Low dead space injecting equipment has less space between the needle and the plunger after injecting. Blood and drug remain in this space, so if needles are shared the risk of spreading blood borne viruses such as HIV and Hepatitis C is lower when there’s less space for blood to be left in the equipment. The traditional injecting equipment with detachable needles supplied by needle and syringe programmes has a higher volume of dead space.
Earlier research by NIHR CLAHRC West and NIHR Health Protection Research Unit (HPRU) in Evaluation of Interventions at the University of Bristol found that people who inject drugs would be willing to switch to this safer equipment, if the benefits were explained and they were introduced gradually.
Explanation taken from the materials of where dead space is found in injecting equipment
Dead space compared, taken from the materials
This project aimed to increase the adoption of this new, safer equipment in needle and syringe programmes, their commissioners and service users.
What we did
We developed posters, a booklet and animation to promote the benefits and use of low dead space equipment, and broader harm reduction messages, for people who inject drugs, the needle and syringe programmes that support them, and policymakers.
Funded by the Economic and Social Research Council (ESRC), Deborah Hussey, Assertive Engagement Worker from Bristol Drugs Project, joined the CLAHRC West team as Knowledge Mobilisation Fellow for the project. Deborah visited needle and syringe programmes around the UK, from Glasgow to London, to understand barriers to the uptake of low dead space equipment, and how different programmes operate and share harm reduction messages. The team’s academic lead was Jo Kesten and communications expertise was brought by Zoe Trinder-Widdess.
Deborah and the rest of the team then worked with Michael Linnell of Linnell Communications, a designer who specialises in information product design for drugs, alcohol and public health campaigns.
Through a series of workshops, the materials were co-designed by service users from Bristol Drugs Project, who shaped the messages, language and look and feel of the materials. Working closely with the intended audiences means the materials have been tailored to their needs and preferences, so will have a greater impact and resonance with them.
The project was overseen by a steering group that included Bristol Drugs Project, Exchange Supplies, Public Health England, the Bristol Health Partners Drug and Alcohol Health Integration Team (HIT), CLAHRC West and HPRU.
The final products are now available to download from Exchange Supplies’ website. Exchange Supplies is a social enterprise that has pioneered the use of detachable low dead space equipment among people who inject drugs.
How we involved people
Deborah visited needle and syringe programmes around the UK, from Glasgow to Wales, to understand barriers to the uptake of low dead space equipment, and how different programmes operate and share harm reduction messages. This information was used to develop the content of the materials. Deborah also invited a group of five service users from Bristol Drugs Project to co-design the materials through workshops. They were a diverse group in terms of age, level of experience in injecting drugs and equipment preferences.
We are sharing the materials widely with service users, needle and syringe programmes, commissioners and public health stakeholders.
The materials were also on public display in the gallery space at the Station on Silver Street from 8-31 January 2019. A special launch event, with the opportunity to hear from the people involved in the project, was held on 24 January at the Kitchen café in the same building. Speakers included some of the service users involved in the project and Deborah Hussey, Michael Linnell, Andrew Preston from Exchange Supplies.
We will monitor downloads and sharing of the materials and changes in the equipment provided by needle and syringe programmes. We will assess any changes to risk behaviours, such as equipment sharing and cleaning, through routinely collected data.
We are working with Exchange Supplies to develop training for staff and volunteers working in needle and syringe programmes.
Watch the animation
Links and downloads
- The materials are available from Exchange Supplies' website Download the materials
- The videos are available to view on CLAHRC West's YouTube channel Watch the videos
- The animations are available for download from the designer Michael Linnell's website Download the animations
- Read the article on the international Talking Drugs website UK Drug Service Users Design Promo Material to Reduce Infection Spread
- Low dead space equipment - new materials promote the benefit Read the blog on the SMMGP website
- Improving safety for people who inject drugs NIHR Making a Difference case study on this project
- Co-design of harm reduction materials for people who inject drugs to implement research findings Read the paper on the co-design process published in Harm Reduction Journal
- Deborah Hussey, Bristol Drugs Project