HCV serostatus and injection sharing practices among those who obtain syringes from pharmacies and directly and indirectly from syringe services programs in rural New England.
HCV serostatus and injection sharing practices among those who obtain syringes from pharmacies and directly and indirectly from syringe services programs in rural New England.
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DOI：
10.1186/s13722-022-00358-7
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发表时间：
2023-01-03
影响因子：
3.7
通讯作者：
Friedmann, Peter D.
中科院分区：
文献类型：
--
作者：
Romo, Eric;Rudolph, Abby E.;Stopka, Thomas J.;Wang, Bo;Jesdale, Bill M.;Friedmann, Peter D.
在注射吸毒者 (PWID) 中，通过注射器服务计划 (SSP) 和药房获取注射器可减少与丙型肝炎病毒 (HCV) 相关的注射共享行为。通过二级交换间接使用 SSP 是否能带来类似的好处仍然未知，特别是在农村地区。我们在农村注射吸毒者样本中按主要注射器来源比较了 HCV 血清状态和注射共享做法。数据来自对新罕布什尔州、佛蒙特州和马萨诸塞州 11 个农村县招募的吸毒成年人的横断面研究，采用受访者驱动抽样（2018-2019 年）。研究人员进行了 HCV 抗体检测。音频计算机辅助自我访谈评估了社会人口特征、过去 30 天的注射实践以及过去 30 天的主要注射器来源。主要注射器来源被分类为直接 SSP、药房、间接 SSP（二次交换）或“其他”（朋友/熟人、街头小贩、合作伙伴/亲戚，找到他们）。混合效应改良泊松模型评估了主要注射器来源与 HCV 血清流行率和注射共享做法的关联。在 397 名注射吸毒者中，最常见的主要注射器来源是“其他”（33%），然后是药房（27%）、SSP（22%）和二次交换（18%）。在多变量模型中，与从“其他”来源获得大多数注射器的人相比，从药房获得大多数注射器的人的 HCV 血清阳性率较低 [调整后患病率 (APR)：0.85，95% 置信区间 (CI) 0.73–0.9985]；然而，95% CI 的上限接近 1.0。与从其他来源获得大多数注射器的注射器相比，直接从 SSP 或药房获得大多数注射器的注射吸毒者不太可能报告借用二手注射器 [APR(SSP):0.60, 95% CI 0.43–0.85 和 APR(药房):0.70, 95% CI 0.52–0.93]、借用二手注射设备 [APR(SSP):0.59, 95% CI 0.50–0.69 和 APR（药房）：0.81，95% CI 0.68–0.98]，以及回载 [APR(SSP)：0.65，95% CI 0.48–0.88 和 APR（药房）：0.78，95% CI 0.67–0.91]。通过二次交换获得大多数注射器与注射共享实践之间的潜在负相关性尚未达到统计显着性的阈值。新英格兰农村地区的注射吸毒者很大程度上依赖于非正式的注射器来源（即二次交换或除 SSP/药房之外的来源）。那些从 SSP 或药房获得大部分注射器的人不太可能共用注射设备/注射器，并且 HCV 血清阳性率较低，这表明使用这些来源可以降低新的 HCV 感染风险，或者可以作为过去注射行为的替代指标。在线版本包含可在 10.1186/s13722-022-00358-7 获取的补充材料。
Among people who inject drugs (PWID), obtaining syringes via syringe services programs (SSPs) and pharmacies reduces injection sharing practices associated with hepatitis C virus (HCV). Whether indirect use of SSPs via secondary exchange confers a similar benefit remains unknown, particularly in rural settings. We compared HCV serostatus and injection sharing practices by primary syringe source among a sample of rural PWID. Data are from a cross-sectional study of adults who use drugs recruited from eleven rural counties in New Hampshire, Vermont, and Massachusetts using respondent-driven sampling (2018–2019). Study staff performed HCV antibody testing. An audio computer-assisted self-interview assessed sociodemographic characteristics, past 30-day injection practices, and past 30-day primary syringe source. Primary syringe source was classified as direct SSP, pharmacy, indirect SSP (secondary exchange), or “other” (friend/acquaintance, street seller, partner/relative, found them). Mixed effects modified Poisson models assessed the association of primary syringe source with HCV seroprevalence and injection sharing practices. Among 397 PWID, the most common primary syringe source was “other” (33%), then pharmacies (27%), SSPs (22%), and secondary exchange (18%). In multivariable models, compared with those obtaining most syringes from “other” sources, those obtaining most syringes from pharmacies had a lower HCV seroprevalence [adjusted prevalence ratio (APR):0.85, 95% confidence interval (CI) 0.73–0.9985]; however, the upper bound of the 95% CI was close to 1.0. Compared with those obtaining most syringes from other sources, PWID obtaining most syringes directly from SSPs or pharmacies were less likely to report borrowing used syringes [APR(SSP):0.60, 95% CI 0.43–0.85 and APR(Pharmacies):0.70, 95% CI 0.52–0.93], borrowing used injection equipment [APR(SSP):0.59, 95% CI 0.50–0.69 and APR (Pharmacies):0.81, 95% CI 0.68–0.98], and backloading [APR(SSP):0.65, 95% CI 0.48–0.88 and APR(Pharmacies):0.78, 95% CI 0.67–0.91]. Potential inverse associations between obtaining most syringes via secondary exchange and injection sharing practices did not reach the threshold for statistical significance. PWID in rural New England largely relied on informal syringe sources (i.e., secondary exchange or sources besides SSPs/pharmacies). Those obtaining most syringes from an SSP or pharmacy were less likely to share injection equipment/syringes and had a lower HCV seroprevalence, which suggests using these sources reduces the risk of new HCV infections or serves as proxy for past injection behavior. The online version contains supplementary material available at 10.1186/s13722-022-00358-7.
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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：
4.2
作者：
Linton, Sabriya L.;Celentano, David D.;Mehta, Shruti H.
通讯作者：
Mehta, Shruti H.
影响因子：
4.4
作者：
Värmå Falk M;Strömdahl S;Ekström AM;Kåberg M;Karlsson N;Dahlborn H;Hammarberg A
通讯作者：
Hammarberg A
影响因子：
4.2
作者：
Lewis, Crystal Fuller;Rivera, Alexis V.;Amesty, Silvia
通讯作者：
Amesty, Silvia
影响因子：
11.8
作者：
Klevens, R. Monina;Hu, Dale J.;Holmberg, Scott D.
通讯作者：
Holmberg, Scott D.