hepatitis C among people who inject drugs.
The provision of interventions that aim to reduce infections among people who inject drugs
should be regularly reviewed to ensure that the coverage of these is appropriate to local
need.