Abstract
Introduction
High-risk injecting practices, such as injecting into the neck, groin and receiving peer-assisted injecting, have been linked with severe health outcomes. This study describes the prevalence, compares characteristics, and explores factors associated with high-risk injecting practices among a sample of people who inject drugs (PWID).
Methods
This cross-sectional study included 547 individuals who reported injecting illicit drugs during the past four weeks. Participants were recruited from low-threshold facilities and street outreach across 14 Norwegian cities. Multinomial logistic regression analyses examined factors associated with high-risk injecting practices. Relative risk ratio (RRR) and 95% confidence intervals (CI) were reported.
Results
Overall, 59.6% of the participants reported high-risk injecting practices. Groin and/or neck injecting (RRR = 1.85, 95% CI: 1.07–3.18), as well as groin and/or neck injecting combined with receiving assistance (RRR = 2.28, 95% CI: 1.32–3.94), were more likely among female participants. Injecting alone (RRR = 2.13, 95% CI: 1.05–4.31) and co-injecting of benzodiazepines and opioids (RRR = 2.47, 95% CI: 1.35–4.54) were associated with groin and/or neck injecting. Reporting an abscess in the past four weeks (RRR = 2.47, 95% CI: 1.40–4.34) was associated with receiving injecting assistance. Participants reporting a recent history of sepsis were more likely to have injected in the groin and/or neck (RRR = 2.10, 95% CI: 1.04–4.27).
Conclusions
High-risk injecting practices were prevalent in this sample of PWID, with female gender, co-injecting of benzodiazepines and opioids, injecting alone, and a recent history of abscess and sepsis, associated with these practices.
Citation
Helene Storbråten Hagene, Thomas Clausen, Linn Gjersing, High-risk injecting practices among people who inject drugs in Norway: Prevalence, characteristics and associated factors, Journal of Substance Use and Addiction Treatment, Volume 189, 2026, https://doi.org/10.1016/j.josat.2026.209999.