Latkin Carl A, Davey Melissa A, Hua Wei
Faculty of Social and Behavioral Sciences, Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD 21205, USA.
Subst Use Misuse. 2006;41(6-7):901-13. doi: 10.1080/10826080600668720.
Although much of the debate surrounding the distribution of sterile syringes to injection drug users (IDUs) has focused on needle exchange programs (NEPs), IDUs acquire their syringes from three major sources: NEPs, pharmacies, and secondary exchangers or needle sellers. The purpose of the present study is to examine types and frequencies of social interactions among drug injectors who sell needles, most of which come from NEPs, compared with individuals who do not sell needles. Specifically, we compared engagement in drug-related behaviors, roles in the drug economy, and social network membership. Data were collected as part of the SHIELD study, an HIV prevention intervention targeted at drug users and their social networks (n=910) from February 2001 through September 2003 in Baltimore, Maryland (USA). In this sample, 56 participants reported selling needles. Needle sellers had higher levels of engagement in drug-related social interactions, including using drugs with others, giving or receiving drugs from others, and buying drugs with other users. Participants who sold needles had a significantly higher number of roles in the drug economy. Also, they had more social network members who were injectors, with whom they talked about risky drug behaviors, gave needles to, and shared cookers and bleach with. Compared with nonselling injectors, needle sellers engage in HIV risk-related behaviors, such as injecting daily and sharing injection equipment, more frequently. The study's findings may be useful to determine whether secondary exchangers should be targeted for HIV prevention activities both to reduce their own risk and to diffuse risk reduction information throughout the drug using community.
尽管围绕向注射吸毒者（IDU）分发无菌注射器的诸多争论都聚焦于针头交换项目（NEP），但注射吸毒者获取注射器主要有三个来源：针头交换项目、药店以及二手交换者或针头售卖者。本研究的目的是，与不出售针头的个体相比，调查出售针头的吸毒者之间社交互动的类型和频率，其中出售的针头大多来自针头交换项目。具体而言，我们比较了他们在与毒品相关行为中的参与度、在毒品经济中的角色以及社交网络成员情况。数据收集于“盾牌研究”，这是一项针对吸毒者及其社交网络的艾滋病毒预防干预研究（n = 910），于2001年2月至2003年9月在美国马里兰州巴尔的摩进行。在这个样本中，56名参与者报告有出售针头的行为。出售针头者在与毒品相关的社交互动中的参与度更高，包括与他人一起吸毒、从他人处获取或给予毒品，以及与其他使用者一起购买毒品。出售针头的参与者在毒品经济中的角色数量显著更多。此外，他们有更多身为注射吸毒者的社交网络成员，会与这些成员谈论危险的吸毒行为、给他们针头，并与他们共用烹饪器具和漂白剂。与不出售针头的注射吸毒者相比，出售针头者更频繁地参与与艾滋病毒风险相关的行为，如每日注射和共用注射设备。该研究结果可能有助于确定是否应将二手交换者作为艾滋病毒预防活动的目标，以降低他们自身的风险，并在吸毒群体中传播风险降低信息。
