Zhang Lei, Chen Xi, Zheng Jun, Zhao Junshi, Jing Jun, Zhang Jun, Chow Eric P F, Wilson David P
Harm Reduct J. 2013 May 7;10:8. doi: 10.1186/1477-7517-10-8.
Needle-syringe exchange programs (NSPs) have been substantially rolled-out in China since 2002. Limited studies reported effectiveness of NSPs in a Chinese setting. This study aimed to assess the association between accessibility to NSPs and drug-use risk behaviors of IDUs by investigating primary (self-reported) data of IDUs recruited from NSP sites, community settings and mandatory detoxification centers (MDCs) in Hunan province, China.
A cross-sectional survey was conducted in Hunan province in 2010. IDU recruits participated in a face-to-face interview to provide information related to their ability to access NSPs, demographic characteristics, and injecting behaviors in the past 30 days.
Of the total 402 participants, 35%, 14% and 51% participants indicated low, medium and high ability to access NSPs in the past 30 days, respectively. A significantly higher proportion of IDUs (77.3%) from the high-access group reported ≤2 injecting episodes per day compared with medium- (46.3%) and low-access (58.8%) groups. Only 29.0% of high-access IDUs re-used syringes before disposal in the past 30 days, significantly lower than those in the medium- (43.1%) and low-access (41.3%) groups. Reported levels of needle/syringe sharing decreased significantly as the ability to access NSPs increased (16.3%, 12.7% and 2.5% in the low, medium and high access groups, respectively). Ninety percent of IDUs recruited from MDCs had low ability to access NSPs.
Increased NSP accessibility is associated with decreased levels of injecting frequency, repetitive use and sharing of injecting equipment among Chinese IDUs. Mandatory detention of IDUs remains as a major barrier for IDUs to access NSPs in China.
自2002年以来，针具交换项目（NSPs）在中国已大规模推广。在中国背景下，关于针具交换项目有效性的研究有限。本研究旨在通过调查从中国湖南省针具交换项目点、社区场所和强制戒毒所（MDCs）招募的注射吸毒者（IDUs）的原始（自我报告）数据，评估针具交换项目的可及性与注射吸毒者吸毒风险行为之间的关联。
2010年在湖南省进行了一项横断面调查。参与调查的注射吸毒者参加了面对面访谈，以提供与他们获取针具交换项目的能力、人口统计学特征以及过去30天内的注射行为相关的信息。
在总共402名参与者中，分别有35%、14%和51%的参与者表示在过去30天内获取针具交换项目的能力低、中、高。与中等可及性组（46.3%）和低可及性组（58.8%）相比，高可及性组中报告每天注射次数≤2次的注射吸毒者比例显著更高（77.3%）。在过去30天内，只有29.0%的高可及性注射吸毒者在丢弃针具前重复使用，显著低于中等可及性组（43.1%）和低可及性组（41.3%）。随着获取针具交换项目能力的提高，报告的针具/注射器共用水平显著下降（低、中、高可及性组分别为16.3%、12.7%和2.5%）。从强制戒毒所招募的注射吸毒者中有90%获取针具交换项目的能力低。
在中国，针具交换项目可及性的提高与注射吸毒者的注射频率、重复使用和注射器具共用水平的降低有关。对注射吸毒者的强制拘留仍然是中国注射吸毒者获取针具交换项目的主要障碍。
