International Journal of Drug Policy最新文献_第10页

Dublin’s supervised injecting facility: An assessment of its impact on discarded needles 都柏林的监督注射设施：对废弃针头影响的评估。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1016/j.drugpo.2025.105101

David S. Evans , Eamon Keenan

Background

Medically Supervised Injecting Facilities (MSIFs) are locations where illicit drugs can be injected using sterile equipment under professional supervision. They aim to reduce risks associated with public injecting and injecting alone such as overdose and related harms. Evidence shows that MSIFs reduce overdoses, public injecting and related litter, and increase service engagement. Ireland’s first MSIF opened in December 2024. The study assesses its impact during its first four months.

Methods

All publicly accessible areas within 500 metres of the facility were patrolled weekly before and after it opened (September 2024-April 2025). Discarded needles, crack pipes, public injecting, loitering, and weight of discarded items were recorded. Weather data was controlled for and client uptake (number of unique clients using MSIF) was obtained. Generalised linear models and bivariate correlations compared pre and post changes.

Results

Attendance increased almost fivefold during the study period. The average number of discarded needles per patrol decreased by 20 % (from 3.14 before to 2.50 after, p = 0.288). Each additional client attending was associated with a 5 % reduction in discarded needles (IRR = 0.95, 95 % CI: 0.92–0.99, p = 0.008). Crack pipes declined by 20 % (p = 0.545), with a 59 % reduction in the weight of drug-related litter (p < 0.001). Loitering declined by 45 % (p = 0.002) while public injecting remained rare (one before, one after).

Conclusions

Early evidence suggests community level benefits after four months including reduced drug-related litter and public loitering. Continued monitoring is required to assess long-term impact.

背景：医学监督注射设施（MSIFs）是在专业监督下使用无菌设备注射非法药物的场所。它们的目的是减少与公共注射和单独注射有关的风险，例如过量注射和相关危害。证据表明，MSIFs减少了过量用药、公共注射和相关垃圾，并提高了服务参与度。爱尔兰第一家MSIF于2024年12月开业。该研究评估了它在头四个月的影响。方法：在设施开放前后（2024年9月- 2025年4月），每周对设施500米范围内的所有公共可达区域进行巡逻。记录丢弃的针头、裂缝管、公共注射、闲逛和丢弃物品的重量。对天气数据进行了控制，并获得了客户端摄取（使用MSIF的唯一客户端数量）。广义线性模型和双变量相关性比较了前后变化。结果：在研究期间，出勤率几乎增加了五倍。每次巡逻平均丢弃针头数量减少了20%（从3.14个减少到2.50个，p = 0.288）。每增加一名患者，废弃针头减少5% （IRR = 0.95, 95% CI: 0.92-0.99, p = 0.008）。崩裂管减少了20% (p = 0.545)，与毒品相关的垃圾重量减少了59% （p < 0.001）。游荡率下降了45% (p = 0.002)，而公共注射仍然很少见（注射前和注射后各一次）。结论：早期证据表明，四个月后社区层面的效益包括减少与毒品有关的垃圾和公共闲逛。需要继续监测以评估长期影响。

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引用次数: 0

Two methods to estimate the population size of people who inject drugs in the country of Georgia: implications for the EECA region 估计格鲁吉亚注射毒品人口规模的两种方法：对欧亚经济共同体区域的影响。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-03 DOI: 10.1016/j.drugpo.2025.105099

George Kamkamidze , Emeli J. Anderson , Liana Shengelaia , Lasha Gulbiani , Giorgi Kanchelashvili , Tinatin Abzianidze , Maia Butsashvili

Background

In the Eastern European country of Georgia, people who inject drugs (PWID) are disproportionately affected by both HIV and hepatitis C virus (HCV) infections. In 2016, it was estimated that over 2 % of adults in Georgia engaged in injection drug use. Updated population size estimates are needed to inform the national public health response to IDU, HIV, and HCV.

Methods

Data were from the 2022 Integrated Bio-Behavioral Surveillance Survey of PWID in Georgia. Participants were recruited from seven cities (n = 2005). Two methods were used to estimate the population size of PWID: the Network Scale-Up (NSU) method and the Multiplier Benchmark Method (MBM). The former used social network data from the general population (n = 680) to estimate the proportion of PWID in an individual’s social network. The MBM used external data of PWID and a multiplier estimated from internal data to generate an estimate of the total population size of PWID for each dataset. An anchor multiplier tool was used to combine the results from the two methods.

