Department of Public Health Sciences, MS1-C, University of California, Davis School of Medicine, One Shields Avenue, Davis, CA 95616, USA.
Am J Epidemiol. 2012 Jul 1;176(1):14-23. doi: 10.1093/aje/kwr492. Epub 2012 May 4.
Since 2005, California law allowed over-the-counter (OTC) syringe sales pending local authorization. Although pharmacy sales of OTC syringes are associated with reduced injection-mediated risks and decreases in human immunodeficiency virus infection rates, little is known about the factors associated with syringe purchase among injection drug users (IDUs). Using a cross-sectional design, the authors applied targeted sampling to collect quantitative survey data from IDUs (n = 563) recruited in San Francisco, California, during 2008. They also compiled a comprehensive list of retail pharmacies, their location, and whether they sell OTC syringes. They used a novel combination of geographic information system and statistical analyses to determine the demographic, behavioral, and spatial factors associated with OTC syringe purchase by IDUs. In multivariate analyses, age, race, injection frequency, the type of drug injected, and the source of syringe supply were independently associated with OTC syringe purchases. Notably, the prevalence of OTC syringe purchase was 53% lower among African-American IDUs (adjusted prevalence ratio = 0.47, 95% confidence interval: 0.33, 0.67) and higher among injectors of methamphetamine (adjusted prevalence ratio = 1.35, 95% confidence interval: 1.07, 1.70). Two neighborhoods with high densities of IDUs had limited access to OTC syringes. Increased access to OTC syringes would potentially prevent blood-borne infectious diseases among IDUs.
自 2005 年以来，加利福尼亚州的法律允许在获得当地授权的情况下在柜台（OTC）出售注射器。尽管药房出售 OTC 注射器与减少注射介导的风险和降低人类免疫缺陷病毒感染率有关，但对于注射吸毒者（IDU）购买注射器的相关因素知之甚少。作者采用横断面设计，通过目标抽样，于 2008 年在加利福尼亚州旧金山招募了 563 名 IDU 进行定量调查数据收集。他们还编制了一份零售药店的综合清单，包括它们的位置以及是否出售 OTC 注射器。他们使用地理信息系统和统计分析的新颖组合，确定 IDU 购买 OTC 注射器与人口统计学、行为和空间因素之间的关联。在多变量分析中，年龄、种族、注射频率、注射药物的类型和注射器供应来源与 OTC 注射器的购买独立相关。值得注意的是，非裔美国 IDU 中 OTC 注射器购买的流行率低 53%（调整后的流行率比=0.47，95%置信区间：0.33，0.67），而注射苯丙胺的 IDU 中 OTC 注射器购买的流行率高（调整后的流行率比=1.35，95%置信区间：1.07，1.70）。两个 IDU 密度高的街区获得 OTC 注射器的机会有限。增加 OTC 注射器的获取渠道可能会预防 IDU 中的血源性传染病。
