The Ontario HIV Treatment Network, 1300 Yonge Street, Suite 600, Toronto, ON, M4T 1X3, Canada.
Division of Clinical Public Health, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Toronto, ON, M5T 3M7, Canada.
Harm Reduct J. 2017 Jul 14;14(1):46. doi: 10.1186/s12954-017-0174-x.
BACKGROUND: Supervised injection services (SIS) have been shown to reduce the public- and individual-level harms associated with injection drug use. While SIS feasibility research has been conducted in large urban centres, little is known about the acceptability of these services among people who inject drugs (PWID) in mid-sized cities. We assessed the prevalence and correlates of willingness to use SIS as well as design and operational preferences among PWID in London, Canada. METHODS: Between March and April 2016, peer research associates administered a cross-sectional survey to PWID in London. Socio-demographic characteristics, drug-use patterns, and behaviours associated with willingness to use SIS were estimated using bivariable and multivariable logistic regression models. Chi-square tests were used to compare characteristics with expected frequency of SIS use among those willing to use SIS. Design and operational preferences are also described. RESULTS: Of 197 PWID included in this analysis (median age, 39; interquartile range (IQR), 33-50; 38% female), 170 (86%) reported willingness to use SIS. In multivariable analyses, being female (adjusted odds ratio (AOR) 0.29; 95% confidence interval (CI) 0.11-0.75) was negatively associated with willingness to use, while public injecting in the last 6 months (AOR 2.76; 95% CI 1.00-7.62) was positively associated with willingness to use. Participants living in unstable housing, those injecting in public, and those injecting opioids and crystal methamphetamine daily reported higher expected frequency of SIS use (p < 0.05). A majority preferred private cubicles for injecting spaces and daytime operational hours, while just under half preferred PWID involved in service operations. CONCLUSIONS: High levels of willingness to use SIS were found among PWID in this setting, suggesting that these services may play a role in addressing the harms associated with injection drug use. To maximize the uptake of SIS, programme planners and policy makers should consider the effects of gender and views of PWID regarding SIS design and operational preferences.
背景：监督注射服务（SIS）已被证明可减少与注射吸毒相关的公共和个人层面的危害。虽然已经在大型城市中心进行了 SIS 的可行性研究，但对于中型城市中的注射吸毒者（PWID）对这些服务的接受程度知之甚少。我们评估了 PWID 使用 SIS 的意愿的普遍性和相关因素，以及在加拿大伦敦的 PWID 中对 SIS 的设计和运营偏好。
方法：2016 年 3 月至 4 月期间，同伴研究助理向伦敦的 PWID 进行了横断面调查。使用二变量和多变量逻辑回归模型估计了与使用 SIS 意愿相关的社会人口统计学特征、吸毒模式和行为。使用卡方检验比较了愿意使用 SIS 的人之间 SIS 使用的预期频率的特征。还描述了设计和运营偏好。
结果：在这项分析中，纳入了 197 名 PWID（中位数年龄，39 岁；四分位间距（IQR），33-50 岁；38%为女性），170 名（86%）报告愿意使用 SIS。在多变量分析中，女性（调整后的优势比（AOR）0.29；95%置信区间（CI）0.11-0.75）与使用意愿呈负相关，而过去 6 个月内公共注射（AOR 2.76；95% CI 1.00-7.62）与使用意愿呈正相关。居住在不稳定住房中的参与者、在公共场所注射的参与者以及每天注射阿片类药物和冰毒的参与者报告 SIS 使用的预期频率更高（p<0.05）。大多数人更喜欢私人小隔间作为注射空间，更喜欢白天运营时间，而近一半的人更喜欢参与服务运营的 PWID。
结论：在这种情况下，PWID 对 SIS 的使用意愿很高，这表明这些服务可能在解决与注射吸毒相关的危害方面发挥作用。为了最大限度地提高 SIS 的使用率，规划者和政策制定者应考虑性别和 PWID 对 SIS 设计和运营偏好的看法的影响。
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