Results

The final estimate resulted in a population size of 54,342 PWID in Georgia, corresponding to a prevalence of 1.4 % among all age groups and 2.4 % among adults aged 18–64.

Conclusion

IDU remains a substantial challenge in Georgia, with an estimated 1.5 % of the population engaging in IDU. These findings underscore the need for targeted interventions and improved engagement of PWID in prevention, treatment, and care services across the country.

背景：在东欧国家格鲁吉亚，注射吸毒者（PWID）受到艾滋病毒和丙型肝炎病毒（HCV）感染的影响不成比例。2016年，据估计，格鲁吉亚超过2%的成年人从事注射毒品使用。需要最新的人口规模估计，以便为国家公共卫生应对IDU、艾滋病毒和丙型肝炎病毒提供信息。方法：数据来自佐治亚州2022年PWID综合生物行为监测调查。参与者来自7个城市（n = 2005）。采用网络放大法（NSU）和乘数基准法（MBM）两种方法估计PWID种群规模。前者使用来自一般人群（n = 680）的社交网络数据来估计PWID在个人社交网络中的比例。MBM使用PWID的外部数据和从内部数据估计的乘数来生成每个数据集的PWID总体大小的估计值。使用锚乘器工具将两种方法的结果结合起来。结果：最终估计格鲁吉亚的PWID人口规模为54,342人，对应于所有年龄组的患病率为1.4%，18-64岁成年人的患病率为2.4%。结论：IDU在格鲁吉亚仍然是一个重大挑战，估计有1.5%的人口参与IDU。这些发现强调了有针对性的干预措施的必要性，以及在全国范围内加强对PWID的预防、治疗和护理服务的参与。

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引用次数: 0

Die ‘Richtlinien für die Risiko-Reduzierung beim Cannabiskonsum (RRRCK)’: EMPFEHLUNGEN “降低大麻使用风险指南（RRCK）”。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2023-03-24 DOI: 10.1016/j.drugpo.2023.103995

Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall

引用次数: 0

Integration of safer smoking equipment in U.S. syringe services programs: Qualitative insights from program staff 美国注射器服务项目中更安全吸烟设备的整合：来自项目人员的定性见解。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-09 DOI: 10.1016/j.drugpo.2025.105106

William H. Eger , Shelby L. Huffaker , Elana Forman , Jessica Smith , Chris F. Akiba , Rose Laurano , Sheila V. Patel , Barrot H. Lambdin , Alexis M. Roth , Angela R. Bazzi

Background

Amidst population-level transitions from injecting to smoking unregulated drugs, US. syringe services programs (SSPs) are increasingly distributing safer smoking equipment.

Methods

We conducted qualitative interviews with representatives of 27 geographically diverse U.S. SSPs from May 2023–March 2024. Guided by the Consolidated Framework for Implementation Research, we explored programs’ experiences distributing safer smoking equipment, including staff perceptions on challenges to implementation and sustainment. Thematic analysis identified key findings.

Results

We interviewed 41 SSP representatives, including leadership (63 %), frontline (22 %), and clinical and clinical support staff (15 %). Two critical incidents–fentanyl adulteration of unregulated drug supplies and the COVID-19 pandemic–drove the adoption of this intervention. Interviewees perceived that safer smoking equipment facilitated client engagement, expanded SSPs’ reach into previously underserved communities, and promoted individual health by reducing the adverse consequences of injecting drugs. Barriers to implementation and sustainment included program staff and leadership concerns about limited evidence on the public health benefits of safer smoking equipment, stigma and negative local attitudes, funding restrictions, and cost (particularly for glass pipes). Strategies to support implementation included incrementally piloting safer smoking equipment, partnering with diverse funders, and adapting services to navigate resource constraints. Nevertheless, limited funding and legal support hindered broader adoption, reach and sustainability.

Conclusions

Implementation of safer smoking equipment represents a critical evolution in harm reduction programming that may engage underserved communities in the range of evidence-based prevention services offered by SSPs. Flexible funding and supportive implementation climates are needed to support SSPs in providing this impactful service.

