Files and links (1)
Published, Version of Record (VoR)Open Access via Drexel Libraries Read and Publish Program 2025CC BY-NC V4.0, Open
Journal article
A quantitative bias analysis of the association between supervised consumption service use and sharing of injection equipment among people who inject drugs in Toronto, Canada
Annals of epidemiology, v 106, pp 11-16
19 Apr 2025
PMID: 40233868
Featured in Collection : Research Supported by Drexel Libraries' OA Programs
Abstract
Supervised consumption services (SCS) prevent fatal overdoses, but less is known about their contemporary impact on infectious disease risk.
We used quantitative bias analyses (QBA) to evaluate the association between SCS use and sharing of injection equipment while accounting for measurement error, selection bias, and unmeasured confounding, drawing on a cross-sectional sample of 695 people who inject drugs in Toronto, Canada surveyed from 2018-2020. We estimated the association between self-reported SCS use and equipment sharing using modified Poisson regression. Sensitivity analyses varied SCS use categories and definitions of sharing. QBA estimated the impact of misclassification, selection bias, and unmeasured confounding.
Almost all participants (96.6%) had recently used a needle and syringe program. Frequent SCS use (≥26% of injections) was not associated with sharing equipment (adjusted prevalence ratio (aPR): 0.98; 95% CI: 0.77-1.24). Results of sensitivity analyses did not meaningfully differ. In multiple bias analysis, the median bias-adjusted PR of 1.04 (range: 0.83-1.42) suggested no association between regular SCS use (≥75% of injections) and syringe sharing.
In summary, SCS use was not associated with equipment sharing in a context of high needle and syringe program coverage. Misclassification, selection bias, and unmeasured confounding did not appear to impact the observed associations.
Metrics
4 Record Views
Details
- Title
- A quantitative bias analysis of the association between supervised consumption service use and sharing of injection equipment among people who inject drugs in Toronto, Canada
- Creators
- Tanner Nassau - Philadelphia Department of Public HealthZachary Bouck - University of TorontoSeth Welles - Drexel UniversityAlison Evans - Drexel UniversityShaun Hopkins - Toronto Public HealthPaula Tookey - Regent Park Community Health CentreDan Werb - St. Michael's HospitalAyden Scheim (Corresponding Author) - Drexel University
- Publication Details
- Annals of epidemiology, v 106, pp 11-16
- Publisher
- Elsevier
- Number of pages
- 6
- Grant note
- Canadian Institutes of Health Research: PJT-153152 St. Michael's Hospital Foundation
We acknowledge that the land on which we are conducting our research is the traditional territory of many Nations including the Mississaugas of the Credit, Anishnabeg, Chippewa, Haudenosaunee, and Wendat peoples, now also home to many diverse First Nations, Inuit, and Me tis peoples. We also acknowledge the members of the Centre on Drug Policy Evaluation's community steering committee. This research was funded by the Canadian Institutes of Health Research (PJT-153152) . Dan Werb is supported in part by the St. Michael's Hospital Foundation.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001476463900001
- Scopus ID
- 2-s2.0-105002832856
- Other Identifier
- 991022048295804721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health