van Ameijden E J, van den Hoek A R, Coutinho R A
Department of Public Health and Environment, Amsterdam, The Netherlands.
Am J Public Health. 1994 Feb;84(2):275-81. doi: 10.2105/ajph.84.2.275.
Serial, cross-sectional trends in injecting risk behavior were studied among drug users from 1986 to 1992.
From a cohort study in Amsterdam, 616 intake visits of drug users who had injected in the 6 months preceding intake were selected.
The proportion of drug users who reported borrowing and lending used injection equipment and reusing needles/syringes (in the previous 6 months), continuously declined from 51% to 20%, from 46% to 10% and from 63% to 39%, respectively. In multivariate analysis, it appeared unlikely that a selective recruitment of participants over time was responsible for these trends. Participants, recruited later in time, had been previously tested for human immunodeficiency virus (HIV) more often, had received daily methadone less often, and had obtained a higher proportion of new needles via exchange programs. Indications were found that (1) voluntary HIV testing and counseling leads to less borrowing, lending, and reusing equipment; and (2) obtaining needles via exchange programs leads to less reusing needles/syringes. It appeared that nonattenders of methadone and exchange programs have reduced borrowing and lending to the same extent as attenders.
Methodologically, evaluating specific measures is difficult. However, the combination of various preventive measures in Amsterdam is likely to be responsible for the observed decrease in injecting risk behavior.
研究1986年至1992年间吸毒者注射风险行为的系列横断面趋势。
从阿姆斯特丹的一项队列研究中，选取了在入组前6个月内有注射行为的616名吸毒者的入组访视。
报告（在过去6个月内）借用和出借用过的注射器具以及重复使用针头/注射器的吸毒者比例分别从51%持续下降至20%、从46%降至10%、从63%降至39%。在多变量分析中，随着时间推移参与者的选择性招募不太可能是导致这些趋势的原因。较晚入组的参与者之前更频繁地接受过人类免疫缺陷病毒（HIV）检测，较少接受每日美沙酮治疗，并且通过交换项目获得新针头的比例更高。有迹象表明：（1）自愿HIV检测和咨询导致借用、出借和重复使用器具的行为减少；（2）通过交换项目获取针头导致重复使用针头/注射器的行为减少。似乎未参加美沙酮和交换项目的人与参加者在减少借用和出借行为方面程度相同。
在方法上，评估具体措施存在困难。然而，阿姆斯特丹多种预防措施的结合可能是观察到的注射风险行为下降的原因。
