Huo Dezheng, Ouellet Lawrence J
Department of Health Studies, University of Chicago, 5841 South Maryland Avenue, MC2007, Chicago, IL 60637, USA.
J Acquir Immune Defic Syndr. 2007 May 1;45(1):108-14. doi: 10.1097/QAI.0b013e318050d260.
To examine whether needle exchange program (NEP) use by injecting drug users (IDUs) affects injection risk behaviors over time.
Between 1997 and 2000, 901 IDUs in Chicago were recruited for a cohort study from a multisite NEP and an area with no NEP. Participants were interviewed and tested for HIV at baseline and 3 annual follow-ups. Non-NEP users received HIV prevention services consistent with the Indigenous Leader Outreach Model. Random-effect logistic models were used to compare 5 injection-related risk behaviors between NEP users and nonusers.
The 30-day prevalence of receptive needle sharing decreased from 27.6% at baseline to 10.0% at visit 4 in NEP users and from 47.1% to 20.0% in nonusers. Similar patterns were observed for lending used needles, and NEP users were less likely to reuse their own needles. In multivariate analyses, NEP use was significantly associated with reduced odds of greater than 60% for receptive needle sharing, 45% for lending used needles, and 30% for sharing other injection paraphernalia as well as approximately a 2-fold increase in the odds of always bleaching used needles.
NEP use facilitates long-term reductions in injection risk practices, and the reductions are in addition to the effects of a behavioral intervention alone.
探讨注射吸毒者使用针头交换项目（NEP）是否会随着时间推移影响注射风险行为。
1997年至2000年期间，从一个多站点针头交换项目和一个无针头交换项目的地区招募了901名芝加哥注射吸毒者进行队列研究。在基线和3次年度随访时对参与者进行访谈并检测HIV。非针头交换项目使用者接受符合本土领袖外展模式的HIV预防服务。使用随机效应逻辑模型比较针头交换项目使用者和非使用者之间5种与注射相关的风险行为。
在针头交换项目使用者中，接受性共用针头的30天患病率从基线时的27.6%降至第4次访视时的10.0%，在非使用者中从47.1%降至20.0%。在出借用过的针头方面也观察到类似模式，且针头交换项目使用者重复使用自己针头的可能性较小。在多变量分析中，使用针头交换项目与接受性共用针头的几率显著降低60%以上、出借用过的针头的几率降低45%、共享其他注射用具的几率降低30%以及总是对用过的针头进行漂白的几率增加约2倍显著相关。
使用针头交换项目有助于长期减少注射风险行为，且这些减少是在单独行为干预效果之外的。
