Adherence to hepatitis B virus vaccination at syringe exchange sites
Adherence to hepatitis B virus vaccination at syringe exchange sites
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DOI：
10.1093/jurban/jti016
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发表时间：
2005-03-01
影响因子：
6.6
通讯作者：
Buitrago, MI
中科院分区：
文献类型：
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作者：
Altice, FL;Bruce, RD;Buitrago, MI
注射毒品使用者（IDUs）感染B型肝炎病毒（HBV）的风险很高;然而，他们往往没有接受预防性疫苗接种。在纽黑文，使用与注射器交换方案相关的移动的卫生保健服务的注射吸毒者定期接受HBV、丙型肝炎病毒和梅毒筛查。没有暴露于HBV的个体被提供了三部分疫苗接种系列。在212名接受HBV感染筛查的ID Us中，134名（63%）符合接种条件（HBV表面和核心抗体阴性），10名（4.7%）有慢性HBV感染的证据。与既往暴露于HBV的患者相比，符合疫苗接种条件的患者更有可能是年轻人，使用海洛因，黑人，无家可归者，每日注射者和可卡因使用者的可能性更小。在134名符合疫苗接种条件的受试者中，103名（77%）和89名（66%）分别完成了两次和三次疫苗接种。完成所有三种疫苗接种的相关因素包括年龄较大（OR = 1.06，95%CI = 1.04-1.07），每天注射（OR = 2.12，95%CI = 1.36-6.73）和无家可归（OR = 1.98，95%CI = 1.14-12.27）。这些结果表明，注射吸毒者仍然是获得HBV感染的高风险。将医疗保健与注射器交换计划联系起来的计划是向注射吸毒者提供预防性医疗保健服务，特别是乙型肝炎疫苗接种的有效途径。这种方案所产生的信任和相互尊重，使活跃的注射吸毒者在一段时间内一再相遇。
Injection drug users (IDUs) are at high risk for hepatitis B virus (HBV); however; they often do not receive preventive vaccination. IDUs who use mobile health care services linked to a syringe exchange prokrain in New Haven were routinely screened for HBV, hepatitis C virus, and syphilis. Individuals without prior exposure to HBV were offered three-part vaccination series. Of the 212 ID Us screened for HBV infection, 134 (63%) were eligible (negative for HBV surface and core antibodies) for vaccination and 10 (4.7%) had evidence of chronic HBV infection. Compared to those with previous exposure to HBV, vaccine-eligible patients were significantly more likely to be younger and use heroin and less likely to be black, homeless, daily injectors, and cocaine users. Of the 134 vaccine-eligible subjects, 103 (77%) and 89 (66%) completed two and three vaccinations, respectively. Correlates of completing all three vaccinations included older age (OR = 1.06, 95% CI = 1.04-1.07), injecting daily (OR = 2.12, 95% CI = 1.36-6.73), and being homeless (OR = 1.98, 95% CI = 1.14-12.27). These results suggest that IDUs remain at high risk for acquiring HBV infection. Programs that link health care to a syringe exchange program are effective ways to provide preventive health care services to IDUs, particularly HBV vaccination. Trust engendered by and mutual respect afforded by such programs result in repeated encounters by active IDUs over time.