Abstract

Background

Sterile syringe access is critical to prevent serious viral and bacterial infections among people who inject drugs (PWID) but many areas across the United States lack sufficient access. Although California law allows nonprescription pharmacy syringe sales and syringe services programs (SSPs), access gaps remain in the largely rural Central Valley.

Objective

The purpose of this study was to examine syringe access and related injection behaviors among PWID in Fresno, California.

Methods

We used respondent driven sampling to recruit 494 individuals for a survey about syringe access and injection behaviors between April and September 2016. Participants were ≥18 years old and injected at least twice in the past 30 days. Descriptive statistics examined syringe access and logistic regression determined if discrete syringe source categories were significantly associated with syringe sharing and/or reuse.

Results

A majority (67%) obtained syringes from an authorized source; SSPs were most common (59%), while few reported pharmacy purchase (14%). Unauthorized sources were even more common (79%), primarily friends (64%) or someone on the street (37%). Compared to PWID who used only authorized sources, those using only unauthorized sources had a higher odds of syringe sharing (AOR = 3.40, 95% CI: 1.66, 6.95) and syringe reuse (AOR = 6.22; 95% CI: 2.24, 17.29), as did those who reported mixed sources (AOR = 3.78; 95% CI: 1.90, 7.54 and AOR = 4.64; 95% CI: 2.08, 10.35).

Conclusions

Our findings demonstrate a need to expand syringe access in nonurban California to prevent the syringe sharing and reuse that contributes to serious viral and bacterial infections among PWID.

中文翻译：

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考虑来源：加利福尼亚中央山谷的注射器来源与危险注射行为之间的关联

摘要

背景

无菌注射器通路对于预防注射吸毒者 (PWID) 的严重病毒和细菌感染至关重要，但美国许多地区缺乏足够的通路。尽管加利福尼亚州法律允许非处方药店注射器销售和注射器服务计划 (SSP)，但在主要是农村的中央谷地，准入差距仍然存在。

客观的

本研究的目的是检查加利福尼亚州弗雷斯诺 PWID 的注射器使用和相关注射行为。

方法

在 2016 年 4 月至 2016 年 9 月期间，我们使用受访者驱动的抽样招募了 494 名个人进行关于注射器使用和注射行为的调查。参与者年龄≥18 岁，并且在过去 30 天内至少注射了两次。描述性统计检查注射器访问和逻辑回归确定离散注射器来源类别是否与注射器共享和/或重复使用显着相关。

结果

大多数 (67%) 从授权来源获得注射器；SSP 最常见（59%），而很少有人报告购买药房（14%）。未经授权的来源更为常见（79%），主要是朋友（64%）或街上的某个人（37%）。与仅使用授权来源的 PWID 相比，仅使用未授权来源的 PWID 共用注射器（AOR = 3.40, 95% CI: 1.66, 6.95）和重复使用注射器（AOR = 6.22; 95% CI: 2.24, 17.29）的几率更高，报告混合来源的人也是如此（AOR = 3.78；95% CI：1.90、7.54 和 AOR = 4.64；95% CI：2.08、10.35）。

结论

我们的研究结果表明，需要扩大加利福尼亚州非城市地区的注射器使用范围，以防止注射器共享和重复使用会导致 PWID 中严重的病毒和细菌感染。