Division of Infectious Diseases, The Miriam Hospital, Providence, RI, USA.
J Urban Health. 2012 Aug;89(4):659-70. doi: 10.1007/s11524-012-9669-7.
Access to sterile syringes for injection drug users (IDUs) is a critical part of a comprehensive strategy to combat the transmission of HIV, hepatitis C virus, and other bloodborne pathogens. Understanding IDUs' experiences and attitudes about syringe acquisition is crucial to ensuring adequate syringe supply and access for this population. This study sought to assess and compare IDUs' syringe acquisition experiences and attitudes and HIV risk behavior in two neighboring states, Massachusetts (MA) and Rhode Island (RI). From March 2008 to May 2009, we surveyed 150 opioid IDUs at detoxification facilities in MA and RI, stratified the sample based on where respondents spent most of their time, and generated descriptive statistics to compare responses among the two groups. A large proportion of our participants (83%) reported pharmacies as a source of syringe in the last 6 months, while only 13% reported syringe exchange programs (SEPs) as a syringe source. Although 91% of our sample reported being able to obtain all of the syringes they needed in the past 6 months, 49% had used syringes or injection equipment previously used by someone else in that same time period. In comparison to syringe acquisition behaviors reported by patients of the same detoxification centers in 2001-2003 (data reported in previous publication), we found notable changes among MA participants. Our results reveal that some IDUs in our sample are still practicing high-risk injection behaviors, indicating a need for expanded and renewed efforts to promote safer injection behavior among IDUs. Our findings also indicate that pharmacies have become an important syringe source for IDUs and may represent a new and important setting in which IDUs can be engaged in a wide array of health services. Efforts should be made to involve pharmacists in providing harm reduction and HIV prevention services to IDUs. Finally, despite limited SEP access (especially in MA), SEPs are still used by approximately one of the three IDUs in our overall sample.
为注射吸毒者（IDU）提供无菌注射器是防治 HIV、丙型肝炎病毒和其他血源性病原体传播的综合策略的重要组成部分。了解 IDU 获取注射器的经验和态度对于确保该人群获得足够的注射器供应和获取至关重要。本研究旨在评估和比较马萨诸塞州（MA）和罗得岛州（RI）两个邻近州的 IDU 获取注射器的经验和态度以及 HIV 风险行为。从 2008 年 3 月到 2009 年 5 月，我们在 MA 和 RI 的戒毒所调查了 150 名阿片类药物 IDU，根据受访者大部分时间所在的地点对样本进行分层，并生成描述性统计数据来比较两组的反应。我们的大部分参与者（83%）报告在过去 6 个月内从药店获得注射器，而只有 13%的人报告从注射器交换计划（SEP）获得注射器。尽管我们的样本中有 91%的人报告在过去 6 个月内能够获得他们所需的所有注射器，但在同一时期，有 49%的人使用过其他人之前使用过的注射器或注射设备。与 2001-2003 年同一戒毒中心患者报告的注射器获取行为（之前发表的数据）相比，我们发现 MA 参与者的行为发生了显著变化。我们的研究结果表明，我们的样本中的一些 IDU 仍在进行高风险的注射行为，这表明需要加强和更新努力，以促进 IDU 更安全的注射行为。我们的研究结果还表明，药店已成为 IDU 的重要注射器来源，可能代表 IDU 可以参与广泛的健康服务的新的重要场所。应努力使药剂师参与为 IDU 提供减少伤害和预防 HIV 的服务。最后，尽管 SEP 的获取途径有限（尤其是在 MA），但我们的整体样本中仍有约三分之一的 IDU 使用 SEP。
