Wood Evan, Tyndall Mark W, Li Kathy, Lloyd-Smith Elisa, Small Will, Montaner Julio S G, Kerr Thomas
British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Am J Prev Med. 2005 Aug;29(2):126-30. doi: 10.1016/j.amepre.2005.04.011.
In Western Europe and elsewhere, medically supervised safer injection facilities (SIFs) are increasingly being implemented for the prevention of health- and community-related harms among injection drug users (IDUs), although few evaluations have been conducted, and there have been questions regarding SIFs' ability to attract high-risk IDUs. We examined whether North America's first SIF was attracting IDUs who were at greatest risk of overdose and blood-borne disease infection.
We examined data from a community-recruited cohort study of IDUs. The prevalence of SIF use was determined based on questionnaire data obtained after the SIF's opening, and we determined predictors of initiating future SIF use based on behavioral information obtained from questionnaire data obtained before the SIF's opening. Pearson's chi-square test was used to compare characteristics of IDUs who did and did not subsequently initiate SIF use.
Overall, 400 active injection drug users returned for follow-up between December 1, 2003 and May 1, 2004, among whom 178 (45%) reported ever using the SIF. When we examined behavioral data collected before the SIF's opening, those who initiated SIF use were more likely to be aged <30 years (odds ratio [OR]=1.6, 95% confidence interval [CI]=1.0-2.7], p=0.04); public injection drug users (OR=2.6, 95% CI=1.7-3.9, p<0.001); homeless or residing in unstable housing (OR=1.7, 95% CI=1.2-2.7, p=0.008); daily heroin users (OR=2.1, 95% CI=1.3-3.2, p=0.001); daily cocaine users (OR=1.6, 95% CI=1.1-2.5, p=0.025); and those who had recently had a nonfatal overdose (OR=2.7, 95% CI=1.2-6.1, p=0.016).
This study indicated that the SIF attracted IDUs who have been shown to be at elevated risk of blood-borne disease infection and overdose, and IDUs who were contributing to the public drug use problem and unsafe syringe disposal problems stemming from public injection drug use.
在西欧及其他地区，为预防注射吸毒者（IDU）中与健康和社区相关的危害，越来越多地实施了有医学监督的安全注射设施（SIF），尽管进行的评估很少，且有人对SIF吸引高风险IDU的能力提出了质疑。我们研究了北美首个SIF是否吸引了过量用药和血源性病原体感染风险最高的IDU。
我们研究了一项针对IDU的社区招募队列研究的数据。根据SIF开放后获得的问卷数据确定SIF的使用 prevalence，并根据SIF开放前获得的问卷数据中的行为信息确定未来开始使用SIF的预测因素。使用Pearson卡方检验比较随后开始使用和未开始使用SIF的IDU的特征。
总体而言，2003年12月1日至2004年5月1日期间，400名活跃的注射吸毒者返回接受随访，其中178人（45%）报告曾使用过SIF。当我们检查SIF开放前收集的行为数据时，开始使用SIF的人更有可能年龄小于30岁（优势比[OR]=1.6，95%置信区间[CI]=1.0 - 2.7]，p = 0.04）；公共场合注射吸毒者（OR = 2.6，95% CI = 1.7 - 3.9，p < 0.001）；无家可归或居住在不稳定住房中的人（OR = 1.7，95% CI = 1.2 - 2.7，p = 0.008）；每日使用海洛因者（OR = 2.1，95% CI = 1.3 - 3.2，p = 0.001）；每日使用可卡因者（OR = 1.6，95% CI = 1.1 - 2.5，p = 0.025）；以及最近有过非致命过量用药的人（OR = 2.7，95% CI = 1.2 - 6.1，p = 0.016）。
本研究表明，SIF吸引了已被证明血源性病原体感染和过量用药风险较高的IDU，以及那些导致公共吸毒问题和因公共场合注射吸毒而产生的不安全注射器处理问题的IDU。
