Safer injection facilities in North America: Their place in public policy and health initiatives
Safer injection facilities in North America: Their place in public policy and health initiatives
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DOI：
10.1177/002204260203200113
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发表时间：
2002-12-01
影响因子：
1.7
通讯作者：
Altice, FL
中科院分区：
文献类型：
--
作者：
Broadhead, RS;Kerr, TH;Altice, FL
在美国和加拿大，艾滋病毒、丙型肝炎病毒、药物过量和其他与注射有关的健康问题构成的持续威胁表明，需要进一步开发针对吸毒者的创新干预措施，以降低疾病和死亡率，并将注射者纳入药物治疗和其他保健计划。政府批准的“更安全的注射设施”(SLF)是世界上许多国家在提供注射器的一系列公共卫生项目中增加的一项服务。除了针头交换计划、街头推广和其他服务外，SLF显然是许多国家市政当局推行的规模更大的综合公共卫生倡议的补充。对现有研究文献的调查，以及作者对在西欧运营的18个SLF和最近在澳大利亚悉尼开设的一个SIF的人种学观察表明，SLF针对的是针头交换、街道推广和其他传统服务未能解决的几个问题：(1)降低公共场所的注射吸毒率和相关风险；(2)让注射器更直接、更及时地接触医疗、药物治疗、咨询和其他社会服务；(3)减少注射者在公共场所丢弃的垃圾的数量，并减少对公共空间的征用。根据证据，现在是时候让北美更多的市政当局开始考虑SLF在公共政策和卫生倡议中的地位，并为在注射吸毒社区运作的SIF的受控实地试验和示范项目提供支持。
The continuing threat posed by HIV, HCV, drug overdose, and other injection-related health problems in both the United States and Canada indicates the need for further development of innovative interventions for drug injectors, for reducing disease and mortality rates, and for enrolling injectors into drug treatment and other health care programs. Governmentally sanctioned "safer injection facilities" (SlFs) are a service that many countries around the world have added to the array of public health programs they offer injectors. In addition to needle exchange programs, street-outreach and other services, SlFs are clearly additions to much larger comprehensive public health initiatives that municipalities pursue in many countries. A survey of the existing research literature, plus the authors' ethnographic observations of 18 SlFs operating in western Europe and one SIF that was recently opened in Sydney, Australia, suggest that SlFs target several problems that needle exchange, street-outreach, and other conventional services fall short in addressing: (1) reducing rates of drug injection and related-risks in public spaces; (2) placing injectors in more direct and timely contact with medical care, drug treatment, counseling, and other social services; (3) reducing the volume of injectors' discarded litter in, and expropriation of, public spaces. In light of the evidence, the time has come for more municipalities within North America to begin considering the place of SlFs in public policy and health initiatives, and to provide support for controlled field trials and demonstration projects of SIFs operating in injection drug-using communities.