Reduced injection frequency and increased entry and retention in drug treatment associated with needle-exchange participation in Seattle drug injectors

FRANÇAIS :
Les participants à cette étude (une cohorte dUDVI de Seattle) ont été observés selon quils ont eu recours ou pas, lors du recrutement ou durant les 6 mois de suivi de létude, à un échange de seringues. Les résultats montrent que les usagers ayant échangé leurs seringues sont plus susceptibles de réduire la fréquence de leurs injections, voire dy renoncer totalement ou encore de rester en traitement, que ceux nayant jamais eu recours à ce procédé. Les usagers ayant récemment eu recours à léchange de seringues étaient, quant à eux, 5 fois plus susceptibles dentrer en traitement. Les auteurs concluent que cette corrélation entre léchange de seringue et un changement de comportement positif pour lusager (diminution des injections, entrée et rétention en traitement), présente un bénéfice considérable en matière de santé publique, notamment concernant la prévention de la transmission des virus par voie sanguine.
ENGLISH :
The association between needle exchange, change in drug use frequency and enrollment and retention in methadone drug treatment was studied in a cohort of Seattle injection drug users (IDUs). Participants included IDUs classified according to whether they had used a needle exchange by study enrollment and during the 12-month follow-up period. The relative risk (RR) and the adjusted RR (ARR) were estimated as measures of the association. It was found that IDUs who had formerly been exchange users were more likely than never-exchangers to report a substantial (>75%) reduction in injection (ARR = 2.85, 95% confidence limit [CL] 1.47-5.51), to stop injecting altogether (ARR = 3.5, 95% CL 2.1-5.9), and to remain in drug treatment. New users of the exchange were five times more likely to enter drug treatment than never-exchangers. We conclude that reduced drug use and increased drug treatment enrollment associated with needle exchange participation may have many public health benefits, including prevention of blood-borne viral transmission. (Editor's abstract.)