Data and public health decision making on HIV prevention in injection drug users.
Data and public health decision making on HIV prevention in injection drug users.
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关于注射吸毒者艾滋病毒预防的数据和公共卫生决策。
DOI：
10.1007/s11524-008-9281-z
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发表时间：
2008
期刊：
影响因子：
--
通讯作者：
DesJarlais,DonC
中科院分区：
文献类型：
--
作者：
DesJarlais,DonC
在这个问题上，Neaigus等人1提出了有趣的数据，比较了来自新泽西州纽瓦克和纽约市的注射毒品使用者（IDUs）的注射器具来源、注射风险行为、人类免疫缺陷病毒（HIV）流行率、丙型肝炎病毒（HCV）流行率和风险行为。纽瓦克距离纽约市仅16公里，但在收集数据时，这两个城市在获得注射毒品的无菌注射设备方面的环境截然不同。在收集数据时（2004-2006年），纽约市既有大规模的注射器交换计划，也有扩大注射器获取计划，通过该计划，吸毒者可以在没有处方的情况下合法地在药店购买针头和注射器，而纽瓦克既没有注射器交换，也没有法律的药店购买。不出所料，纽瓦克的注射吸毒者从有保证的安全来源获得针头和注射器的可能性要小得多（交易所和药房;校正比值比[AOR]= 0.004，95%置信区间[CI]= 0.001至0.01），更有可能报告接受注射器共享（AOR= 2.3，95%CI = 1.1至5.0），更可能是HIV血清阳性（AOR= 3.2，95%CI = 1.6至6.1），更可能是HCV血清阳性（AOR= 3.0，95%CI = 1.8至4.9）。这些数据应该被视为20世纪90年代中期纽约市注射器交换计划法律的扩展所出现的差异的延续。在1996年的一项研究中，在纽约/新泽西大都市地区，参加交易所的注射吸毒者与未参加交易所的注射吸毒者之间艾滋病毒发病率的调整风险比为3.5（95% CI= 1.3至9.1）。2正如Neaigus等人的文章所指出的，1新泽西最近通过了一项法律，允许该州最多6个注射器交换项目。这项法律包括额外的1000万美元用于该州的药物滥用治疗计划，但不包括任何用于注射器交换计划的资金。截至2008年3月，新泽西的注射器交换计划陷入困境。只有三家开业，只有一个项目--大西洋城--吸引了大量客户。[3]大西洋城的项目资金相对充足，还得到了当地艾滋病服务组织的额外支持，并利用了附近一个药物治疗项目的工作人员。新泽西的大多数项目都在苦苦挣扎，这也不足为奇。除了启动困难外，缺乏公共资金与美国注射器交换计划提供的注射器交换和服务减少密切相关。第五、六条
In this issue, Neaigus et al. 1 present interesting data comparing sources of injection equipment, injecting risk behavior, human immunodeficiency virus (HIV) prevalence, hepatitis C virus (HCV) prevalence, and risk behavior among injecting drug users (IDUs) from Newark, NJ, and New York City. Newark is only 10 mi (16 km) from New York City, but at the time of data collection, the two cities had radically different environments with respect to obtaining sterile injection equipment for injecting drugs. At the time of data collection (2004–2006), New York City had both large-scale syringe exchange programs and the Expanded Syringe Access Program through which drug users can legally purchase needles and syringes at pharmacies without a prescription, while Newark had neither syringe exchange nor legal pharmacy purchase.As expected, IDUs in Newark were much less likely to obtain needles and syringes from guaranteed safe sources (exchanges and pharmacies; adjusted odds ratio [AOR]= 0.004, 95% confidence interval [CI]= 0.001 to 0.01), much more likely to report receptive syringe sharing (AOR= 2.3, 95% CI= 1.1 to 5.0), much more likely to be HIV seropositive (AOR= 3.2, 95% CI= 1.6 to 6.1), and much more likely to be HCV seropositive (AOR= 3.0, 95% CI= 1.8 to 4.9). These data should be seen as a continuation of differences that emerged with the legal expansion of syringe exchange programs in New York City in the mid-1990s. In a 1996 study, the adjusted hazard ratio of HIV incidence among IDUs attending the exchanges compared to IDUs not attending exchanges in the New York/New Jersey metropolitan area was 3.5 (95% CI= 1.3 to 9.1). 2 As noted in the article of Neaigus et al., 1 New Jersey recently passed a law permitting up to six syringe exchange programs in the state. This law included an extra $10 million for drug abuse treatment programs in the state but did not include any funding for syringe exchange programs. As of March 2008, the New Jersey syringe exchange programs were struggling. Only three had opened, and only one program—Atlantic City—was attracting large numbers of clients. 3 The Atlantic City program was relatively well funded, had additional support from a local acquired immunodeficiency syndrome (AIDS) service organization, and was utilizing staff from a nearby drug treatment program. 4 That most of the New Jersey programs were struggling is also not surprising. In addition to the startup difficulties, the lack of public funding is strongly associated with both fewer syringes exchanged and fewer services offered by syringe exchange programs in the USA. 5, 6
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影响因子：
158.5
作者：
S. O. C. Hristin;P. Hilippe;B. Ouchard;I. R. M. S. Pitz
通讯作者：
I. R. M. S. Pitz
影响因子：
--
作者：
Kerr, T;Stoltz, JA;Wood, E
通讯作者：
Wood, E
预防艾滋病毒危险行为的干预措施。
DOI：
--
发表时间：
1997
期刊：
NIH consensus statement
影响因子：
--
作者：
R. Coutinho;W. Cates
通讯作者：
W. Cates
影响因子：
14.6
作者：
Wood, E;Kerr, T;Tyndall, MW
通讯作者：
Tyndall, MW
需要在非法药物使用领域促进公共卫生
影响因子：
14.6
作者：
M. Wainberg
通讯作者：
M. Wainberg