Lorvick Jennifer, Bluthenthal Ricky N, Scott Andrea, Gilbert Mary Lou, Riehman Kara S, Anderson Rachel L, Flynn Neil M, Kral Alex H
Urban Health Program, RTI International, San Francisco, CA, USA.
Subst Use Misuse. 2006;41(6-7):865-82. doi: 10.1080/10826080600669041.
This article describes the secondary syringe exchange (SSE) practices of injection drug users (IDUs) attending 23 syringe exchange programs (SEPs) in the state of California during 2002 (n=539). The sample was primarily heroin injecting, about two thirds male, half White and half other racial/ethnic groups. Participants were interviewed with a structured questionnaire that included items on sociodemographic factors, drug use practices, sexual practices, use of SEP and other social services, and satisfaction with SEP services. Interviews lasted about 30 minutes. SSE was highly prevalent: 75% of IDUs reported participating in SSE in the 6 months before interview. Program characteristics, such as legal status, SSE policy, and exchange policy, did not affect the prevalence of SSE among SEP clients. Infectious disease risk behaviors were significantly more common among SSE participants than nonparticipants. SSE participants were more likely to share syringes (p<.001) and cookers (p<.001) in the previous 6 months. SSE was significantly associated with being stuck with another person's syringe (needle-stick), a little-discussed "occupational hazard" of this practice. In multivariate analysis, the adjusted odds ratio of needle-stick among SSE participants was 2.8 (95% confidence interval, 1.3, 6.0). The high prevalence of SSE and the infectious disease risk associated with it warrant additional research to determine the causality of these associations. In the interim, SEPs should consider reinforcing HIV prevention education messages and training IDUs who engage in SSE in safe handling of biohazardous materials.
本文描述了2002年期间，加利福尼亚州23个注射器交换项目（SEP）中注射吸毒者（IDU）的二次注射器交换（SSE）行为（n = 539）。样本主要为注射海洛因者，约三分之二为男性，一半是白人，另一半是其他种族/族裔群体。通过结构化问卷对参与者进行访谈，问卷内容包括社会人口学因素、吸毒行为、性行为、SEP及其他社会服务的使用情况，以及对SEP服务的满意度。访谈持续约30分钟。SSE非常普遍：75%的IDU报告在访谈前6个月参与过SSE。项目特征，如法律地位、SSE政策和交换政策，并未影响SEP客户中SSE的流行率。SSE参与者中传染病风险行为比未参与者显著更常见。SSE参与者在过去6个月中更有可能共用注射器（p <.001）和烹饪器具（p <.001）。SSE与被他人注射器刺伤（针刺）显著相关，这是这种行为中较少讨论的“职业危害”。在多变量分析中，SSE参与者针刺的调整优势比为2.8（95%置信区间，1.3，6.0）。SSE的高流行率及其相关的传染病风险值得进一步研究以确定这些关联的因果关系。在此期间，SEP应考虑加强HIV预防教育信息，并培训参与SSE的IDU安全处理生物危害材料。
