Sources of clean injecting equipment referred to by IDUs who participated in this study included the following:

  • primary NSP outlets
  • secondary outlets such as those operating at community health services or hospitals
  • mobile or outreach NSP services
  • community pharmacies
  • vending or dispensing machines
  • friends, fellow-injectors and/or drug dealers.
There were frequent references, in particular, to obtaining needles and syringes from friends or peers – consistent with the proposition that some Indigenous IDUs are reluctant themselves to visit NSP outlets and prefer to rely on others to collect equipment on their behalf26. As previously noted, this was thought to be especially true of young injectors. In Carnarvon and some other locations it was noted that the person who was asked to obtain equipment from the NSP might not personally be an IDU. Outreach or mobile NSP services are of course designed to overcome some of the access barriers experienced by particularly marginalised groups (eg homeless people) or those who are reluctant to visit fixed services, and several stakeholders saw these as an important mechanism for reaching Indigenous IDUs in particular.

At a CNP (Clean Needle Program) outlet in Adelaide it was reported that Aboriginal women often pick up equipment for male partners. In Dubbo there was again reference to couples injecting, with either the male or the female partner accessing an NSP service on behalf of both. People consulted in Dubbo suggested that the female partners of male IDUs tended themselves to take up injecting in the context of developing or maintaining the relationship.

Consultations indicated that, reasonably enough, Indigenous IDUs generally prefer outlets where injecting equipment is free, and where they can expect to be treated in a courteous and nonjudgemental fashion (which in very broad terms may point to primary rather than secondary outlets).

In several locations, including Cairns and Perth for example, workers expressed the view that Indigenous clients who do use NSP services tend to visit more often and to take smaller amounts of equipment for personal use.

Footnotes

26 In Western Sydney the comment was made that a similar pattern applies to buying drugs: one person will go to the dealer 'to get on' on behalf of a group of acquaintances.

The fact of intermediaries accessing needle and syringe services on behalf of others is recognised in the international literature, and in the USA has been described as 'secondary syringe exchange': see, for example, Snead J, Downing M, Lorvick J, Garcia B, Thawley R, Kegeles S and Edlin B, 'Secondary Syringe exchange among injection drug users', Journal of Urban Health 80:2, June 2003.