Examining risk behavior and syringe coverage among people who inject drugs accessing a syringe services program: A latent class analysis
Examining risk behavior and syringe coverage among people who inject drugs accessing a syringe services program: A latent class analysis
复制标题
DOI：
10.1016/j.drugpo.2020.102716
复制
发表时间：
2020-04-01
影响因子：
4.4
通讯作者：
Feaster, Daniel J.
中科院分区：
文献类型：
--
作者：
Bartholomew, Tyler S.;Tookes, Hansel E.;Feaster, Daniel J.
1.注射吸毒仍然是一个重大的公共卫生问题。IDU与阿片类药物危机密切相关;在全国范围内驾驶过量，HIV和丙型肝炎（HCV）感染。注射器服务项目（SSP）仍然是关键的循证干预措施，以减少伤害并吸引注射毒品人群（PWID）。本研究的目的是提供从IDEA SSP，第一个法律的SSP在佛罗里达州的政策考虑。方法：我们进行了一个潜在的类分析的参与者（N = 982）新登记的注射器服务计划（SSP）之间的物质使用模式。使用R3 STEP和BCH三步程序在潜在类regression.Results中分析了物质使用类别与社会人口学变量、危险注射和性行为、HIV/HCV状态和注射器覆盖率之间的关联：我们发现了三个类解决方案：海洛因主导类（73.9%）、甲基苯丙胺主导类（9.5%）和海洛因/可卡因类（16.6%）。与海洛因主导类相比，海洛因/可卡因类更有可能报告无家可归，分享工作，无保护的性行为，公共注射和HCV阳性。与海洛因主导和海洛因/可卡因类别相比，甲基苯丙胺主导类别更有可能是男性，西班牙裔，同性恋或双性恋取向，HIV阳性，报告无保护性行为和与PWID发生性行为。此外，最低和最高的注射器覆盖率是在海洛因/可卡因和甲基苯丙胺为主的classes.Conclusion：现有的干预措施，在这一人群中，以减轻传染病的风险，如SSP，可以用来从事不同的PWID人群。然而，需要多组分，有针对性的预防干预措施和基于需求的注射器分配政策，以进一步降低各种PWID人群中的艾滋病毒和HCV风险。
Introduction: Injection drug use (IDU) remains a significant public health problem. IDU has been associated closely with the opioid crisis; driving overdose, HIV, and Hepatitis C (HCV) infection nationwide. Syringe services programs (SSPs) remain pivotal evidence-based interventions to reduce harm and engage subgroups of people who inject drugs (PWID). This study aims to provide policy considerations from the IDEA SSP, the first legal SSP in the state of Florida.Methods: We performed a latent class analysis on patterns of substance use among participants (N = 982) newly enrolled in a syringe services program (SSP). Associations between classes of substance use and sociodemographic variables, risky injection and sex behaviors, HIV/HCV status and syringe coverage were analyzed using the R3STEP and BCH 3-step procedures in latent class regression.Results: We found a three-class solution: Heroin-Dominant class (73.9%), Methamphetamine-Dominant class (9.5%) and Heroin/Cocaine class (16.6%). Compared to Heroin-Dominant class, the Heroin/Cocaine class were more likely to report homelessness, sharing works, unprotected sex, public injection, and to be HCV positive. Compared to both Heroin-Dominant and Heroin/Cocaine classes, the Methamphetamine-Dominant class were more likely to be male, Hispanic, gay or bisexual orientation, HIV positive, to report unprotected sex and sex with PWID. In addition, the lowest and highest syringe coverage were among those in the Heroin/Cocaine and Methamphetamine-Dominant classes, respectively.Conclusion: Existing interventions among this population to mitigate infectious disease risk, such as SSPs, can be a used to engage differing PWID populations. However, multi-component, targeted preventive interventions and need-based syringe distribution policies are required to further reduce HIV and HCV risk among various PWID populations.