Irwin Kevin, Karchevsky Evgeni, Heimer Robert, Badrieva Larissa
Department of Epidemiology and Public Health, Yale University, New Haven, CT 06510, USA.
Subst Use Misuse. 2006;41(6-7):979-99. doi: 10.1080/10826080600667219.
Effective prevention of syringe-borne transmission of HIV and the hepatitis viruses can be undermined if contact between injection drug users and the staff of prevention programs is impeded by police harassment, limited program resources, and the absence of an open "drug scene." All these are commonplace in the Russian Federation. In response, "Project Renewal," the harm reduction program of the AIDS Prevention and Control Center of the Tatarstan Ministry of Health in Kazan, has created a hybrid syringe exchange program that as its primary focus recruited and trained volunteers to provide secondary syringe exchange. To compensate for operational barriers, the program staff identified private venues and trained responsible individuals to work through their own and related networks of injectors to provide clean syringes, other harm reduction supplies, and educational materials, while facilitating the collection and removal of used and potentially contaminated syringes. Program staff developed a detailed set of tracking instruments to monitor, on a daily and weekly basis, the locations and types of contacts and the dissemination of trainings and materials to ensure that the secondary distribution network reaches its target audience. Data show that these secondary exchange sites have proven more productive than the primary mobile and fixed-site syringe exchanges in Kazan. Beginning in 2001, Project Renewal has trained other harm reduction programs in the Russian Federation to use this model of reaching injectors, identifying and training volunteers, and monitoring results of secondary syringe exchange.
如果注射吸毒者与预防项目工作人员之间的接触因警方骚扰、项目资源有限以及缺乏公开的“毒品场所”而受到阻碍，那么有效预防通过注射器传播艾滋病毒和肝炎病毒的工作就会受到破坏。所有这些在俄罗斯联邦都很常见。作为回应，喀山鞑靼斯坦共和国卫生部艾滋病预防与控制中心的减少伤害项目“更新项目”创建了一个混合注射器交换项目，该项目的主要重点是招募和培训志愿者来进行二级注射器交换。为了弥补操作上的障碍，项目工作人员确定了私人场所，并培训了相关负责人，让他们通过自己以及相关的注射者网络来提供清洁注射器、其他减少伤害用品和教育材料，同时促进用过的以及可能受污染的注射器的收集和处理。项目工作人员制定了一套详细的跟踪工具，以便每天和每周监测接触的地点和类型以及培训和材料的分发情况，以确保二级分发网络能够覆盖目标受众。数据显示，这些二级交换点已被证明比喀山的主要流动和固定站点注射器交换点更有成效。从2001年开始，“更新项目”已培训俄罗斯联邦的其他减少伤害项目采用这种接触注射者、识别和培训志愿者以及监测二级注射器交换结果的模式。
