Bravo Maria J, Royuela Luis, Barrio Gregorio, de la Fuente Luis, Suarez Mónica, Teresa Brugal M
Universidad Complutense, Madrid, Spain.
Soc Sci Med. 2007 Oct;65(8):1773-8. doi: 10.1016/j.socscimed.2007.05.004. Epub 2007 Jul 19.
International policy on the prevention of HIV and other health problems among drug users should be guided by scientific evidence. However, it has frequently been argued that Needle Exchange Programs (NEPs) have negative effects such as facilitation of injection of illicit drugs, without providing evidence to support this hypothesis. Since the early 1980s Spain has experienced a severe HIV epidemic among drug injectors. A delayed but comprehensive implementation of harm reduction programs has taken place since the early 1990s. This paper assesses trends between 1991 and 2004, both in the number of sterile syringes exchanged or delivered by NEPs or other programs to improve injectors' access to sterile injection material, and in the number of injectors admitted to first treatment for heroin or cocaine dependence, as a proxy for trends in the number of new drug injectors in Spain. The results show increased access to sterile syringes and a sharp decrease in the number of new drug injectors, suggesting that NEPs have not promoted drug injection. A positive overall transition from injecting to smoking was also observed in the most frequent route of heroin or cocaine administration.
预防吸毒者感染艾滋病毒及其他健康问题的国际政策应以科学证据为指导。然而，人们经常认为针头交换项目（NEPs）有负面影响，比如便利了非法药物注射，但却没有提供证据支持这一假设。自20世纪80年代初以来，西班牙吸毒注射者中经历了严重的艾滋病毒流行。自20世纪90年代初以来，实施了延迟但全面的减少伤害项目。本文评估了1991年至2004年间的趋势，包括针头交换项目或其他项目为改善注射者获得无菌注射材料的机会而交换或分发的无菌注射器数量，以及因海洛因或可卡因依赖而首次接受治疗的注射者数量，以此作为西班牙新吸毒注射者数量趋势的指标。结果显示，获得无菌注射器的机会增加，新吸毒注射者数量大幅减少，这表明针头交换项目并未助长药物注射。在海洛因或可卡因最常见的使用途径方面，还观察到从注射到吸食的总体积极转变。
