Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada
Social determinants predict needle-sharing behaviour among injection drug users in Vancouver, Canada
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DOI：
10.1046/j.1360-0443.1997.9210133910.x
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发表时间：
1997-10-01
期刊：
影响因子：
6
通讯作者：
OShaughnessy, MV
中科院分区：
文献类型：
--
作者：
Strathdee, SA;Patrick, DM;OShaughnessy, MV
尽管温哥华早在1988年就实行了针头交换，但共用针头仍然很普遍。进行了一项分析，以确定参与病例对照研究的受试者中借用使用过的针头的决定因素。注射吸毒者在1994年1月1日之后有记录的艾滋病毒血清转换（n = 89），或在该日期之后反复检测艾滋病毒血清阴性（n = 192）。由访谈者填写的调查问卷侧重于吸毒、性行为、针头来源和抑郁症。被试者被问到他们在儿童、青年或成年时是否“曾经被迫发生性行为”。Logistic回归确定了借用针头的决定因素。在控制HIV血清状态后，与借贷独立相关的因素是注射> 4次/天、多种药物使用和曾经经历过非自愿性行为（AOR = 3.4，95%CI：1.8，6.5）。抑郁症与借贷有关，尽管不是独立的。同性恋活动与男性的借贷独立相关，而与性伴侣生活是女性的独立预测因素。清洁针头使用的获得或障碍与借贷无关。社会决定因素，特别是性虐待史，是温哥华注射吸毒者中最重要的针头借用预测因素。及早查明这些因素应成为艾滋病毒预防方案的一个组成部分。
Despite the fact that needle exchange was introduced in Vancouver as early as 1988, needle sharing remains common. An analysis was conducted to identify determinants of borrowing used needles among subjects participating in a case-control study. IDUs had a documented HIV seroconversion after 1 January, 1994 (n = 89), or repeatedly tested HIV-seronegative after this date (n = 192). Interviewer-administered questionnaires focused on drug use, sexual behaviours, source of needles and depression. Subjects were asked if they had ''ever been forced to have sex'' as a child, youth or adult. Logistic regression identified determinants of borrowing needles. After controlling for HIV serostatus, factors independently associated with borrowing were injecting > 4 times/day, polydrug use, and ever experiencing non-consensual sex (AOR = 3.4, 95% CI: 1.8, 6.5). Depression was associated with borrowing, although not independently so. Homosexual activity was independently associated with borrowing among males, whereas living with a sexual partner was an independent predictor for females. Access or barriers to clean needle use were not associated with borrowing. Social determinants, particularly a history of sexual abuse, are among the most significant predictors of needle borrowing among Vancouver's IDUs. Early identification of these factors should be a component of HIV prevention programmes.