Sharing “Cookers” Heightens HIV Transmission Risk—But There’s An Easy Way To Fix That

April 30, 2019

Sharing injection drug preparation equipment, like “cookers,” increases people’s risks of transmitting HIV, according to a study released online in the Journal of Acquired Immune Deficiency Syndrome on April 19. But another study published alongside these findings suggests a simple way to greatly mitigate those risks: Heat the “wash,” or drug mixture, in your metal cooker to a boil for 10 seconds.

The twin studies, conducted by Western University and Lawson Health Research Institute, came in response to an HIV outbreak amongst people who inject drugs (PWID) in London, Canada. This occurred even though harm reduction service providers, like Counterpoint Needle and Syringe Program, were widespread. In fact, London has Canada’s largest per capita sterile needle and syringe distribution program.

The discrepancy between abundant resources and continued negative health outcomes posed a question for study author Dr. Michael Silverman, a Lawson associate scientist and chair/chief of Infectious Diseases at the Schulich School of Medicine and Dentistry. “We knew there must be a novel method of HIV transmission at play,” said Silverman.

Indeed, the results of more than a hundred interviews with PWID found a startling trend. Without sharing needles, PWID who shared cookers were 22 times more likely to contract HIV than those who did not. Dr. Sharon Koivu, associate scientist at Lawson and associate professor at Schulich Medicine and Dentistry, noted this may have driven London’s HIV outbreak. “While people know not to share needles, some use their own needle multiple times, allowing for contamination of the equipment,” she said.

To close this gap in harm reduction knowledge, the scientists partnered with Middlesex-London Health Unit and Regional HIV/AIDS Connection to launch the “Cook Your Wash” campaign, which Koivu characterized as the product of a collaborative relationship between researchers and people who use drugs. “We learned from persons who inject drugs, took that information to the lab to develop a solution and then brought that solution back to the community in record time.”

The simple message evidenced by their studies and amplified by the campaign—that the heat from a cigarette lighter can be the difference in preventing an HIV transmission—is part of a broader medical and political goal of ending HIV infections.

“We hope our findings can be used to reduce the incidence of HIV transmissions even further,” said Silverman, “and that, one day, society will be HIV-free.”

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