Shrestha Sadeep, Smith Michael W, Broman Karl W, Farzadegan Homayoon, Vlahov David, Strathdee Steffanie A
Laboratory of Genomic Diversity, National Cancer Institute, NCI-Frederick, MD 21702, USA.
J Acquir Immune Defic Syndr. 2006 Nov 1;43(3):335-43. doi: 10.1097/01.qai.0000230528.25083.0b.
Syringe-sharing behaviors among injection drug users (IDUs) are typically based on self-reports and subject to socially desirable responding. We used 3 short tandem repeat (STR) genetic biomarkers to detect sharing in 2,512 syringes exchanged by 315 IDUs in the Baltimore needle exchange program (NEP; 738 person-visits). Demographic characteristics as well as direct and indirect needle-sharing behaviors corresponding to the closest AIDS Link to Intravenous Experience (ALIVE) study visits were examined for association with multiperson use (MPU) of syringes. Overall, 56% of the syringes exchanged at the Baltimore NEP had evidence of MPU. Less MPU of syringes (48% vs. 71%; P < 0.0001) was seen with more rapid syringe turnaround (<3 days). IDUs always exchanging their own syringes ("primary" syringes) were less likely to return syringes with evidence of MPU (52%) than those who exchanged syringes for others ("secondary" syringes; 64%; P = 0.0001) and those exchanging primary and secondary syringes (58%; P = 0.004). In a multivariate analysis restricted to primary exchangers, MPU of syringes was associated with sharing cotton (adjusted odds ratio [AOR] = 2.06, 95% confidence interval [CI]: 1.30 to 3.28), lending syringes (AOR = 1.70, 95% CI: 1.24 to 2.34), and injecting less than daily (AOR = 0.64, 95% CI: 0.43 to 0.95). These findings support additional public health interventions such as expanded syringe access to prevent HIV and other blood-borne infections. Testing of STRs represents a promising approach to examining and accessing complex behavioral data, including syringe sharing.
注射吸毒者（IDU）之间的注射器共享行为通常基于自我报告，且容易受到社会期望反应的影响。我们使用3种短串联重复序列（STR）基因生物标志物，对巴尔的摩针头交换项目（NEP；738人次访问）中315名注射吸毒者交换的2512支注射器进行共享检测。我们研究了与最近的艾滋病静脉注射经验关联研究（ALIVE）访问相对应的人口统计学特征以及直接和间接的针头共享行为，以探讨其与多人共用（MPU）注射器的相关性。总体而言，在巴尔的摩针头交换项目中交换的注射器有56%存在多人共用的迹象。注射器周转更快（<3天）时，多人共用注射器的情况较少（48%对71%；P<0.0001）。总是交换自己注射器（“主要”注射器）的注射吸毒者带回有多人共用迹象注射器的可能性（52%）低于那些为他人交换注射器的人（“次要”注射器；64%；P = 0.0001）以及既交换主要注射器又交换次要注射器的人（58%；P = 0.004）。在一项仅限于主要交换者的多变量分析中，注射器的多人共用与共用棉花（调整后的优势比[AOR]=2.06，95%置信区间[CI]：1.30至3.28）、出借注射器（AOR = 1.70，95%CI：1.24至2.34）以及非每日注射（AOR = 0.64，95%CI：0.43至0.95）相关。这些发现支持了诸如扩大注射器获取途径等额外的公共卫生干预措施，以预防艾滋病毒和其他血源感染。STR检测是一种有前景的方法，可用于检查和获取包括注射器共享在内的复杂行为数据。