背景：在人口水平从注射到吸烟无管制药物的转变中，美国。注射器服务计划（ssp）越来越多地分发更安全的吸烟设备。方法：从2023年5月至2024年3月，我们对27个地理上不同的美国ssp的代表进行了定性访谈。在实施研究综合框架的指导下，我们探讨了项目分发更安全吸烟设备的经验，包括工作人员对实施和维持挑战的看法。专题分析确定了主要发现。结果：我们采访了41名SSP代表，包括领导（63%），一线（22%）以及临床和临床支持人员（15%）。两起重大事件——芬太尼掺假不受管制的药物供应和COVID-19大流行——促使采取了这一干预措施。受访者认为，更安全的吸烟设备促进了客户的参与，将ssp的覆盖面扩大到以前服务不足的社区，并通过减少注射毒品的不良后果促进了个人健康。实施和维持的障碍包括方案工作人员和领导对更安全的吸烟设备对公共健康的益处证据有限、污名化和当地消极态度、资金限制和成本（特别是玻璃烟斗）的担忧。支持实施的战略包括逐步试用更安全的吸烟设备，与各种资助者合作，以及调整服务以应对资源限制。然而，有限的资金和法律支助阻碍了更广泛的采用、覆盖面和可持续性。结论：实施更安全的吸烟设备代表了减少危害规划的关键演变，可能会使服务不足的社区参与到由ssp提供的循证预防服务的范围内。需要灵活的供资和支持性的实施环境来支持可持续发展服务提供者提供这种有影响力的服务。

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引用次数: 0

A scoping review and concept analysis to inform Canada’s safe(r) opioid supply research agenda 为加拿大阿片类药物安全供应研究议程提供信息的范围审查和概念分析。

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-11-24 DOI: 10.1016/j.drugpo.2025.105070

Uyen Do , Sarah Larney , Matthew Bonn , Ingrid Matei , Camille Zolopa , Amy Bergeron , Mohammad Karamouzian , Elaine Hyshka , Thomas D. Brothers , Nikki Bozinoff , Dan Werb , Didier Jutras-Aswad , Stine Høj , Isabelle Boisvert , Igor Yakovenko , Julie Bruneau

Background

Providing pharmaceutical opioid medications as alternatives to the unregulated drug market, commonly referred to as safe supply or safer supply (hereafter “safe(r) supply”), has emerged as a harm reduction strategy in Canada, with wide variation in principles and implementation. We aimed to clarify the concept of safe(r) opioid supply across harm-reduction and clinical contexts.

Methods

We conducted a scoping review and concept analysis. We systematically searched six major electronic databases and the grey literature to identify articles published between 2010 and 2024. Informed by Walker and Avant’s concept analysis methodology, we extracted definitions and descriptions of programs and interventions, organizing key characteristics into thematic dimensions to develop a framework distinguishing various care approaches.

Results

Our review included 95 articles. Safe(r) supply operationalizes under two broad approaches: a medicalized/prescribed approach (‘safer supply’) and a non-medicalized/community-based approach (‘safe supply’). We outlined three illustrative cases that nest within these approaches: (1) Prescribed opioids with opioid agonist therapy (OAT) offered and/or co-prescribed, (2) Prescribed opioids without OAT, (3) Community-based distribution of unregulated drugs with known composition.

Conclusion

Safe(r) supply encompasses prescribed opioid alternatives interventions (safer supply) and non-medicalized (safe supply) approaches with shared antecedents but distinct attributes and consequences. This study highlights the need to better define and standardize the parameters of safer supply approaches, including population, dosing, and intended objectives, to enable a more precise assessment of their potential benefits and risks. This nuanced understanding is crucial for developing evidence-based strategies in response to Canada’s drug poisoning crisis.

背景：提供阿片类药物作为不受管制药品市场的替代品，通常被称为安全供应或更安全供应（以下简称“安全(r)供应”），已成为加拿大的一项减少危害战略，其原则和实施方法差异很大。我们的目的是澄清安全(r)阿片类药物供应在危害减少和临床背景下的概念。方法：我们进行了范围回顾和概念分析。我们系统地检索了六个主要的电子数据库和灰色文献，以确定2010年至2024年间发表的文章。根据Walker和Avant的概念分析方法，我们提取了项目和干预措施的定义和描述，将关键特征组织到主题维度中，以开发一个区分各种护理方法的框架。结果：我们纳入了95篇文章。安全(r)供应在两种广泛的方法下运作：医疗化/处方化方法（“更安全的供应”）和非医疗化/社区为基础的方法（“安全供应”）。我们概述了这些方法中的三个说明性案例：(1)处方阿片类药物与阿片类激动剂治疗（OAT）一起提供和/或共同开处方；(2)处方阿片类药物不含OAT；(3)基于社区的已知成分的未监管药物分布。结论：安全(r)供应包括处方阿片类药物替代干预措施（更安全的供应）和非医疗（安全供应）方法，具有共同的前提，但不同的属性和后果。这项研究强调需要更好地定义和标准化安全供应方法的参数，包括人口、剂量和预期目标，以便能够更准确地评估其潜在利益和风险。这种细致入微的理解对于制定以证据为基础的战略以应对加拿大的药物中毒危机至关重要。

