Hantman J A
Urban Health Initiative, New York Academy of Medicine, NY 10029, USA.
Bull N Y Acad Med. 1995 Winter;72(2):397-412.
Researchers studying needle-exchange programs in the United States pursue a two-fold agenda that requires answers to these questions: (1) Do such programs successfully reduce HIV seroprevalence among injecting drug users? (2) Do they promote drug use? Several federal laws and regulations require convincing data on each question before the release of federal funds for needle exchange. Fears that needle exchange promotes drug use are at the core of federal concerns, and these fears are shared by community leaders, scientists, and public health professionals. Nonetheless, the manner in which the "drug use" question has been framed and addressed in scientific research has been given insufficient attention. This article aims to stimulate debate about current research, and restore a focus on HIV prevention, by addressing several methodological, logical, and ethical weaknesses that characterize the scientific inquiry into whether needle exchange promotes drug use.
在美国，研究针头交换项目的研究人员有双重议程，这需要回答以下问题：（1）此类项目是否能成功降低注射吸毒者中的艾滋病毒血清阳性率？（2）它们是否会助长吸毒行为？在联邦政府为针头交换项目发放资金之前，多项联邦法律法规要求就每个问题提供有说服力的数据。担心针头交换会助长吸毒行为是联邦政府关注的核心，社区领袖、科学家和公共卫生专业人员也有同样的担忧。然而，科学研究中对“吸毒行为”问题的界定和处理方式却未得到足够的重视。本文旨在通过解决科学探究针头交换是否助长吸毒行为时所具有的一些方法、逻辑和伦理弱点，来激发关于当前研究的辩论，并重新将重点放在艾滋病毒预防上。
