Wodak Alex, Cooney Annie
Alcohol and Drug Service, St. Vincent's Hospital, Sydney, Australia.
Subst Use Misuse. 2006;41(6-7):777-813. doi: 10.1080/10826080600669579.
This first international review of the evidence that needle syringe programs reduce HIV infection among injecting drug users found that conservative interpretation of the published data fulfills six of the nine Bradford Hill criteria (strength of association, replication of findings, temporal sequence, biological plausibility, coherence of evidence, and reasoning by analogy) and all six additional criteria (cost-effectiveness, absence of negative consequences, feasibility of implementation, expansion and coverage, unanticipated benefits, and application to special populations). The Bradford Hill criteria are often used to evaluate public health interventions. The principal finding of this review was that there is compelling evidence of effectiveness, safety, and cost-effectiveness, consistent with seven previous reviews conducted by or on behalf of U.S. government agencies. Authorities in countries affected or threatened by HIV infection among injecting drug users should carefully consider this convincing evidence now available for needle syringe programs with a view to establishing or expanding needle syringe programs to scale.
首次对针头注射器项目能减少注射吸毒者中艾滋病毒感染的证据进行的国际审查发现，对已发表数据的保守解读符合九项布拉德福德·希尔标准中的六项（关联强度、研究结果的重复性、时间顺序、生物学合理性、证据的连贯性以及类推推理）以及所有六项额外标准（成本效益、无负面后果、实施的可行性、推广和覆盖范围、意外益处以及对特殊人群的适用性）。布拉德福德·希尔标准常被用于评估公共卫生干预措施。本次审查的主要发现是，有令人信服的证据表明该项目有效、安全且具有成本效益，这与美国政府机构或代表美国政府机构进行的七次先前审查结果一致。受注射吸毒者中艾滋病毒感染影响或面临威胁的国家的当局现在应仔细考虑目前可获得的关于针头注射器项目的这一令人信服的证据，以期建立或扩大针头注射器项目至规模化。
