Hunter G M, Donoghoe M C, Stimson G V, Rhodes T, Chalmers C P
Department of Psychiatry, Charing Cross and Westminster Medical School, University of London, UK.
AIDS. 1995 May;9(5):493-501.
To describe changes in the injecting risk behaviour of injecting drug users (IDU) in London between 1990 and 1993.
Injecting risk behaviour was measured over 4 years (1990-1993) in a serial point HIV prevalence study of 2062 IDU recruited in both drug treatment and non-treatment community-based settings within greater London. The study used a structured questionnaire and common sampling and interview strategy developed by a World Health Organization technical group and implemented in 13 cities.
Log-linear models were used to assess patterns of change over years and of differences in injecting risk behaviour, including syringe sharing and syringe hygiene between 1990 and 1993. The log likelihood chi 2 statistic, G2, was used to test statistical significance. Changes in the mean values were assessed first using parametric tests assuming normality and the results were compared with Kruskal-Wallis (non-parametric) tests. Pearsons chi 2 was used to measure differences in frequency of sharing occasions and partner selectivity.
An overall reduction in injecting risk behaviour was observed during the first 2 years of this study, including a decline in syringe sharing (both accepting and passing on used syringes), the number of sharing partners and the frequency of sharing occasions. Most sharers restricted sharing to sexual partners and close friends. The majority of sharers reported always cleaning injecting equipment. Main source of sterile equipment was pharmacies and syringe exchanges. Indirect sharing (of spoons, filters, and by front- or backloading) was reported. Since 1991 there has been a stabilization in risk behaviour.
The data indicate that IDU in London have made positive reductions in risk behaviour. Levels of syringe sharing were substantially lower than those reported up to 1987 before AIDS awareness and the introduction of HIV prevention measures. The majority did not share syringes or confined their sharing to close friends and sexual partners, and if shared, cleaned their syringes. Continuation of indirect sharing indicates the need for more detailed prevention messages. While the initial decline in syringe-sharing rates may be attributed to the wide availability of sterile injecting equipment and other preventive measures, it may now be necessary to look beyond current intervention initiatives to develop interventions which seek to change the social etiquette of sharing and move towards the long-term maintenance of low levels of injecting risk behaviour.
描述1990年至1993年间伦敦注射吸毒者（IDU）注射风险行为的变化。
在一项针对大伦敦地区2062名在药物治疗和非治疗社区环境中招募的注射吸毒者的连续点HIV流行率研究中，对4年（1990 - 1993年）期间的注射风险行为进行了测量。该研究使用了世界卫生组织技术小组制定并在13个城市实施的结构化问卷以及常见的抽样和访谈策略。
使用对数线性模型来评估多年来的变化模式以及1990年至1993年间注射风险行为的差异，包括共用注射器和注射器卫生情况。使用对数似然卡方统计量G2来检验统计学显著性。首先使用假设正态性的参数检验评估均值的变化，并将结果与Kruskal - Wallis（非参数）检验进行比较。使用Pearson卡方来测量共用场合频率和伙伴选择性的差异。
在本研究的前两年观察到注射风险行为总体下降，包括共用注射器（接受和传递用过的注射器）、共用伙伴数量和共用场合频率的下降。大多数共用者将共用限制在性伙伴和亲密朋友之间。大多数共用者报告总是清洁注射设备。无菌设备的主要来源是药店和注射器交换点。报告了间接共用（勺子、过滤器以及通过前装或后装方式）。自1991年以来，风险行为趋于稳定。
数据表明伦敦的注射吸毒者在风险行为方面有积极的减少。共用注射器的水平大大低于1987年艾滋病意识提高和HIV预防措施引入之前报告的水平。大多数人不共用注射器或将共用限制在亲密朋友和性伙伴之间，并且如果共用会清洁注射器。间接共用的持续存在表明需要更详细的预防信息。虽然共用注射器率的最初下降可能归因于无菌注射设备的广泛可得性和其他预防措施，但现在可能有必要超越当前的干预举措，制定旨在改变共用社交礼仪并朝着长期维持低水平注射风险行为发展的干预措施。
