Spatial Access to Syringe Exchange Programs and Pharmacies Selling Over-the-Counter Syringes as Predictors of Drug Injectors' Use of Sterile Syringes
Spatial Access to Syringe Exchange Programs and Pharmacies Selling Over-the-Counter Syringes as Predictors of Drug Injectors' Use of Sterile Syringes
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DOI：
10.2105/ajph.2009.184580
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发表时间：
2011-06-01
影响因子：
12.7
通讯作者：
Friedman, Samuel R.
中科院分区：
文献类型：
--
作者：
Cooper, Hannah L. F.;Des Jarlais, Don C.;Friedman, Samuel R.
目标.我们研究了注射器交换计划（SEP）和药店销售非处方（OTC）注射器的空间访问与纽约市药物注射者的危害减少实践的关系。从1995年到2006年，我们每年测量42个城市卫生区的表面积的百分比，这是在1英里的SEP或OTC药房。我们应用分层广义线性模型来研究这些暴露与注射者（n=4003）在过去6个月内至少75%的注射使用无菌注射器的几率之间的关系。1995年，SEP一英里范围内一个地区表面积百分比的自然对数增加1个单位，与使用无菌注射器注射的几率增加26%相关;随着时间的推移，这种暴露增加1个单位，这些几率增加23%。非处方药可及性的自然对数每增加1个单位，这些几率就提高15%。更大的空间获得SEPs和OTC药房提高了注射者参与减少艾滋病毒和HCV传播的减少危害做法的能力。(Am J公共卫生。2011;101：1118-1125。doi：10.2105/AJPH.2009.184580）
Objectives. We examined relationships of spatial access to syringe exchange programs (SEPs) and pharmacies selling over-the-counter (OTC) syringes with New York City drug injectors' harm reduction practices.Methods. Each year from 1995 to 2006, we measured the percentage of 42 city health districts' surface area that was within 1 mile of an SEP or OTC pharmacy. We applied hierarchical generalized linear models to investigate relationships between these exposures and the odds that injectors (n=4003) used a sterile syringe for at least 75% of injections in the past 6 months.Results. A 1-unit increase in the natural log of the percentage of a district's surface area within a mile of an SEP in 1995 was associated with a 26% increase in the odds of injecting with a sterile syringe; a 1-unit increase in this exposure over time increased these odds 23%. A 1-unit increase in the natural log of OTC pharmacy access improved these odds 15%.Conclusions. Greater spatial access to SEPs and OTC pharmacies improved injectors' capacity to engage in harm reduction practices that reduce HIV and HCV transmission. (Am J Public Health. 2011;101:1118-1125. doi:10.2105/AJPH.2009.184580)