Risking risk: the influence of types of capital and social networks on the injection practices of drug users
Risking risk: the influence of types of capital and social networks on the injection practices of drug users
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DOI：
10.1016/s0277-9536(01)00204-0
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发表时间：
2002-09-01
影响因子：
5.4
通讯作者：
Lovell, AM
中科院分区：
文献类型：
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作者：
Lovell, AM
虽然注射器交换和其他减少危害的干预措施通常可以有效减少注射吸毒者 (IDU) 中血源性病原体的发生率，但在某些情况下，少数 IDU 仍继续从事危险的注射行为。社会流行病学和人类学吸毒研究的新兴观点指出了研究危险行为的基本社会原因或使个人面临危险的因素的重要性，本研究以多层次视角探讨资本形式、社交网络特征和其他背景因素是否影响持续的危险注射行为。我们收集了法国马赛市注射吸毒者的定量和定性数据，该市自 1995 年起无菌注射设备就已合法化并正式推广。在对活跃用户数据的多变量分析中，位于注射吸毒者大型互联网络最密集部分的位置大大增加了危险注射行为的可能性，而低后天文化和经济资本预测这种行为的趋势并不显着。预测这一结果的最强烈的个人特征是非法使用处方药（通常是高剂量丁丙诺啡）和无保护性行为。另一方面，父母在受试者童年期间滥用精神药物，大大降低了从事危险注射行为的机会。此外，定性数据分析表明，危险注射可能与缺乏采购药品的资源有关，而不仅仅是与无菌注射设备不足有关。需要进一步的研究，包括生态模型，以更好地理解基本社会条件与“风险对风险”的关系。然而，公共卫生干预措施已经可以满足社区一级干预措施的需求，同时重新思考由于引入丁丙诺啡和其他阿片类药物依赖药物治疗而导致药物难以获得和意外“泄漏”的后果。 (C) 2002 Elsevier Science Ltd. 保留所有权利。
Although syringe exchange and other harm reduction interventions have generally been effective in reducing bloodborne pathogen incidence among injection drug users (IDUs), in some cases a minority of IDUs continues to engage in risky injection behavior. Building on emerging perspectives in social epidemiology and research on drug use in anthropology that point to the importance of examining fundamental social causes of risk behavior, or what puts individuals at risk for risk, this study used a multilevel perspective to explore whether forms of capital, social network characteristics, and other contextual factors influence continued risky injection behavior. Quantitative and qualitative data were collected on IDUs in the city of Marseilles, France, where sterile injection equipment has been legal and officially promoted since 1995. In multivariate analysis on data concerning active users, location in the densest part of a large, interconnected network of IDUs greatly increased the likelihood of risky injection practices, while there was a non-significant tendency for low Acquired Cultural and Economic Capital to predict this behavior. Among the strongest individual-level characteristics to predict this outcome were illicit use of prescribed medication, generally high dose buprenorphine, and unprotected sex. Parental abuse of psychoactive drugs during the subject's childhood, on the other hand, greatly decreased the chances of engaging in risky injection behavior. Additionally, qualitative data analysis suggests that risky injection may be linked to lack of resources to procure drugs, and not simply to inadequate sterile injection equipment. Further research, including ecological models, is needed to better understand how fundamental social conditions are related to "risk for risk". However, public health interventions can already address the need for community-level interventions, while rethinking the consequences of inaccessible drugs and unintended "leakage" from the introduction of buprenorphine and other medicalized treatments for opiate dependency. (C) 2002 Elsevier Science Ltd. All rights reserved.