Harvey E, Strathdee S A, Patrick D M, Ofner M, Archibald C P, Eades G, O'Shaughnessy M V
St. Paul's Hospital, Vancouver, Canada.
AIDS Care. 1998 Jun;10(3):313-21. doi: 10.1080/713612412.
The proportion of injection drug users (IDUs) testing positive for Human Immunodeficiency Virus (HIV) in British Columbia has increased from 3 to 7% since January 1993 (Patrick et al., 1997). We conducted a qualitative study as a first step in a case control investigation aimed at identifying risk factors associated with HIV seroconversion. Sixteen subjects participated in in-depth interviews which were transcribed and analysed using grounded theory methods. Three dominant themes emerged: Addiction, Prevention, and Social Determinants. The results suggest that prevention efforts such as the availability of clean needles and condoms are not adequate to combat the complex social determinants of addiction--be they causal or consequential--which in turn contribute to unsafe injection practices.
自1993年1月以来，不列颠哥伦比亚省注射吸毒者（IDU）中检测出人类免疫缺陷病毒（HIV）呈阳性的比例已从3%升至7%（帕特里克等人，1997年）。作为病例对照调查的第一步，我们开展了一项定性研究，旨在确定与HIV血清转化相关的风险因素。16名受试者参与了深度访谈，访谈内容经转录后采用扎根理论方法进行分析。出现了三个主要主题：成瘾、预防和社会决定因素。结果表明，诸如提供清洁针头和避孕套等预防措施不足以应对成瘾这一复杂的社会决定因素——无论是因果关系还是后果关系——而这些因素反过来又导致了不安全的注射行为。
