Article de Périodique
Acceptability of low dead space syringes and implications for their introduction: A qualitative study in the West of England (2017)
Auteur(s) :
KESTEN, J. M. ;
AYRES, R. ;
NEALE, J. ;
CLARK, J. ;
VICKERMAN, P. ;
HICKMAN, M. ;
REDWOOD, S.
Année :
2017
Page(s) :
99-108
Langue(s) :
Anglais
Domaine :
Drogues illicites / Illicit drugs
Thésaurus géographique
ANGLETERRE
;
ROYAUME-UNI
Thésaurus mots-clés
ACCEPTABILITE
;
ETUDE QUALITATIVE
;
SERINGUE
;
MATERIEL D'INJECTION
;
REDUCTION DES RISQUES ET DES DOMMAGES
;
USAGER
Note générale :
* Response: Implementation of low dead space syringes in response to an outbreak of HIV among people who inject drugs: A response to Kesten et al. McAuley A., Campbell J., Milosevic C., Hunter C., Goldberg D.J. International Journal of Drug Policy, 2017, Vol. 43, p. 140-141.
* Rejoinder to: Implementation of low dead space syringes in response to an outbreak of HIV among people who inject drugs: A response to Kesten et al. Kesten J.M., Ayres R., Neale J., Clark J., Vickerman P., Hickman M., Redwood S. International Journal of Drug Policy, 2017, Vol. 43, p. 142-143.
* Rejoinder to: Implementation of low dead space syringes in response to an outbreak of HIV among people who inject drugs: A response to Kesten et al. Kesten J.M., Ayres R., Neale J., Clark J., Vickerman P., Hickman M., Redwood S. International Journal of Drug Policy, 2017, Vol. 43, p. 142-143.
Résumé :
Background: It is recommended that needle and syringe programmes (NSP) distribute low dead space syringes (LDSS) to reduce blood-borne virus transmission. We explored the acceptability of detachable LDSS among people who inject drugs (PWID) and staff who work to support them.
Methods: Semi-structured interviews were performed with 23 PWID (15 men and 8 women) and 13 NSP staff members (6 men and 7 women) in Bath and Bristol, England. Recruited PWID reflected varying demographic characteristics, drug use and injecting preferences. Interviews explored experiences of different types of injecting equipment, facilitators and barriers of changing this equipment and attitudes towards detachable LDSS. Interviews were audio recorded, transcribed verbatim and analysed using the Framework Method.
Results: Decisions about injecting practices were underpinned by several factors, including early experiences and peer initiation; awareness and availability of alternatives; and the ability to inject successfully. Rinsing and re-using syringes represented a quandary where rinsing could encourage re-use, but not rinsing could result in the re-use of unclean equipment. Most PWID were reluctant to change equipment particularly in the absence of any problems injecting. Prioritising getting a 'hit' over the prevention of potential problems was an important barrier to change. Overall detachable LDSS are likely to be acceptable. Lower risk of transferring infections and reduced drug wastage were valued benefits of detachable LDSS. There was a preference for a gradual introduction of detachable LDSS in which PWID are given an opportunity to try the new equipment alongside their usual equipment.
Conclusion: Detachable LDSS are likely to be acceptable and should therefore be offered to those using detachable high dead space syringes and/or fixed 1 ml LDSS syringes to inject into deeper femoral veins. An intervention is needed to support their introduction with 'training', 'education', 'persuasion' and eventual 'restriction' components.
Methods: Semi-structured interviews were performed with 23 PWID (15 men and 8 women) and 13 NSP staff members (6 men and 7 women) in Bath and Bristol, England. Recruited PWID reflected varying demographic characteristics, drug use and injecting preferences. Interviews explored experiences of different types of injecting equipment, facilitators and barriers of changing this equipment and attitudes towards detachable LDSS. Interviews were audio recorded, transcribed verbatim and analysed using the Framework Method.
Results: Decisions about injecting practices were underpinned by several factors, including early experiences and peer initiation; awareness and availability of alternatives; and the ability to inject successfully. Rinsing and re-using syringes represented a quandary where rinsing could encourage re-use, but not rinsing could result in the re-use of unclean equipment. Most PWID were reluctant to change equipment particularly in the absence of any problems injecting. Prioritising getting a 'hit' over the prevention of potential problems was an important barrier to change. Overall detachable LDSS are likely to be acceptable. Lower risk of transferring infections and reduced drug wastage were valued benefits of detachable LDSS. There was a preference for a gradual introduction of detachable LDSS in which PWID are given an opportunity to try the new equipment alongside their usual equipment.
Conclusion: Detachable LDSS are likely to be acceptable and should therefore be offered to those using detachable high dead space syringes and/or fixed 1 ml LDSS syringes to inject into deeper femoral veins. An intervention is needed to support their introduction with 'training', 'education', 'persuasion' and eventual 'restriction' components.
Affiliation :
NIHR Collaboration for Leadership in Applied Health Research and Care West (NIHR CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, UK
Autre(s) lien(s) :
http://findings.org.uk/PHP/dl.php?file=Kesten_JM_1.cab&s=ln
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