Golub Elizabeth T, Bareta Joseph C, Mehta Shruti H, McCall Lisa D, Vlahov David, Strathdee Steffanie A
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
Subst Use Misuse. 2005;40(12):1751-64. doi: 10.1080/10826080500259513.
Because multi-person syringe use is the most common vehicle for HIV and hepatitis C virus transmission among injection drug users (IDUs), safe sources of sterile syringes and safe methods of disposal are necessary to curb these epidemics. We examined syringe acquisition and disposal in a cohort of IDUs in Baltimore. Between January 1, 1998 and December 31, 2001, 1034 participants reported on syringe acquisition at 3492 visits, and 953 reported on disposal at 2569 visits. Participants were 69.9% male, 93.9% African-American, and median age was 44. Syringes were acquired exclusively from unsafe sources at 32.3% of visits, while exclusively unsafe disposal was reported at 59.3% of visits. Significant correlates of unsafe acquisition were: attending shooting galleries, anonymous sex, sharing needles, smoking crack, and emergency room visits. Significant correlates of unsafe disposal were: injecting speedball, no methadone treatment, acquiring safely, and frequent injection. Having a primary source of medical care was associated with safe acquisition, but unsafe disposal. IDUs continue to acquire safely but dispose unsafely, especially among those with a primary source of care; this suggests that messages about safe disposal are not being disseminated as widely as those about acquisition. These data suggest the need for a more active program involving pharmacists, an expanded syringe access program, and better efforts to enhance safe disposal.
由于多人共用注射器是注射吸毒者中艾滋病毒和丙型肝炎病毒传播的最常见途径，因此，必须有安全的无菌注射器来源和安全的处理方法来遏制这些流行病。我们调查了巴尔的摩一组注射吸毒者的注射器获取和处理情况。在1998年1月1日至2001年12月31日期间，1034名参与者在3492次就诊时报告了注射器的获取情况，953名参与者在2569次就诊时报告了注射器的处理情况。参与者中男性占69.9%，非裔美国人占93.9%，年龄中位数为44岁。在32.3%的就诊中，注射器完全从不安全来源获取，而在59.3%的就诊中报告了完全不安全的处理方式。不安全获取的显著相关因素包括：光顾射击馆、匿名性行为、共用针头、吸食快克可卡因和急诊室就诊。不安全处理的显著相关因素包括：注射速球、未接受美沙酮治疗、安全获取和频繁注射。有主要医疗保健来源与安全获取相关，但与不安全处理相关。注射吸毒者继续安全获取但不安全处理注射器，特别是在那些有主要医疗保健来源的人群中；这表明关于安全处理的信息没有像关于获取的信息那样广泛传播。这些数据表明需要一个更积极的项目，包括药剂师参与、扩大注射器获取项目以及更好地努力加强安全处理。
