University of California, Berkeley and University of California, San Francisco Joint Medical Program, Berkeley and San Francisco, CA, USA.
J Urban Health. 2013 Jun;90(3):500-15. doi: 10.1007/s11524-012-9718-2.
Young injection drug users (IDUs), a highly mobile population, engage in high levels of injecting risk behavior, yet little is understood about how such risk behavior may vary by the characteristics of the cities to which they travel, including the existence of a syringe exchange program (SEP), as well as travel partner characteristics. In 2004-2005, we conducted a 6-month prospective study to investigate the risk behavior of 89 young IDUs as they traveled, with detailed information gathered about 350 city visits. In multivariable analyses, travel to larger urban cities with a population of 500,000-1,000,000 was significantly associated with injecting drugs (adjusted odds ratio (AOR) = 3.71; 95 % confidence interval (CI), 1.56-8.82), ancillary equipment sharing (AES; AOR = 7.05; 95 % CI, 2.25-22.06) and receptive needle sharing (RNS; AOR = 5.73; 95 % CI, 1.11-27.95), as compared with visits to smaller cities with populations below 50,000. Region of the country, and the existence of a SEP within the city visited, were not independently associated with injecting drugs, AES, or RNS during city visits. Traveling with more than one injecting partner was associated with injecting drugs during city visits (AOR = 2.77; 95 % CI, 1.46-5.27), when compared with traveling alone. Additionally, both non-daily and daily/almost daily alcohol use during city visits were associated with AES (AOR = 3.37; 95 % CI, 1.42-7.68; AOR = 3.03; 95 % CI, 1.32-6.97, respectively) as compared with no alcohol consumption. Traveling young IDUs are more likely to inject when traveling with other IDUs and to engage in higher risk injection behavior when they are in large cities. Risk behavior occurring in city visits, including equipment sharing and alcohol consumption, suggests further need for focused interventions to reduce risk for viral infection among this population.
年轻的注射吸毒者（IDU）是一个高度流动的群体，他们从事着高风险的注射行为，但对于他们旅行时的行为特征，例如旅行目的地城市是否存在针具交换项目（SEP）以及旅行伙伴的特征，可能会如何影响这些风险行为，我们了解甚少。2004-2005 年，我们进行了一项为期 6 个月的前瞻性研究，调查了 89 名年轻 IDU 在旅行时的风险行为，并详细收集了他们在 350 次城市访问中的信息。在多变量分析中，与前往人口低于 50,000 的较小城市相比，前往人口 500,000-1,000,000 的较大城市旅行与注射毒品（调整后的优势比（AOR）=3.71；95%置信区间（CI），1.56-8.82）、辅助设备共享（AES；AOR=7.05；95%CI，2.25-22.06）和接受性针具共享（RNS；AOR=5.73；95%CI，1.11-27.95）显著相关。与访问的城市内是否存在 SEP 相比，国家的地区以及访问的城市的 SEP 并不独立与注射毒品、AES 或 RNS 相关。与独自旅行相比，与多个注射伙伴一起旅行与城市访问期间的注射毒品（AOR=2.77；95%CI，1.46-5.27）有关。此外，与不饮酒相比，城市访问期间非每日/每日/几乎每日饮酒与 AES（AOR=3.37；95%CI，1.42-7.68；AOR=3.03；95%CI，1.32-6.97）有关。年轻的 IDU 在与其他 IDU 一起旅行时更有可能注射，并且在他们在大城市时更有可能从事高风险的注射行为。城市访问中发生的风险行为，包括设备共享和饮酒，表明需要进一步采取有针对性的干预措施，以减少该人群的病毒感染风险。
