农村阿巴拉契亚地区注射吸毒者使用新针具所面临的障碍：对针具交换的启示。
Barriers to using new needles encountered by rural Appalachian people who inject drugs: implications for needle exchange.
机构信息
Department of Health Policy, Management, and Leadership, School of Public Health, Robert C. Byrd Health Sciences Center, West Virginia University, PO Box 9190, Morgantown, WV, 26506, USA.
Department of Emergency Medicine, West Virginia University, PO Box 9149, Morgantown, WV, 26506, USA.
出版信息
Harm Reduct J. 2019 Apr 2;16(1):23. doi: 10.1186/s12954-019-0295-5.
BACKGROUND
Using a new needle for every injection can reduce the spread of infectious disease among people who inject drugs (PWID). No previous study has examined new needle use barriers among PWIDs residing in the rural Appalachian part of the United States, an area currently in the midst of a heroin epidemic.
OBJECTIVE
Therefore, our primary aim was to explore self-reported barriers to using a new needle by PWID attending a needle exchange program (NEP).
METHODS
We conducted a cross-sectional survey of PWID attending two NEPs in rural West Virginia located in the heart of Central Appalachia. A convenience sample of PWID (n = 100) completed the Barriers to Using New Needles Questionnaire.
RESULTS
The median number of barriers reported was 5 (range 0-19). Fear of arrest by police (72% of PWID "agreed" or "strongly agreed") and difficulty with purchasing needles from a pharmacy (64% "agreed" or "strongly agreed") were the most frequently cited barriers.
CONCLUSIONS/IMPORTANCE: Congruent with previous findings from urban locations, in rural West Virginia, the ability of PWID to use a new needle obtained from a needle exchange for every injection may be compromised by fear of arrest. In addition, pharmacy sales of new needles to PWID may be blunted by an absence of explicit laws mandating nonprescription sales. Future studies should explore interventions that align the public health goals of NEPs with the occupational safety of law enforcement and health outreach goals of pharmacists.
背景
对于注射毒品者（PWID）而言，每次注射使用新针具可以减少传染性疾病的传播。之前没有研究调查过居住在美国阿巴拉契亚农村地区的 PWID 使用新针具的障碍，而该地区目前正处于海洛因流行之中。
目的
因此，我们的主要目的是探索参加针具交换项目（NEP）的 PWID 报告的使用新针具的障碍。
方法
我们对西弗吉尼亚州农村地区的两个 NEP 中的 PWID 进行了横断面调查。阿巴拉契亚中部地区的中心位置。便利抽样的 100 名 PWID 完成了《使用新针具障碍问卷》。
结果
报告的障碍中位数为 5（范围 0-19）。害怕警察逮捕（72%的 PWID“同意”或“强烈同意”）和从药店购买针具困难（64%“同意”或“强烈同意”）是最常被提及的障碍。
结论/重要性：与来自城市地区的先前发现一致，在西弗吉尼亚州农村地区，PWID 可能因害怕被捕而无法使用从针具交换获得的新针具进行每次注射。此外，药店向 PWID 出售新针具可能会因缺乏明确的非处方销售法律而受到阻碍。未来的研究应探索将 NEP 的公共卫生目标与执法人员的职业安全和药剂师的健康宣传目标相协调的干预措施。
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