Community Organizations in Syringe Exchange in Springfi

描述(由申请人提供)：尽管科学证据表明，注射器交换计划(SEP)在降低注射吸毒者的风险和感染方面有效，但事实证明，该计划是最具争议的公共卫生艾滋病毒预防努力之一。在一些地区，社区对SEP的反对已经足以阻止SEP的启动，并在其他地方关闭现有的计划。鉴于SEPS作为艾滋病毒预防方法已被证明是有效的，这项研究试图理解为什么它们没有得到普遍的支持。这项拟议的研究将研究马萨诸塞州斯普林菲尔德少数族裔社区的社会生态，以了解艾滋病毒风险的社会和物理动态。马萨诸塞州斯普林菲尔德是一个缺乏药房获得无菌注射器和针头交换的城市。1997至2001年间，斯普林菲尔德的艾滋病发病率在全国(在大都市统计地区中)从第49位上升到第11位。斯普林菲尔德的社区组织历来不支持将针头交换作为预防艾滋病毒的措施，认为这类似于给酒鬼送鸡尾酒杯。通过将我们的注意力转向以社区为基础的组织，我们寻求查明促进或阻碍对吸毒人群的艾滋病毒预防干预措施有效性的背景环境因素。现有关于针具交换实施情况的研究没有考虑到促进或阻碍这类计划的体制因素，包括关键社区组织的支持或反对。我们建议通过对社区组织工作人员和其他利益相关者的深入访谈，研究斯普林菲尔德基层动员反对针头交换的原因。我们还建议进行有限的社区调查，以确定社区组织在多大程度上代表社区态度，反之亦然。这项研究的具体目的如下：1.了解马萨诸塞州斯普林菲尔德社区反对针头交换的社会、历史和政治动态；2.探索社区机构在支持或反对合法针头交换作为艾滋病毒预防措施方面的作用；3.通过定量调查，检查社区对针头交换和其他方面的意见。

DESCRIPTION (provided by applicant): Syringe exchange programs (SEPs) have proven to be among the most controversial public health HIV prevention efforts, despite demonstrated scientific evidence of their effectiveness in lowering risk and infection among injection drug users. Community opposition to SEPs in some locales has been sufficient to block initiation of SEPs and, elsewhere, to shut down existing programs. Given the demonstrated effectiveness of SEPs as an HIV prevention method, this study seeks to understand why they have not received universal support. The proposed study will examine the social ecology of minority communities in Springfield, Massachusetts, a city that lacks pharmacy access to sterile syringes and needle exchange, to understand the social and physical dynamics of HIV risk. Between 1997 and 2001, Springfield moved from having the 49 th highest AIDS rate in the nation (among metropolitan statistical areas) to the 1lth highest AIDS rate. Community-based organizations in Springfield have historically failed to support needle exchange as an HIV prevention measure, believing that it is analogous to "giving a cocktail glass to an alcoholic." By directing our attention to community-based organizations we seek to identify contextual environmental factors that promote or impede the effectiveness of HIV prevention interventions for drug-using populations. Existing studies of the implementation of needle exchange fail to account for the institutional factors that facilitate or impede such programs, including the support or opposition of key community organizations. We propose to examine the reasons for grassroots mobilization against needle exchange in Springfield through in-depth interviews with community organization staff and other stakeholders. We further propose a limited community survey to determine the degree to which community organizations represent community attitudes, and vice versa. The specific aims of the proposed study are as follows: 1. To understand the social, historical and political dynamics of community opposition to needle exchange in Springfield, Massachusetts; 2. To explore the role of community institutions in supporting or opposing legal needle exchange as an HIV prevention measure; 3. To examine community opinions on needle exchange and other aspects of IDU-targeted HIV prevention through quantitative surveys.