Bluthenthal Ricky N, Anderson Rachel, Flynn Neil M, Kral Alex H
Health Program and Drug Policy Research Center, RAND Corporation, 1776 Main Street, PO Box 2138, Santa Monica, CA 90407-2138, USA.
Drug Alcohol Depend. 2007 Jul 10;89(2-3):214-22. doi: 10.1016/j.drugalcdep.2006.12.035. Epub 2007 Feb 5.
To determine if adequate syringe coverage --"one shot for one syringe"--among syringe exchange program (SEP) clients is associated with injection-related HIV risk behaviors and syringe disposal.
HIV risk assessments with 1577 injection drug users (IDUs) recruited from 24 SEPs in California between 2001 and 2003. Individual syringe coverage was calculated as a proportion of syringes retained from SEP visits to total number of injections in the last 30 days.
Participants were divided into four groups based on syringe coverage: <50%, 50-99%, 100-149%, and 150% or more. In multivariate logistic regression, SEP clients with less than 50% syringe coverage had significantly higher odds of reporting receptive syringe sharing in the last 30 days (adjusted odds ratio [AOR]=2.3; 95% confidence interval [CI]=1.4, 3.6) and those with 150% or more coverage had lower odds of reporting receptive syringe sharing (AOR=0.5; 95%CI=0.3, 0.8) as compared to SEP clients with adequate syringe coverage of 100-149%. Similar associations were observed for other main outcomes of distributive syringe sharing and syringe re-use. No differences in safe syringe disposal were observed by syringe coverage.
Individual syringe coverage is strongly associated with safer injection behaviors without impacting syringe disposal among SEP clients. Syringe coverage is a useful measure for determining if IDUs are obtaining sufficient syringes to lower HIV risk.
确定注射器交换项目（SEP）的客户中是否实现了充足的注射器覆盖（“一针一器”）与注射相关的艾滋病毒风险行为及注射器处理之间的关联。
对2001年至2003年间从加利福尼亚州24个SEP招募的1577名注射吸毒者（IDU）进行艾滋病毒风险评估。个体注射器覆盖率的计算方法是，SEP访视中留存的注射器数量占过去30天注射总数的比例。
根据注射器覆盖率，参与者被分为四组：<50%、50 - 99%、100 - 149%以及150%及以上。在多因素逻辑回归分析中，注射器覆盖率低于50%的SEP客户在过去30天内报告接受性共用注射器的几率显著更高（调整优势比[AOR]=2.3；95%置信区间[CI]=1.4, 3.6），而覆盖率在150%及以上的客户报告接受性共用注射器的几率较低（AOR=0.5；95%CI=0.3, 0.8），相比之下，注射器覆盖率充足（100 - 149%）的SEP客户。在其他主要的分发性注射器共用和注射器重复使用结果方面也观察到类似的关联。在注射器处理的安全性方面，未观察到因注射器覆盖率而产生的差异。
个体注射器覆盖率与更安全的注射行为密切相关，且不会影响SEP客户的注射器处理。注射器覆盖率是确定注射吸毒者是否获得足够注射器以降低艾滋病毒风险的一项有用指标。
