Kübler D, Hausser D, Joye D
Institut de recherche sur I'environnement construit Département d'architecture, Ecole polytechnique fédérale de Lausanne.
Soz Praventivmed. 1996;41 Suppl 1:S96-104. doi: 10.1007/BF01318593.
A legal context that classifies the consumption of heroin and cocaine as an illegal act, poses a considerable methodological challenge to research on users of these substances. This is in particular the case for research on those users who are not in treatment and, therefore, cannot be recruited through treatment settings. In a research project on heroin and/or cocaine users outside treatment settings, a sample of 917 individuals was recruited through "Privileged Access Interviewers" in the whole of Switzerland. In the first part of this article, we discuss matters of reliability as well as of validity concerning this method of data collection. In the second part of the article, we discuss the use of low threshold syringe exchange schemes by the user groups represented in the sample. Only intravenous drug users frequent those services - they are however a minority in the sample (n = 238). In several regions of Switzerland syringe exchange schemes do not exist. Where they do exist, they appear to correspond to a need which they are able to cover largely. In the regions without such services, intravenous drug users get their supply of syringes more frequently from pharmacies. However, pharmacies do not compensate the absence of specific syringe exchange schemes. In regions without such schemes, injections with used syringes are more frequent. Thus, regarding Aids-Prevention, there is an urgent need to develop syringe exchange schemes in all parts of the country.
将海洛因和可卡因的使用归类为违法行为的法律背景，给这些物质使用者的研究带来了相当大的方法学挑战。对于那些未接受治疗、因此无法通过治疗机构招募的使用者的研究而言，情况尤其如此。在一项针对治疗机构以外的海洛因和/或可卡因使用者的研究项目中，通过“特许访问访谈员”在瑞士全国招募了917名个体作为样本。在本文的第一部分，我们讨论了这种数据收集方法的可靠性和有效性问题。在本文的第二部分，我们讨论了样本中所代表的用户群体对低门槛注射器交换计划的使用情况。只有静脉注射吸毒者会频繁光顾这些服务——然而他们在样本中占少数（n = 238）。在瑞士的几个地区不存在注射器交换计划。在存在此类计划的地方，它们似乎满足了一种需求，并且能够在很大程度上覆盖这种需求。在没有此类服务的地区，静脉注射吸毒者更频繁地从药店获取注射器供应。然而，药店无法弥补特定注射器交换计划的缺失。在没有此类计划的地区，使用用过的注射器注射的情况更为频繁。因此，在预防艾滋病方面，迫切需要在该国所有地区开展注射器交换计划。
