Department of Global Health and Socio-epidemiology, Kyoto University School of Public Health, Yoshida-Konoe-cho, Sakyo-ku, Kyoto 606-8501, Japan.
Ministry of Health - Libya, Alfornaj Street, Libya.
Int J Drug Policy. 2018 Mar;53:23-31. doi: 10.1016/j.drugpo.2017.11.026. Epub 2017 Dec 19.
Libya is facing a rapidly growing epidemic of illicit drug use and HIV. This situation is fueled by a complex array of factors, mainly the consequences of the political and military turmoil of the Arab Spring. Although it is extensively documented in other settings that young people are one of the most vulnerable groups to both HIV and illicit drug use, no study has explored this issue among young people in Libya. The current study addresses this research gap.
This study is a qualitative study using in-depth interviews guided by a semi-structured questionnaire. We used a maximum variation, purposive sampling strategy to recruit male and female participants, aged 14-18 years, from schools, prisons, and community-based informal re-education and rehabilitation centers in Tripoli, Libya.
In total, 31 participants were recruited: 6 females and 25 males. Sixteen participants were prisoners and residents of community-based informal re-education and rehabilitation centers, and 15 were recruited in schools. Risk factors for drug use included peer influence, the increased availability and affordability of drugs, disruption of social life and healthy recreational activities, and the distress and casualties of the war. Protective factors were religious beliefs and practices, good parent-child connectedness, and high self-esteem and future aspiration. Risk factors for HIV were insufficient knowledge related to HIV transmission and unsafe injection practices, such as sharing needles and syringes.
We found individual, interpersonal, family, and structural-level factors that interplayed to shape the vulnerability of young people to drug use and HIV infection in Tripoli, Libya. Structural factors, including the increased availability and affordability of drugs, provided the frame within which other factors, such as peer influence, insufficient knowledge of substance use, and HIV, operated to increase the vulnerability of young people to drugs and HIV, while religious beliefs and parent-child connectedness acted as protective factors. Multisectoral efforts and studies to quantitatively evaluate the magnitude and distribution of these problems are urgently needed.
利比亚正面临非法药物使用和艾滋病毒迅速蔓延的局面。这种情况是由一系列复杂因素造成的，主要是阿拉伯之春的政治和军事动荡的后果。尽管在其他环境中广泛记录了年轻人是艾滋病毒和非法药物使用的最脆弱群体之一，但尚无研究探讨利比亚年轻人中的这一问题。本研究旨在填补这一研究空白。
本研究采用定性研究方法，使用半结构化问卷进行深入访谈。我们采用最大变异、有针对性的抽样策略，从利比亚的学校、监狱和社区非正规再教育和康复中心招募年龄在 14-18 岁的男女参与者。
共有 31 名参与者被招募：6 名女性和 25 名男性。16 名参与者是囚犯和社区非正规再教育和康复中心的居民，15 名参与者是从学校招募的。药物使用的风险因素包括同伴影响、药物的可用性和可负担性增加、社会生活和健康娱乐活动的中断，以及战争的痛苦和伤亡。保护因素包括宗教信仰和实践、良好的亲子关系以及高度的自尊和未来的愿望。艾滋病毒的风险因素包括与艾滋病毒传播相关的知识不足以及不安全的注射习惯，如共用针头和注射器。
我们发现了个体、人际、家庭和结构层面的因素，这些因素相互作用，塑造了的年轻人在利比亚的黎波里容易受到药物使用和艾滋病毒感染的脆弱性。结构因素，包括药物的可用性和可负担性增加，为其他因素，如同伴影响、对药物使用的知识不足以及艾滋病毒，提供了框架，这些因素增加了年轻人对药物和艾滋病毒的易感性，而宗教信仰和亲子关系则起到了保护因素的作用。迫切需要多部门努力和研究来定量评估这些问题的规模和分布。
