Department of Health Sciences European University of Cyprus, Nicosia, Cyprus.
Medical School, University of Cyprus, Nicosia, Cyprus.
AIDS Res Hum Retroviruses. 2021 Feb;37(2):130-138. doi: 10.1089/AID.2020.0050. Epub 2020 Nov 26.
Drug use involves social interactions. Therefore, norms in the proximal environment of people who inject drugs (PWID) can favor behaviors that may result in HIV transmission. This work aimed at studying drug injection-related norms and their potential association with risky behaviors among PWID in Athens, Greece, in the context of economic recession and political activism that followed the fiscal crisis and soon after a recent HIV outbreak had leveled off. The Transmission Reduction Intervention Project (TRIP) was a social network-based approach (June 2013 to July 2015) that involved two groups of PWID seeds-with recent HIV infection and with long-term HIV infection and one control group of HIV-negative PWID. Network contacts of seeds were also enrolled. TRIP participants answered a questionnaire that included items on injection-related norms and behaviors. TRIP recruited 320 PWID (HIV positive, 44.4%). TRIP participants, especially those without HIV, often recalled or perceived as normative among their partners and in their networks some behaviors that can lead to HIV transmission. TRIP participants who recalled that they were encouraged by their regular drug partners to use an unclean syringe were almost twice as likely to report that they share syringes [odds ratio (OR) = 2.03; 95% confidence interval (CI) = 1.86-2.21], or give syringes to someone else (OR = 1.70; 95% CI = 1.42-2.04) as those who did not recall such an encouragement. Associations were modified by HIV status. HIV negatives, who were reportedly encouraged to share nonsyringe injecting equipment, were almost 4.5 times as likely to share that material as HIV-negative participants who were not encouraged (OR = 4.59, 95% CI = 4.12-5.11). Further research is needed on the multiple determinants (social, economic, and political) of norms in the social environments of PWID. Since peer norms are associated with risky behaviors, interventions should be developed to encourage norms and peer pressure against the sharing of injection equipment.
药物使用涉及社会互动。因此，注射毒品者（PWID）的近端环境中的规范可以支持可能导致 HIV 传播的行为。这项工作旨在研究与注射毒品相关的规范及其与希腊雅典 PWID 中危险行为的潜在关联，研究背景是经济衰退和财政危机后的政治激进主义，以及最近 HIV 疫情得到控制后。传播减少干预项目（TRIP）是一种基于社会网络的方法（2013 年 6 月至 2015 年 7 月），涉及两组 PWID 种子人群 - 最近感染 HIV 人群和长期感染 HIV 人群以及一组 HIV 阴性 PWID 对照组。种子的网络联系人也被招募。TRIP 参与者回答了一份问卷，其中包括与注射相关的规范和行为的项目。TRIP 招募了 320 名 PWID（HIV 阳性，44.4%）。TRIP 参与者，特别是那些没有 HIV 的参与者，经常回忆或认为他们的伴侣和网络中的一些行为可能导致 HIV 传播。回忆说他们受到经常使用药物的伙伴鼓励使用不洁注射器的 TRIP 参与者报告他们更有可能共享注射器[比值比（OR）= 2.03；95%置信区间（CI）= 1.86-2.21]，或将注射器给别人（OR= 1.70；95% CI= 1.42-2.04），而那些没有回忆起这种鼓励的参与者。关联受 HIV 状况的影响。据报道，鼓励共享非注射器注射设备的 HIV 阴性参与者几乎有 4.5 倍的可能性与未受鼓励的 HIV 阴性参与者共享该材料（OR= 4.59，95% CI= 4.12-5.11）。需要进一步研究 PWID 社会环境中规范的多种决定因素（社会、经济和政治）。由于同伴规范与危险行为相关，因此应制定干预措施，以鼓励规范和抵制共享注射设备的同伴压力。