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引用次数: 0

When words and images diverge: Challenges of AI-generated drug use representations 当文字和图像出现分歧：人工智能生成的药物使用表征的挑战

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-05 DOI: 10.1016/j.drugpo.2025.105104

Jeffrey K. Hom , Kathryn Heley , Linnea I. Laestadius

引用次数: 0

Problem representation of the Risk Mitigation Guidance (RMG) within the context of dual public health emergencies of COVID-19 and toxic drug deaths in British Columbia, Canada 在加拿大不列颠哥伦比亚省COVID-19和有毒药物死亡双重公共卫生突发事件背景下，风险缓解指南的问题表述

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-12-11 DOI: 10.1016/j.drugpo.2025.105102

Daniel Gudiño Pérez , Celeste Macevicius , Alexa Norton , Phoenix Beck-McGreevy , Marion Selfridge , Jeremy Kalicum , Karen Urbanoski , Brittany Barker , Amanda Slaunwhite , Jaime Arredondo , Bruce Wallace , Bernie Pauly

Background

Risk Mitigation Guidance (RMG) was released in response to the dual public health emergencies of COVID-19 and overdose in British Columbia (BC), Canada. RMG enabled the provision of prescribed alternatives to the unregulated drug supply for people at risk of COVID-19 and overdose. Our objective was to gain insight into how health planners in BC problematized the dual health emergencies and the impacts of such on the design and implementation of RMG.

Methods

Qualitative interviews (n = 28) were conducted with health planners across BC about their understanding of RMG, the implementation process, and context. Carol Bacchi’s “What’s the Problem Represented to be?” framework was used to interrogate the data and guide analysis.

Results

From the perspectives of health planners, RMG was a solution to the primary problem of COVID-19 and to reduce spread of the virus. We identified four problem representations related to the problematization of safer supply as a COVID-19 response: 1) COVID-19 opened a window of opportunity; 2) dual public health emergency, but COVID-19 as the priority ‘problem’; 3) the effects of making COVID-19 problem priority; 4) expanding understandings of safer supply beyond COVID-19.

Conclusion

Our study builds on the importance of evaluating problem representations in the process of policymaking. The RMG illustrates how crisis-driven policymaking shapes problem representations, enabling rapid intervention through the COVID-19 response while constraining responses to the toxic drug emergency. As a medicalized emergency response, the RMG addressed contagion but failed to confront the structural drivers of toxic drug deaths. Our study highlights the needs for prescribed safer supply models to directly address the unregulated toxic drug supply.

背景：针对加拿大不列颠哥伦比亚省COVID-19和药物过量双重突发公共卫生事件，发布了风险缓解指南（RMG）。RMG能够为面临COVID-19和过量用药风险的人提供处方替代药物，以替代不受管制的药物供应。我们的目标是深入了解不列颠哥伦比亚省的卫生规划人员如何对双重卫生紧急情况提出问题，以及这些问题对RMG的设计和实施的影响。方法：对BC省各地的卫生规划人员进行定性访谈（n = 28），了解他们对RMG、实施过程和背景的理解。Carol Bacchi的“问题代表是什么？”框架被用来询问数据并指导分析。结果：从卫生规划人员的角度来看，RMG解决了COVID-19的首要问题，并减少了病毒的传播。我们确定了与应对COVID-19时安全供应问题化相关的四个问题：1)COVID-19打开了机会之窗；2)双重突发公共卫生事件，但COVID-19作为优先“问题”；3)优先解决COVID-19问题的效果；4)扩大对新冠肺炎疫情以外更安全供应的认识。结论：本研究建立在评估问题表征在政策制定过程中的重要性之上。RMG说明了危机驱动的政策制定如何形成问题表征，从而能够通过COVID-19应对措施进行快速干预，同时限制对有毒药物紧急情况的响应。作为一种医疗化的应急反应，RMG解决了传染问题，但未能解决有毒药物死亡的结构性驱动因素。我们的研究强调，需要规定更安全的供应模式，以直接解决不受管制的有毒药物供应。

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引用次数: 0

Les ‘Lignes Directrices Pour l'Usage du Cannabis à Moindre Risque (LUCMR)’: RECOMMENDATIONS [The ‘Lower-Risk Cannabis Use Guidelines (LRCUG)’: RECOMMENDATIONS (FRENCH)] 《低风险大麻使用指南》（LRCUG）：建议（法国）

