London School of Hygiene and Tropical Medicine, London, United Kingdom.
Qual Health Res. 2012 Jan;22(1):31-42. doi: 10.1177/1049732311420579. Epub 2011 Aug 25.
Hepatitis C virus (HCV) infection is a significant global public health problem. In developed countries, 90% of new infections occur among people who inject drugs (PWID), with seroprevalence increasing rapidly among new injectors. Staying Safe is an international, qualitative, social research project, the aim of which is to draw on the experiences of long-term PWID to inform a new generation of HCV prevention strategies. The Sydney project team employed life history interviews and computer-generated timelines to elicit detailed data about unexposed participants' (n =13) injecting practices, circumstances, and social networks over time. The motivations and strategies that enabled participants to avoid risk situations, and which might have helped them to "stay safe," appeared not to be directly related to harm-reduction messages or HCV avoidance. These included the ability and inclination to maintain social and structural resources, to mainly inject alone, to manage withdrawal, and to avoid injecting-related scars. These findings point to the multiple priorities that facilitate viral avoidance among PWID and the potential efficacy of nonspecific HCV harm-reduction interventions for HCV prevention.
丙型肝炎病毒 (HCV) 感染是一个重大的全球公共卫生问题。在发达国家，90%的新感染发生在注射毒品者 (PWID) 中，新注射者中的血清阳性率迅速上升。“保持安全”是一个国际性的、定性的、社会研究项目，旨在借鉴长期 PWID 的经验，为新一代 HCV 预防策略提供信息。悉尼项目团队采用生活史访谈和计算机生成的时间线，来引出未暴露参与者（n=13）的详细数据，包括他们随时间推移的注射行为、环境和社交网络。参与者避免风险情况的动机和策略，以及可能帮助他们“保持安全”的策略，似乎与减少伤害信息或 HCV 避免没有直接关系。这些策略包括维持社会和结构资源的能力和意愿，主要独自注射，管理戒断，以及避免与注射相关的疤痕。这些发现指出了促进 PWID 中病毒避免的多个优先事项，以及非特异性 HCV 减少伤害干预对 HCV 预防的潜在效果。
