Huo Dezheng, Ouellet Lawrence J
Department of Health Studies, University of Chicago, Chicago, Illinois 60637, USA.
Sex Transm Dis. 2009 Jan;36(1):35-40. doi: 10.1097/OLQ.0b013e318186dee3.
To examine the impact of a needle exchange program (NEP) on sexual risk behaviors of injecting drug users (IDUs).
: Between 1997 and 2000, 889 IDUs in Chicago were recruited from NEPs and an area with no NEP into a cohort study. They were interviewed and tested for HIV at baseline and 3 annual follow-up visits. Random-effect logistic models were used to compare NEP users and nonusers regarding the number of sex partners, number of unprotected sex acts, and frequency of condom use.
Compared to NEP nonusers, NEP users had a similar number of sex partners over time, but had 49% higher odds of using condoms with their main partners (P = 0.047). At baseline, there was no difference between NEP users and nonusers in episodes of vaginal intercourse, but over time the odds of having a higher number of unprotected instances of vaginal intercourse were reduced by 26% per year for NEP users but only 10% per year for nonusers (P = 0.02).
This study suggests that NEP participation may help reduce the absolute risk of HIV sexual transmission.
探讨针头交换项目（NEP）对注射吸毒者（IDU）性风险行为的影响。
1997年至2000年期间，从针头交换项目和无针头交换项目地区招募了889名芝加哥注射吸毒者，纳入队列研究。在基线期以及随后3年的年度随访中，对他们进行访谈并检测HIV。采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在性伴侣数量、无保护性行为次数以及避孕套使用频率方面的差异。
与非针头交换项目使用者相比，随着时间推移，针头交换项目使用者的性伴侣数量相似，但与主要伴侣使用避孕套的几率高49%（P = 0.047）。在基线期，针头交换项目使用者和非使用者在阴道性交次数方面没有差异，但随着时间推移，针头交换项目使用者每年发生无保护阴道性交次数较多的几率降低26%，而非使用者仅降低10%（P = 0.02）。
本研究表明，参与针头交换项目可能有助于降低HIV性传播的绝对风险。
