Huo Dezheng, Bailey Susan L, Hershow Ronald C, Ouellet Lawrence
Division of Epidemiology and Biostatistics, Community Outreach Intervention Projects, School of Public Health, University of Illinois at Chicago, IL 60637, USA.
AIDS Educ Prev. 2005 Apr;17(2):170-84. doi: 10.1521/aeap.17.3.170.62900.
This study examines HIV risk practices associated with secondary needle exchange, obtaining needles from a needle exchange program (NEP) through others who attend in person. We analyzed data from NEP logs, a survey and HIV testing from 901 drug injectors who (a) always visited NEPs themselves to get needles (primary-only NEP users), (b) obtained at least some NEP needles by having others exchange for them (mixed/secondary NEP users), and (c) obtained no needles from an NEP. About 22% of 40,000 NEP visits involved secondary exchanges, and these accounted for over half of all needles exchanged. In multiple logistic regression analyses, primary-only needle exchange was significantly associated with lower levels of receptive needle sharing, backloading, sharing other injection equipment and lending used needles, and positively associated with obtaining drug treatment. Mixed/secondary needle exchange was associated with less receptive needle sharing and a greater likelihood of drug treatment. Secondary exchange facilitated HIV risk reduction but the salutary effects of NEPs were attenuated in mixed/secondary exchangers.
本研究调查了与二级针头交换相关的艾滋病病毒（HIV）风险行为，即通过亲自参与针头交换项目（NEP）的其他人获取针头。我们分析了来自NEP日志、一项调查的数据以及901名药物注射者的HIV检测结果，这些注射者分为三类：（a）总是亲自前往NEP获取针头（仅为一级NEP使用者）；（b）至少有部分NEP针头是通过让他人代换而获得的（混合/二级NEP使用者）；（c）未从NEP获取针头。在40000次NEP访问中，约22%涉及二级交换，且这些交换占所有交换针头的一半以上。在多项逻辑回归分析中，仅一级针头交换与较低水平的接受性针头共用、回注、共享其他注射设备以及出借用过的针头显著相关，且与接受药物治疗呈正相关。混合/二级针头交换与较少的接受性针头共用以及更高的药物治疗可能性相关。二级交换有助于降低HIV风险，但NEP的有益效果在混合/二级交换者中有所减弱。
