National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia.
Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.
Int J Drug Policy. 2020 Oct;84:102866. doi: 10.1016/j.drugpo.2020.102866. Epub 2020 Jul 24.
Injecting risk behaviour, such as receptive sharing of injecting equipment and/or re-using one's equipment, is associated with bloodborne virus transmission and infections in people who inject drugs (PWID). We aimed to estimate prevalence and correlates of injecting risk behaviours amongst PWID.
We conducted a systematic review and meta-analyses to estimate country, regional, and global prevalences of injecting risk behaviours (including sharing or re-using needle/syringe and sharing other injecting equipment). Using meta-regression analyses, we determined associations between study- and country-level characteristics and receptive needle/syringe sharing.
From 61,077 identified papers and reports and 61 studies from expert consutation, evidence on injecting risk behaviours was available for 464 studies from 88 countries. Globally, it is estimated that 17.9% (95%CI: 16.2-19.6%) of PWID engaged in receptive needle/syringe sharing at last injection, 23.9% (95%CI: 21.2-26.5%) in the past month, and 32.8% (95%CI: 28.6-37.0%) in the past 6-12 months. Receptive sharing of other injecting equipment was common. Higher prevalence of receptive needle/syringe sharing in the previous month was associated with samples of PWID with a lower proportion of females, shorter average injecting duration, a higher proportion with ≥daily injecting, and older studies. Countries with lower development index, higher gender inequality and lower NSP coverage had higher proportions reporting receptive needle/syringe sharing.
High levels of injecting risk behaviours were observed amongst PWID globally, although estimates were only available for half of the countries with evidence of injecting drug use. There is a need for better capturing of injecting risk behaviours in these countries to inform implementation of harm reduction services and evaluate potential impacts of interventions to reduce risk.
注射风险行为，如接受性共用注射设备和/或重复使用自己的设备，与血液传播病毒的传播和吸毒者（PWID）的感染有关。我们旨在估计 PWID 中注射风险行为的流行率和相关因素。
我们进行了系统评价和荟萃分析，以估计国家、地区和全球范围内接受性共用注射设备（包括共用或重复使用针/注射器和共用其他注射设备）的风险行为的流行率。使用荟萃回归分析，我们确定了研究和国家层面特征与接受性针/注射器共享之间的关联。
从 61077 篇已识别的论文和报告以及专家咨询的 61 项研究中，有 88 个国家的 464 项研究提供了关于注射风险行为的证据。全球估计有 17.9%（95%CI：16.2-19.6%）的 PWID 在最近一次注射时接受性地共用针/注射器，23.9%（95%CI：21.2-26.5%）在过去一个月内，32.8%（95%CI：28.6-37.0%）在过去 6-12 个月内。接受性地共用其他注射设备也很常见。过去一个月内接受性地共用针/注射器的比例较高与以下因素有关：女性比例较低、平均注射时间较短、每日注射比例较高、以及研究时间较早。发展指数较低、性别不平等程度较高和无国家药物管制计划（NSP）覆盖率较高的国家，报告接受性地共用针/注射器的比例较高。
全球范围内，PWID 中存在高水平的注射风险行为，尽管只有一半有注射药物使用证据的国家提供了估计值。需要在这些国家更好地捕捉注射风险行为，以提供减少伤害服务的实施信息，并评估减少风险干预措施的潜在影响。
