Association of spatial proximity to fixed-site syringe services programs with HCV serostatus and injection equipment sharing practices among people who inject drugs in rural New England, United States.
Association of spatial proximity to fixed-site syringe services programs with HCV serostatus and injection equipment sharing practices among people who inject drugs in rural New England, United States.
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DOI：
10.1186/s12954-023-00916-5
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发表时间：
2024-01-28
影响因子：
4.4
通讯作者：
Friedmann, Peter D.
中科院分区：
文献类型：
--
作者：
Romo, Eric;Stopka, Thomas J.;Jesdale, Bill M.;Wang, Bo;Mazor, Kathleen M.;Friedmann, Peter D.
关键词：
丙型肝炎病毒 (HCV) 对卫生服务地理分散的农村社区影响尤为严重。目前尚不清楚接近注射器服务计划 (SSP) 是否与农村注射吸毒者 (PWID) 中的丙型肝炎病毒感染有关。数据来自从新罕布什尔州、佛蒙特州和马萨诸塞州（2018-2019 年）农村县招募的过去 30 天内报告注射毒品的成年人的横截面样本。我们计算了每个参与者的地址和最近的固定站点 SSP 之间的路网距离，分为≤≤1 英里、1-3 英里、3-10 英里和≥10 英里。工作人员进行了 HCV 抗体检测，并进行了一项调查，评估了过去 30 天的注射设备共享做法：借用用过的注射器、借用其他用过的注射设备以及重新装填。混合效应修正泊松回归估计患病率 (aPR) 和 95% 置信区间 (95% CI)。分析还按交通方式进行了分层。在 330 名吸毒者中，25% 的人居住在距离最近的 SSP ≤ 1 英里的地方，17% 的人居住在距离 SSP 1-3 英里的地方，12% 的人居住在距离 SSP 3-10 英里的地方，46% 的人居住在距离 SSP 距离≥10 英里的地方。在多变量模型中，与居住在距离 SSP 1 英里以内的注射吸毒者相比，居住在 3 至 10 英里之外的注射吸毒者的 HCV 血清阳性患病率更高（aPR：1.25，95% CI 1.06–1.46）、借用其他二手注射设备（aPR：1.23，95% CI 1.04–1.46）和回装（aPR： 1.48，95% CI 1.17–1.88）。对于居住在距 SSP>10 英里的吸毒者中也观察到了类似的结果：aPR [HCV]：1.19，95% CI 1.01–1.40； aPR [借用其他二手设备]：1.45，95% CI 1.29–1.63； aPR [回载]：1.59，95% CI 1.13–2.24。居住在 SSP 1 至 3 英里范围内与每个结果之间的关联并未达到统计显着性。当按交通方式分层时，仅在通过其他方式出行（相对于乘汽车出行）的吸毒者中观察到到 SSP 的距离与每个结果（借用其他使用过的注射设备除外）之间的关联。在新英格兰农村地区的注射吸毒者中，居住地离固定地点 SSP 较远与 HCV 血清阳性率较高、借用其他用过的注射设备和回装有关，因此需要增加农村地区 SSP 的可及性。交通方式可能会改变这种关系。在线版本包含可在 10.1186/s12954-023-00916-5 获取的补充材料。
Hepatitis C virus (HCV) disproportionately affects rural communities, where health services are geographically dispersed. It remains unknown whether proximity to a syringe services program (SSP) is associated with HCV infection among rural people who inject drugs (PWID). Data are from a cross-sectional sample of adults who reported injecting drugs in the past 30 days recruited from rural counties in New Hampshire, Vermont, and Massachusetts (2018–2019). We calculated the road network distance between each participant’s address and the nearest fixed-site SSP, categorized as ≤ 1 mile, 1–3 miles, 3–10 miles, and > 10 miles. Staff performed HCV antibody tests and a survey assessed past 30-day injection equipment sharing practices: borrowing used syringes, borrowing other used injection equipment, and backloading. Mixed effects modified Poisson regression estimated prevalence ratios (aPR) and 95% confidence intervals (95% CI). Analyses were also stratified by means of transportation. Among 330 PWID, 25% lived ≤ 1 mile of the nearest SSP, 17% lived 1–3 miles of an SSP, 12% lived 3–10 miles of an SSP, and 46% lived > 10 miles from an SSP. In multivariable models, compared to PWID who lived within 1 mile of an SSP, those who lived 3 to 10 miles away had a higher prevalence of HCV seropositivity (aPR: 1.25, 95% CI 1.06–1.46), borrowing other used injection equipment (aPR: 1.23, 95% CI 1.04–1.46), and backloading (aPR: 1.48, 95% CI 1.17–1.88). Similar results were observed for PWID living > 10 miles from an SSP: aPR [HCV]: 1.19, 95% CI 1.01–1.40; aPR [borrowing other used equipment]:1.45, 95% CI 1.29–1.63; and aPR [backloading]: 1.59, 95% CI 1.13–2.24. Associations between living 1 to 3 miles of an SSP and each outcome did not reach statistical significance. When stratified by means of transportation, associations between distance to SSP and each outcome (except borrowing other used injection equipment) were only observed among PWID who traveled by other means (versus traveled by automobile). Among PWID in rural New England, living farther from a fixed-site SSP was associated with a higher prevalence of HCV seropositivity, borrowing other used injection equipment, and backloading, reinforcing the need to increase SSP accessibility in rural areas. Means of transportation may modify this relationship. The online version contains supplementary material available at 10.1186/s12954-023-00916-5.
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DOI：
10.1186/1479-5868-9-124
发表时间：
2012-10-16
期刊：
The international journal of behavioral nutrition and physical activity
影响因子：
--
作者：
Gropp KM;Pickett W;Janssen I
通讯作者：
Janssen I
影响因子：
4.2
作者：
Linton, Sabriya L.;Celentano, David D.;Mehta, Shruti H.
通讯作者：
Mehta, Shruti H.
DOI：
10.1080/09540121.2010.516346
发表时间：
2011-01-01
影响因子：
1.7
作者：
Havens, Jennifer R.;Oser, Carrie B.;Leukefeld, Carl G.
通讯作者：
Leukefeld, Carl G.
影响因子：
11.8
作者：
Klevens, R. Monina;Hu, Dale J.;Holmberg, Scott D.
通讯作者：
Holmberg, Scott D.
影响因子：
5.3
作者：
Lin, Swu-Jane
通讯作者：
Lin, Swu-Jane