Amundsen Ellen J, Eskild Anne, Stigum Hein, Smith Else, Aalen Odd O
Norwegian Institute for Alcohol and Drug Research, Oslo, Norway.
Eur J Public Health. 2003 Sep;13(3):252-8. doi: 10.1093/eurpub/13.3.252.
Countries have adopted different strategies to prevent the transmission of HIV among intravenous drug users. Legal access to needles and syringes/needle exchange programmes as part of such a strategy has been heavily debated. HIV counselling and testing has also been part of prevention strategies. The objective of this study was to discuss the effectiveness of legal access to needles and syringes/ needle exchange programmes versus HIV counselling and testing among intravenous drug users (IDUs) as part of HIV prevention strategies.
Differences in HIV prevention strategies in Denmark, Norway and Sweden among IDUs are described. Outcome variables of effectiveness were HIV incidence rates over time. These were estimated by back calculation methods from 1980 through 1996, using data from the national HIV and AIDS registers.
A comparison of HIV prevention strategies in Denmark, Norway and Sweden suggests that a high level of HIV counselling and testing might be more effective than legal access to needles and syringes/needle exchange programmes. Sweden and Norway, with higher levels of HIV counselling and testing, have had significantly lower incidence rates of HIV among IDUs than Denmark where there was legal access to needles and syringes and a lower level of HIV counselling and testing. In Sweden there was no legal access to drug injection equipment.
Promotion and accessibility of HIV counselling and testing among intravenous drug users should be considered in countries where such a strategy is not adopted or has low priority.
各国已采取不同策略来预防艾滋病毒在静脉吸毒者中的传播。作为该策略一部分的合法获取针头和注射器/针头交换计划一直备受争议。艾滋病毒咨询和检测也是预防策略的一部分。本研究的目的是讨论合法获取针头和注射器/针头交换计划与静脉吸毒者（IDU）中的艾滋病毒咨询和检测作为艾滋病毒预防策略一部分的有效性。
描述了丹麦、挪威和瑞典针对静脉吸毒者的艾滋病毒预防策略的差异。有效性的结果变量是随时间推移的艾滋病毒发病率。这些是通过回溯计算方法，利用国家艾滋病毒和艾滋病登记处的数据，从1980年到1996年进行估计的。
丹麦、挪威和瑞典艾滋病毒预防策略的比较表明，高水平的艾滋病毒咨询和检测可能比合法获取针头和注射器/针头交换计划更有效。艾滋病毒咨询和检测水平较高的瑞典和挪威，静脉吸毒者中的艾滋病毒发病率明显低于丹麦，丹麦合法获取针头和注射器且艾滋病毒咨询和检测水平较低。在瑞典，无法合法获取毒品注射设备。
在未采用此类策略或该策略优先级较低的国家，应考虑在静脉吸毒者中推广艾滋病毒咨询和检测并提高其可及性。
