HIV and other blood borne viruses,

While the public health benefits of supervised injection facilities (SIFs) have been well documented, there is lack of research examining the views of people who inject drugs regarding the operation of these facilities. This study used 50 semistructured qualitative interviews to explore the perspectives of people who inject drugs on the design and operation of a supervised injection facility in Vancouver, Canada. Although the environment and operation of the supervised injection facility are well accepted, long wait times and limited operating hours, as well as regulations that prohibit sharing drugs and assisted injections, pose barriers to using the supervised injection facility. Modifying operating procedures and expanding the capacity of the current facility could address these barriers.

Editors’ note: The first officially sanctioned supervised injecting facility (SIF) opened in Switzerland in 1986. Until 2000, only Germany and the Netherlands had joined Switzerland in offering such services in major cities but, since 2000, SIFs have begun operating in Spain, Australia, Canada, Norway, and Luxembourg. They vary in hours, staffing, operating models, etc. but all include professional supervision of hygienic consumption of pre-obtained drugs with the goals of preventing overdose, reducing injecting-related transmission of HIV and other blood borne viruses, and providing an entry point to psychosocial and medical services. Unlike a study conducted in Montreal a decade ago to determine whether people who inject drugs would use a supervised injecting facility if it were to be created (Green et al 13^th IHRA conference Slovenia March 2002), this qualitative study gathered views on current functioning of the well-known Vancouver SIF ‘Insite’. Two major concerns voiced were the prohibition on sharing drugs, a prohibition that holds in most SIFs as it is deemed to constitute a form of trafficking, and a prohibition on assisted injecting. Individuals who require assistance to inject are by definition dependent on another person for their safe injection. Some SIFs acknowledge this vulnerability and are able to accommodate such individuals and their injectors. In other countries, some modification to the legal framework may be required to allow these individuals to benefit from this harm reduction service.