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2023-04-11 DOI: 10.1016/j.drugpo.2023.103994

Benedikt Fischer , Tessa Robinson , Chris Bullen , Valerie Curran , Didier Jutras-Aswad , Maria Elena Medina-Mora , Rosalie Pacula , Jürgen Rehm , Robin Room , Wim van den Brink , Wayne Hall

引用次数: 0

Characterizing non-fatal overdose among people who inject drugs in India: prevalence and risk factor analysis, 2022-2024 印度注射毒品人群中非致命性过量的特征：患病率和风险因素分析，2022-2024

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-11-22 DOI: 10.1016/j.drugpo.2025.105073

Mihili P. Gunaratne , Talia A. Loeb , Allison M. McFall , Lakshmi Ganapathi , Jiban J. Baishya , Ashwini Kedar , Archit K. Sinha , Aylur K. Srikrishnan , Sunil S. Solomon , Gregory M. Lucas , Shruti H. Mehta

Background

Non-fatal overdose strongly predicts future fatal overdose, yet limited prior work describes the burden among people who inject drugs (PWID) in India. We estimated prevalence and identified correlates of non-fatal overdose among PWID from India.

Methods

We conducted respondent-driven sampling (RDS) surveys among PWID across 6 Indian cities (n∼750/site; Amritsar, Bilaspur, Churchandpur, Delhi, Kanpur, and Ludhiana) during 2022–2024. Prevalence of non-fatal overdose in the prior 6 months and non-mutually exclusive events following the overdose were estimated using RDS-weighted descriptive statistics. Correlates (i.e., sociodemographics, HIV and hepatitis C status, substance use in the prior 6 months, and psychosocial symptoms) were assessed using multilevel logistic regression.

Results

Prevalence of non-fatal overdose was 8.8% among 4495 PWID. Factors significantly associated with overdose included daily or seasonal employment (vs. monthly or weekly wages), hepatitis C antibody positive status, witnessing a fatal overdose, injecting 3 or more times per day (vs. 1–2 times per day), concurrent use of heroin and stimulants (vs. buprenorphine or other prescription opioids only), hazardous alcohol use, attending a medical facility for addiction or detoxification, and experiencing mild or depressive symptoms (vs. none). Following the overdose, 44.7% reported help from a friend or family member, 25.5% reported nothing happened, 12.9% went to a hospital, and 5.6% were referred to drug treatment or detoxification.

Conclusions

We observed a variable burden of non-fatal overdose associated with high injection frequency, combination drug use, alcohol use, attending medical detoxification, and depressive symptoms. Low levels of subsequent linkage to treatment services suggest opportunities to improve overdose prevention and management.

背景：非致命性药物过量强烈预测未来致命性药物过量，然而有限的先前工作描述了印度注射吸毒者（PWID）的负担。我们估计了印度PWID的患病率，并确定了非致命性用药过量的相关因素。方法我们在2022-2024年期间对印度6个城市的PWID进行了受访者驱动抽样（RDS）调查（n ~ 750/站点；阿姆利则、比拉斯普尔、丘尔昌普尔、德里、坎普尔和卢迪亚纳）。使用rds加权描述性统计估计前6个月内非致死性用药过量发生率和用药过量后非互斥事件发生率。相关因素（即社会人口统计学、艾滋病毒和丙型肝炎状况、前6个月的药物使用情况以及心理社会症状）采用多水平logistic回归进行评估。结果4495例PWID患者非致死性用药过量发生率为8.8%。与药物过量显著相关的因素包括每日或季节性就业（相对于每月或每周工资）、丙型肝炎抗体阳性、目睹致命的药物过量、每天注射3次或更多次（相对于每天1-2次）、同时使用海洛因和兴奋剂（相对于丁丙诺啡或其他处方阿片类药物）、危险饮酒、因成瘾或戒毒而前往医疗机构、经历轻度或抑郁症状（相对于无）。在吸毒过量后，44.7%的人表示得到了朋友或家人的帮助，25.5%的人表示什么也没发生，12.9%的人去了医院，5.6%的人接受了药物治疗或戒毒。结论：我们观察到非致死性药物过量的可变负担与高注射频率、联合用药、酒精使用、参加医学解毒和抑郁症状相关。随后与治疗服务的低水平联系表明有机会改进过量预防和管理。

