Effectiveness of sterile needle and syringe programmes
Effectiveness of sterile needle and syringe programmes
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无菌针头和注射器计划的有效性
DOI：
10.1016/j.drugpo.2005.02.004
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发表时间：
2005
影响因子：
4.4
通讯作者：
A. Cooney
中科院分区：
文献类型：
--
作者：
A. Wodak;A. Cooney
这是对针头注射器计划证据的首次全面国际审查。主要的、现在极为有力的发现是，针头注射器计划可以有效、安全且具有成本效益地减少艾滋病毒传播。好处的规模是巨大的。有令人信服的证据表明，针头注射器计划通过减少艾滋病毒危险行为来降低艾滋病毒发病率和艾滋病毒流行率。评估框架采用了布拉德福德希尔标准，通常被认为是评估公共卫生干预措施最稳健的方法。保守地说，布拉德福德希尔的九项标准中有六项得到满足（关联强度、研究结果的重复性、时间顺序、生物学合理性、证据的一致性和类比推理）。布拉德福德希尔标准中的三项未满足（关联特异性、生物梯度和实验证据）。明确满足了另外五项标准（成本效益、无负面后果、实施的可行性、扩展和覆盖面、意想不到的好处以及对特殊人群的适用）。本次审查的结果与由美国政府机构或代表美国政府机构进行的七项已发表的国家审查一致，这些审查此前发现针头注射器计划可有效减少注射吸毒者中的艾滋病毒感染，并且不会增加非法或注射吸毒的使用。受到注射吸毒者艾滋病毒感染影响或威胁的国家应仔细考虑现有的关于针头注射器计划的有效性和安全性的令人信服的证据，以期建立或扩大针头注射器计划的规模。尽管一些研究问题仍未得到解答，并且存在需要改进研究方法的领域，但不能因为缺乏现有证据而未能及时、足够规模地实施针头注射器计划。
This is the first comprehensive international review of the evidence for needle syringe programmes. The major, and now overwhelmingly strong, finding is that needle syringe programmes reduce HIV transmission effectively, safely and cost effectively. The size of the benefit is substantial. There is compelling evidence that needle syringe programmes reduce HIV incidence and HIV prevalence by reducing HIV risk behaviour. The Bradford Hill criteria, generally regarded as the most robust method of assessing public health interventions, were used for the evaluation framework. Conservatively, six of the nine Bradford Hill criteria were fulfilled (strength of association, replication of findings, temporal sequence, biological plausibility, coherence of evidence, and reasoning by analogy). Three of the Bradford Hill criteria were not fulfilled (specificity of association, biological gradient and experimental evidence). Five additional criteria were clearly fulfilled (cost-effectiveness, absence of negative consequences, feasibility of implementation, expansion and coverage, unanticipated benefits, and application to special populations). The findings in this review are consistent with seven published national reviews conducted by, or on behalf of, United States government agencies, which had previously found that needle syringe programmes were effective in reducing HIV infection among injecting drug users and did not increase illicit or injecting drug use. Countries affected or threatened by HIV infection among injecting drug users should carefully consider the convincing evidence now available for the effectiveness and safety of needle syringe programs with a view to establishing or expanding needle syringe programs to scale. Although some research questions still remain unanswered, and areas exist where improved research methodology is needed, the failure to implement needle syringe programmes in time and on a sufficient scale cannot be justified by a lack of available evidence.
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影响因子：
12.7
作者：
DesJarlais,C;Perlis,T;Friedman,SR;Chapman,T;Kwok,J;Rockwell,R;Paone,D;Milliken,J;Monterroso,E
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Monterroso,E
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影响因子：
4.2
作者：
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通讯作者：
Kaplan,E
DOI：
10.1001/jama.1994.03510260053028
发表时间：
1994-01
期刊：
JAMA
影响因子：
--
作者：
D. C. Jarlais;S. R. Friedman;J. L. Sotheran;J. Wenston;M. Marmor;S. Yancovitz;B. Frank;S. Beatrice;D. Mildvan
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D. C. Jarlais;S. R. Friedman;J. L. Sotheran;J. Wenston;M. Marmor;S. Yancovitz;B. Frank;S. Beatrice;D. Mildvan
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DOI：
--
发表时间：
1991
期刊：
JAMA : the journal of the American Medical Association
影响因子：
--
作者：
Nelson,KE;Vlahov,D;Cohn,S;Lindsay,A;Solomon,L;Anthony,JC
通讯作者：
Anthony,JC
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DOI：
10.1111/j.1360-0443.1994.tb00955.x
发表时间：
1994
期刊：
Addiction (Abingdon, England)
影响因子：
--
作者：
Lima,ES;Friedman,SR;Bastos,FI;Telles,PR;Friedmann,P;Ward,TP;desJarlais,DC
通讯作者：
desJarlais,DC