Community Organizations in Syringe Exchange in Springfi

描述（由申请人提供）：注射器交换计划（SEPs）已被证明是最具争议的公共卫生艾滋病毒预防工作之一，尽管有科学证据证明其在降低注射吸毒者风险和感染方面的有效性。在一些地方，社区对SEPs的反对足以阻止SEPs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的有效性，本研究旨在了解为什么它们没有得到普遍支持。这项拟议的研究将研究马萨诸塞州斯普林菲尔德少数民族社区的社会生态，这是一个缺乏无菌注射器和针头交换的城市，以了解艾滋病毒风险的社会和物理动态。1997年至2001年，斯普林菲尔德从全国艾滋病发病率第49位（在大都市统计区中）上升到第11位。斯普林菲尔德的社区组织历来不支持针具交换作为艾滋病毒预防措施，认为这类似于“给酒鬼一个鸡尾酒杯。“通过将我们的注意力转向以社区为基础的组织，我们寻求确定促进或阻碍吸毒人群艾滋病毒预防干预措施有效性的背景环境因素。现有的针具交换实施研究未能说明促进或阻碍此类计划的制度因素，包括关键社区组织的支持或反对。我们建议通过与社区组织工作人员和其他利益相关者的深入访谈，研究基层动员反对斯普林菲尔德针具交换的原因。我们进一步提出了一个有限的社区调查，以确定社区组织代表社区态度的程度，反之亦然。具体研究目的如下：1.了解马萨诸塞州春田市社区反对针具交换的社会、历史及政治动力; 2.探讨社区机构在支持或反对法律的针具交换作为艾滋病预防措施方面的作用;通过定量调查来检查社区对针具交换和针对注射吸毒者的艾滋病毒预防的其他方面的意见。

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.