de la Fuente L, Barrio G, Royuela L, Bravo M J
Delegación del Gobierno para el Plan Nacional sobre Drogas, Madrid.
Addiction. 1997 Dec;92(12):1749-63.
To measure the current prevalence of different routes of heroin administration among users and to describe the most frequent patterns in the evolution of the main route from the time of first use to the present and their implications for the control of the HIV epidemic.
Cross-sectional study. Face-to-face interviews using a structured questionnaire.
Nine hundred and nine regular heroin users from Madrid, Barcelona and Seville (about 300 per city), half of them recruited in treatment centres and the other half out of treatment.
Socio-demographic characteristics, current and historical behaviours related to route of administration.
Before 1980 injection was the first main route of heroin administration for most users in Barcelona and Madrid; in Seville smoking already predominated, although 40% of users began by injecting. Sniffing subsequently became predominant in Barcelona, while smoking became the predominant first route in Madrid and Seville (smoking has been the only first route in Seville since 1991). The prevalence of injection as the main route of administration during the last 30 days was 77.3% in Barcelona, 24.3% in Madrid and 23.9% in Seville; smoking predominated in the latter two cities. The factors most strongly associated with injection as the preferred route were city of recruitment and having a partner who injected. Some 73% of those who stopped injecting in their last change of route stated that the results of their HIV test or fear of becoming infected had been important in making this decision.
The change from injecting to smoking will greatly facilitate the control of HIV infection in Spain. However, the main causal factor does not appear to be the perception of HIV risk, but rather other, ecological factors (cultural or market-related). The absence of these factors in some areas may impede the spread of smoking.
测定海洛因使用者中不同给药途径的当前流行情况，并描述从首次使用到现在主要给药途径演变过程中最常见的模式及其对艾滋病毒疫情控制的影响。
横断面研究。使用结构化问卷进行面对面访谈。
来自马德里、巴塞罗那和塞维利亚的909名海洛因常规使用者（每个城市约300名），其中一半在治疗中心招募，另一半未接受治疗。
社会人口学特征、与给药途径相关的当前和历史行为。
1980年以前，注射是巴塞罗那和马德里大多数使用者的首要主要给药途径；在塞维利亚，吸食已经占主导地位，尽管40%的使用者从注射开始。随后，在巴塞罗那，鼻吸成为主要方式，而在马德里和塞维利亚，吸食成为首要主要途径（自1991年以来，吸食一直是塞维利亚唯一的首要主要途径）。在过去30天内，注射作为主要给药途径的流行率在巴塞罗那为77.3%，在马德里为24.3%，在塞维利亚为23.9%；后两个城市以吸食为主。与选择注射作为首选途径最密切相关的因素是招募城市以及有注射的伴侣。在最后一次改变给药途径时停止注射的人中，约73%表示他们的艾滋病毒检测结果或对感染的恐惧在做出这一决定中起到了重要作用。
从注射到吸食的转变将极大地促进西班牙对艾滋病毒感染的控制。然而，主要的因果因素似乎不是对艾滋病毒风险的认知，而是其他生态因素（文化或与市场相关的因素）。某些地区缺乏这些因素可能会阻碍吸食的传播。
