Doing harm reduction better: syringe exchange in the United States
Doing harm reduction better: syringe exchange in the United States
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DOI：
10.1111/j.1360-0443.2008.02465.x
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发表时间：
2009-09-01
期刊：
影响因子：
6
通讯作者：
Purchase, David
中科院分区：
文献类型：
--
作者：
Des Jarlais, Don C.;McKnight, Courtney;Purchase, David
目的跟踪注射器交换计划（SEPs）在美国的增长，自1994-95年以来，并评估SEPs的现状。MethodsAnnual survey of US SEPs known to North American Syringe Exchange Network（NASEN）。向执行主任邮寄调查表，并通过电话和/或电子邮件进行后续访谈。自1996年开始调查以来，答复率在70%和88%之间变化。结果NASEN已知的项目数量从1994-95年的68个增加到2007年的186个。在参与调查的方案中，交换注射器的数量从每年800万增加到每年2950万，年度预算总额从630万美元增加到1960万美元，公共资金（来自州和地方政府）从390万美元增加到1440万美元。2007年，89%的计划允许二次交换，76%的计划鼓励二次交换。除了基本的注射器交换外，最常见的服务包括咨询、转介药物滥用治疗、人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）、B型肝炎病毒（HBV）咨询和检测以及纳洛酮过量。这些服务中的每一个都是由40%或更多的SEPs在2007.ConclusionsWhile注射器交换在美国仍然存在争议，有非常大的增长，在项目数量，注射器交换和项目预算。利用二次交换接触大量注射毒品使用者和利用SEPs作为提供基本注射器交换以外的卫生和社会服务的新平台，是美国SEPs增长的两个主要组织战略。
ObjectiveTo trace the growth of syringe exchange programs (SEPs) in the United States since 1994-95 and assess the current state of SEPs.MethodsAnnual surveys of US SEPs known to North American Syringe Exchange Network (NASEN). Surveys mailed to executive directors with follow-up interviews by telephone and/or e-mail. Response rates have varied between 70% and 88% since surveys were initiated in 1996.ResultsThe numbers of programs known to NASEN have increased from 68 in 1994-95 to 186 in 2007. Among programs participating in the survey, numbers of syringes exchanged have increased from 8.0 million per year to 29.5 million per year, total annual budgets have increased from $6.3 to $19.6 million and public funding (from state and local governments) has increased from $3.9 to $14.4 million. In 2007, 89% of programs permitted secondary exchange and 76% encouraged it. Condoms, referrals to substance abuse treatment, human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV) counseling and testing and naloxone for overdose were among the most commonly provided services in addition to basic syringe exchange. Each of these services was provided by 40% or more of SEPs in 2007.ConclusionsWhile syringe exchange has remained controversial in the United States, there has been very substantial growth in numbers of programs, syringes exchange and program budgets. Utilizing secondary exchange to reach large numbers of injecting drug users and utilizing SEPs as a new platform for providing health and social services beyond basic syringe exchange have been the two major organizational strategies in the growth of SEPs in the United States.