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为每位吸毒者提供无菌注射器:每年会发生多少次注射,药剂师如何为注射器分发做出贡献?

A sterile syringe for every drug user injection: how many injections take place annually, and how might pharmacists contribute to syringe distribution?

作者信息

Lurie P, Jones T S, Foley J

机构信息

University of California, San Francisco, USA.

出版信息

J Acquir Immune Defic Syndr Hum Retrovirol. 1998;18 Suppl 1:S45-51. doi: 10.1097/00042560-199802001-00009.

Abstract

Our objectives were to estimate the annual number of injections by injection drug users (IDUs) in the United States of America, and to describe the potential role of pharmacists in providing IDUs with a sterile syringe for every injection. We estimated the number of annual injections by IDUs for the United States, selected U.S. states, and selected U.S. cities according to the following formula: number of injections per year = (number of IDUs) x (average number of injections per IDU per day) x 365. Data were obtained from published articles, personal communications with local experts, and selected national databases. We also reviewed published and unpublished studies of pharmacy kits, pharmacist attitudes, and pharmacist practices in the United States and abroad. Between 920 million and 1.7 billion injections by IDUs take place each year in the United States. We estimated 12 million injections per year in San Francisco and >80 million in New York City. A similar number of syringes would be needed to satisfy the goal of a sterile syringe for every injection. Pharmacy-based strategies, including the sale of kits for injection drug use, have provided sterile syringes to IDUs in Europe, Australia, and New Zealand. Modification of laws restricting syringe purchase and possession has led to marked increases in purchase of syringes from pharmacies and reductions in needle-sharing. In conclusion, large numbers of syringes would be required to provide a sterile syringe for every injection, but significant numbers of pharmacists seem to be willing to play a central role in syringe sale and distribution. Outreach programs should emphasize that using a sterile syringe for every injection is the optimal HIV prevention practice for IDUs who cannot or will not stop injecting. Pharmacy-based syringe sale or distribution has the potential to augment current efforts to prevent HIV infection in IDUs, their sex partners, and their children.

摘要

我们的目标是估算美国注射吸毒者(IDU)每年的注射次数,并描述药剂师在为每位IDU每次注射提供无菌注射器方面可能发挥的作用。我们根据以下公式估算了美国、美国选定的州以及美国选定城市中IDU每年的注射次数:每年注射次数 = (IDU数量)×(每位IDU每天平均注射次数)×365。数据来源于已发表的文章、与当地专家的个人交流以及选定的国家数据库。我们还查阅了美国国内外关于药房套件、药剂师态度和药剂师实践的已发表和未发表的研究。在美国,IDU每年进行9.2亿至17亿次注射。我们估计旧金山每年有1200万次注射,纽约市每年超过8000万次。要实现每次注射都使用无菌注射器的目标,所需注射器数量与此相近。基于药房的策略,包括销售注射吸毒用品套件,已在欧洲、澳大利亚和新西兰为IDU提供了无菌注射器。放宽限制注射器购买和持有量的法律,使得从药房购买注射器的数量显著增加,共用针头的情况减少。总之,要为每次注射都提供无菌注射器,将需要大量注射器,但相当数量的药剂师似乎愿意在注射器销售和分发中发挥核心作用。外展项目应强调,对于无法或不愿停止注射的IDU来说,每次注射都使用无菌注射器是预防艾滋病的最佳做法。基于药房的注射器销售或分发有潜力加强目前在预防IDU及其性伴侣和子女感染艾滋病方面所做的努力。

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