학술논문

Predictors of needle exchange program utilization during its implementation and expansion in Tijuana, Mexico
Document Type
article
Source
American Journal on Addictions. 25(2)
Subject
Psychology
Clinical and Health Psychology
Applied and Developmental Psychology
Substance Misuse
Infectious Diseases
Drug Abuse (NIDA only)
Good Health and Well Being
Adult
Female
Humans
Male
Mexico
Middle Aged
Needle-Exchange Programs
Patient Acceptance of Health Care
Police
Substance Abuse
Intravenous
for Proyecto El Cuete
Substance Abuse
Applied and developmental psychology
Clinical and health psychology
Language
Abstract
ObjectiveUntil the early 2000s, there was only one needle exchange program (NEP) offered in Mexico. In 2004, the second Mexican NEP opened in Tijuana, but its utilization has not been studied. We studied predictors of initiating NEP during its early expansion in Tijuana, Mexico.MethodsFrom April 2006 to April 2007, people who inject drugs (PWID) residing in Tijuana who had injected within the last month were recruited using respondent-driven sampling. Weighted Poisson regression incorporating generalized estimating equations was used to identify predictors of initiating NEP, while accounting for correlation between recruiter and recruits.ResultsNEP uptake increased from 20% at baseline to 59% after 6 months. Among a subsample of PWID not accessing NEP at baseline (n = 480), 83% were male and median age was 37 years (Interquartile Range: 32-43). At baseline, 4.4% were HIV-infected and 5.9% had syphilis titers >1:8. In multivariate models, factors associated with NEP initiation (p 2500 pesos/month (ARR: .66); and reporting needle sharing (ARR: .71).ConclusionsUptake of NEP expansion in Tijuana was vigorous among PWID. We identified a range of factors that influenced the likelihood of NEP initiation, including police interaction. These findings have important implications for the scale-up of NEP in Mexico.