针具交换结合同伴宣传对注射吸毒人群吸毒行为的影响

目的通过同伴宣传和针具交换项目减少吸毒者的共用注射器行为，降低吸毒人群中艾滋病病毒的传播流行。方法通过卫生工作人员和同伴宣传员向吸毒者提供清洁针具并回收污染针具，发放宣传折页，张贴宣传画以及对吸毒者进行面对面的宣传等措施，在广西壮族自治区某县注射吸毒者中开展了为期一年的针具交换和同伴宣传项目。在干预前后分别进行基线和终期横断面调查，通过对比两次调查中吸毒者自我报告的高危注射行为等变化情况对于预效果进行评估。结果基线调查205人，终期调查234人。终期调查时吸毒者的针具共用率、水和容器的共用率分别为30．34％、33．33％和11．54％，均显著地低于基线调查(分别为60．59％、62．69％和61．00％)；同基线调查相比，终期调查中吸毒者的每日注射毒品次数也显著减少。结论针具交换结合同伴宣传干预措施不仅能显著减少吸毒者对针具、清洗水和容器等的共用行为，还能有效降低吸毒者的针具共用频率，同时并不会增加吸毒者的毒品注射次数。

Effectiveness of needle exchange combined with peer education among IDUs in Guangxi

Objective To reduce needle sharing practices and HIV transmission among drug users through implementing needle exchange combined with peer education program.Methods Health workers and peer educators provided and reclaimed needles and syringes,disseminated health education pamphlets,and health education posters,and provided face-to-face health education to IDUs for a period of one year.Baseline and final questionnaire surveys on their risk injecting behaviors were conducted before and after the interventions for the purpose of evaluating the effectiveness of the program.Results A total of 205 IDUs were interviewed at baseline survey and 234 at the final survey.The needle,water and container sharing were significantly lower in the final survey(30.34%,33.33% and 11.54% respectively) compared with those in the baseline survey(60.59%,62.69% and 61.00% respectively,P<0.01).Furthermore,IDUs injected less frequently per day in the final survey.Conclusion Needle exchange combined with peer education program reduced needle,water and container sharing practices among IDUs,and also reduced needls sharing frequencies among IDUs.Providing IDUs with free needles was not associated with the increase of injecting times among IDUs.