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'Your DVT is in the post': femoral injecting, DVT's and needle size
Allison Downing, Specialist Harm Reduction Worker, Project 6, Keighley

Abstract
From our unique assessments and reviews of our IDUs we began tracking the incidence of DVT amongst our groin injecting population. We attempted to isolate the different factors which could have contributed towards the development of thromboses, and specifically looked at needle size.

Every 6 months, each IDU is asked what size needle they use, how many attempted injections they make each day, the drug or drugs injected and if they have had a DVT diagnosed in the last 6 months. The condition of the injecting site is also described and recorded.

We found that those who use green needles experienced problems the soonest, those using blue needles are next soonest, and orange needles are the slowest to lead to deep vein thrombosis. The shortest time scale from beginning femoral injection to a diagnosis of DVT was just 7 months. Conversely, some injectors have been injecting in their femoral vein for over 4 years with no diagnosis or suspicion of DVT.

We have developed a visual scale of risk so that IDUs are able to identify themselves on this scale and plan their own harm reduction responses. We are able to target discreet interventions towards users of different needle sizes and encourage them to adopt the next size down on the scale. Working within this framework, we have seen:

• An overall decline in femoral injecting, from 35% to 26%
• An increase in femoral injectors choosing Orange needles, from 45% to 64%
• A reduction in reported DVTs

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Biography
Allison Downing's interest in Blood Borne Viruses began in 1990 when she joined Bradford's Youth Forum on HIV & Aids at 16 years old. The following year, she spoke at The National AIDS Trust's 'Living For Tomorrow' event, urging education ministers to critically evaluate sex education in Britain. After graduating, Allison went on to work for Leeds Housing Concern in the UK's first wet hostel for women drinkers as a Housing Support Worker. She helped develop the service from its opening for 6 years, before joining the team at Project 6 in 2002. Initially employed as a structured treatment worker, she eventually moved to the Harm Reduction service. Allison is proud of her development of both the service and her role as Specialist Harm Reduction worker, and enjoys strong, trusting relationships with her service users.  

Allison has also been podcasting with Simply Syndicated (the largest independent podcast network in the UK) since 2004. She presents three weekly shows and is a guest on others across the network. She takes an active role in production and editing. She maintains and moderates the online community of listeners that has sprung up around the network and takes an active part in the forum. Allison co-presents 'Hooked - A drug talk podcast' with Nigel Brunsdon.