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引用次数: 0

Population size estimation of people who inject drugs using capture-recapture analysis of multiple respondent-driven sampling rounds: Implications for HIV/HCV burden and harm reduction service planning in Thessaloniki, Greece 在希腊塞萨洛尼基，使用多轮应答者驱动抽样的捕获-再捕获分析来估计注射吸毒者的人口规模：对艾滋病毒/丙型肝炎病毒负担和减少危害服务规划的影响

IF 4.4 2区医学 Q1 SUBSTANCE ABUSE

International Journal of Drug Policy

Pub Date : 2026-01-01 Epub Date: 2025-11-28 DOI: 10.1016/j.drugpo.2025.105078

Sotirios Roussos , Effrosyni Tsirogianni , Ioannis Goulis , Georgios Kalamitsis , Angelos Hatzakis , Vana Sypsa

Background

Accurate population size estimation of people who inject drugs (PWID) is essential for evidence-based drug policy and service planning, yet it remains challenging. An emerging HIV outbreak in Thessaloniki, Greece's second-largest city, highlighted the urgent need for evidence-based population size estimates.

Methods

We applied capture-recapture analysis to five respondent-driven sampling (RDS) rounds conducted during 2019–2021 to estimate PWID population size in Thessaloniki for the 2019–2021 period. These RDS rounds were part of a community-based program aimed at increasing HIV/HCV testing and linkage to care among PWID. We treated each RDS round as a capture source and used log-linear models to estimate PWID population size (past 12 months and past 30 days), accounting for potential dependencies between rounds through interaction terms. We then estimated HIV/HCV disease burden and assessed prevention and harm reduction service coverage against international standards (HIV testing, OAT, NSP).

Results

Based on data from 1093 unique participants across five rounds (53.9% currently injecting, 20.3% currently in OAT), capture-recapture analysis estimated 1512 PWID (95% confidence interval (CI): 1345–1741) who had injected drugs in the past 12 months. The estimated prevalence of injecting drug use was 0.22% (95% CI: 0.20–0.25) among adults aged 18–64 years. We estimated 106 people living with HIV (95% uncertainty interval (UI): 83–130) and 945 HCV-antibody–positive individuals (95% UI: 815–1077) among PWID. Needle and syringe program coverage was 36 (95% CI: 31–40) syringes per PWID in 2021.

Conclusion

Based on this community-based population size estimate, the prevalence of injection was nearly double the official national Greek average. The annual distribution of syringes should increase by 5.6 times to reach the WHO target (≥200 syringes/PWID/year). These findings demonstrate how community-based programs with multiple RDS rounds can also yield population estimates essential for evidence-based drug policy interventions.

准确估计注射吸毒者（PWID）的人口规模对于循证药物政策和服务规划至关重要，但这仍然具有挑战性。希腊第二大城市塞萨洛尼基正在爆发艾滋病毒疫情，这凸显了对基于证据的人口规模估计的迫切需要。方法对2019-2021年期间进行的5轮受访者驱动抽样（RDS）进行捕获-再捕获分析，以估计2019-2021年期间塞萨洛尼基PWID的种群规模。这些RDS轮次是一个以社区为基础的项目的一部分，该项目旨在增加艾滋病毒/丙型肝炎病毒检测，并将艾滋病患者与护理联系起来。我们将每一轮RDS视为捕获源，并使用对数线性模型估计PWID种群规模（过去12个月和过去30天），通过相互作用项考虑轮之间的潜在依赖关系。然后，我们估计了HIV/HCV疾病负担，并根据国际标准（HIV检测、OAT、NSP）评估了预防和减少危害服务的覆盖范围。基于5轮1093名独特参与者的数据（53.9%目前在注射，20.3%目前在OAT），捕获-再捕获分析估计了1512名PWID（95%置信区间（CI）： 1345-1741）在过去12个月内注射过药物。18-64岁成年人中注射吸毒的估计流行率为0.22% （95% CI: 0.20-0.25）。我们估计PWID中有106名HIV感染者（95%不确定区间（UI）： 83-130）和945名hcv抗体阳性个体（95% UI: 815-1077）。2021年，每个PWID的针头和注射器规划覆盖率为36支（95% CI: 31-40）支。基于社区人口规模估计，注射流行率几乎是希腊官方全国平均水平的两倍。为达到世卫组织的目标（≥200支/PWID/年），注射器的年分发量应增加5.6倍。这些发现表明，以社区为基础的多轮RDS项目也可以产生对基于证据的药物政策干预至关重要的人口估计。

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引用次数: 0