Ruiz Monica S, O'Rourke Allison, Allen Sean T
Milken Institute School of Public Health, George Washington University, 950 New Hampshire Ave, Suite 300, Washington, DC, 20052, USA.
AIDS Behav. 2016 Jan;20(1):22-8. doi: 10.1007/s10461-015-1143-6.
Syringe exchange programs (SEPs) lower HIV risk. From 1998 to 2007, Congress prohibited Washington, DC, from using municipal revenue for SEPs. We examined the impact of policy change on IDU-associated HIV cases. We used surveillance data for new IDU-associated HIV cases between September 1996 and December 2011 to build an ARIMA model and forecasted the expected number of IDU-associated cases in the 24 months following policy change. Interrupted time series analyses (ITSA) were used to assess epidemic impact of policy change. There were 176 IDU-associated HIV cases in the 2 years post-policy change; our model predicted 296 IDU-associated HIV cases had the policy remained in place, yielding a difference of 120 averted HIV cases. ITSA identified significant immediate (B = -6.0355, p = .0005) and slope changes (B = -.1241, p = .0427) attributed to policy change. Policy change is an effective structural intervention for HIV prevention when it facilitates the implementation of services needed by vulnerable populations.
注射器交换项目（SEPs）可降低感染艾滋病毒的风险。1998年至2007年期间，国会禁止华盛顿特区将市政收入用于注射器交换项目。我们研究了政策变化对与注射吸毒者相关的艾滋病毒病例的影响。我们利用1996年9月至2011年12月期间新的与注射吸毒者相关的艾滋病毒病例的监测数据建立了自回归积分移动平均模型（ARIMA），并预测了政策变化后24个月内与注射吸毒者相关的病例预期数量。采用中断时间序列分析（ITSA）来评估政策变化对疫情的影响。政策变化后的两年内有176例与注射吸毒者相关的艾滋病毒病例；我们的模型预测，如果政策保持不变，将会有296例与注射吸毒者相关的艾滋病毒病例，这意味着避免了120例艾滋病毒病例。ITSA确定了政策变化导致的显著即时变化（B = -6.0355，p = .0005）和斜率变化（B = -.1241，p = .0427）。当政策变化有助于实施弱势群体所需的服务时，它是预防艾滋病毒的一种有效的结构性干预措施。
