The injection of a formerly legal high known as ‘snow blow’ is linked to an upsurge in HIV infections among chaotic drug users in Dublin, research shows.
There have been 38 cases of confirmed and probable HIV infections among people who inject drugs (PWID) in Dublin over the last two years.
The HSE’s Department of Public Health identified an “unexpected increase” in cases of acute HIV infection in February 2015 and set up a multi-disciplinary group to engage with this cohort of drug users.
At the time, drug treatment clinicians also identified that a new psychoactive substance (a-PVP), known as snow blow, was being used by chaotic injectors, who were mainly homeless.
Experts in six health agencies in Dublin, and two bodies abroad, conducted research as to the reasons for the increase.
The research found that HIV cases among PWID rose from 17 in 2014 (15 confirmed and two probable) to 21 during 2015 (17 confirmed and four probable).
A sudden rise in cases began in September 2014 and continued to February 2015, before rising again during the summer months.
The study, made available by the Health Research Board, found that 16 of the 38 people were female, with ages ranging from 24 to 51.
Since January 2014, 29 of the 38 had been registered as homeless and seven had not registered. All the females, and 13 of the 20 males with information available, were homeless.
Of the 20 PWID where there was information, 18 (90%) reported injecting snow blow. At-risk practices, namely sex with PWID or with a HIV-positive partner, was reported in 20 of the 38 cases.
The authors recruited 15 cases and conducted detailed research on them and compared them to a control group. As well as being more likely to inject snow blow, the case group also injected methamphetamine more and were also more likely to reuse needles or syringes.
Researchers said: “This investigation among homeless chaotic PWID in Dublin is the first evidence of an association between injecting snow blow and recent HIV infection, with daily snow blow injectors being at highest risk.”
The report said the findings were consistent with the known stimulant effects of synthetic cathinones suchas a-PVP.
“Drug treatment clinicians raised concerns that clients who injected snow blow generally exhibited more chaotic behaviours, leading to disinhibition, more sharing of needles and syringes, and unprotected sex,” it said.
The study said that between 2005 and 2014, more than 81 synthetic cathinone derivatives had been reported to the EU Early Warning System, operated by the European Monitoring Centre for Drugs and Drug Addiction.
They said Dublin had more than 500 homeless PWID and that a “significant proportion” were at risk of HIV infection.
“The general situation regarding homelessness in Dublin has also deteriorated significantly over 2014 and 2015, with a 28% increase in the number of individuals accessing emergency accommodation in Dublin in the 12 months to June 2015,” the report said.
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