Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects

Detalhes bibliográficos
Autor(a) principal: Bastos, Francisco Inácio Pinkusfeld Monteiro
Data de Publicação: 2000
Outros Autores: Strathdee, Steffanie Anne
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/612
Resumo: The authors gratefully acknowledge Dr. T. Valente who provided a critical review of the manuscript and Ms. T.O. Johnson who assisted in manuscript preparation. They thank also Drs. Nick Crofts (Australia)and Fernando Marques (Brazil) for the unpublished information they kindly provided. FIB is partially supported by a National Research Council (CNPq) salary grant (IIA) and is a recipient of an award scholarship from Rio de Janeiro Research Council (FAPERJ).
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spelling Bastos, Francisco Inácio Pinkusfeld MonteiroStrathdee, Steffanie Anne2010-08-23T16:58:31Z2010-11-04T14:19:50Z2010-08-23T16:58:31Z2010-11-04T14:19:50Z2000BASTOS, Francisco Inácio Pinkusfeld Monteiro; STRATHDEE, Steffanie Anne. Evaluating e efectiveness of syringe exchange programmes: current issues and future prospects. Social Science & Medicine, v. 51, p. 1771-1782, 2000.0277-9536https://www.arca.fiocruz.br/handle/icict/612The authors gratefully acknowledge Dr. T. Valente who provided a critical review of the manuscript and Ms. T.O. Johnson who assisted in manuscript preparation. They thank also Drs. Nick Crofts (Australia)and Fernando Marques (Brazil) for the unpublished information they kindly provided. FIB is partially supported by a National Research Council (CNPq) salary grant (IIA) and is a recipient of an award scholarship from Rio de Janeiro Research Council (FAPERJ).Although a large body of international literature has found syringe exchange programmes (SEPs) to be associated with reduced incidence of blood borne pathogens among injection drug users, recent studies have fuelled controversy surrounding SEP e ectiveness. Existing studies are observational in nature and have seldom considered ecologic aspects a ecting SEP functioning and evaluation. The authors apply concepts from infectious disease epidemiology to discuss the direct and indirect e ects of SEP upon the spread of blood borne pathogens in drug users, their social networks and the broader community. Further, the authors discuss social policies, particularly drug control policies, which have directly and/or indirectly limited SEP functioning at local and national levels. A critical review of the literature suggests that biases common to observational studies can account for higher HIV incidence among SEP attenders relative to non-attenders. Strong selection factors often lead high-risk drug users to be over-represented among SEP attenders. Failure to account for these factors and the indirect e ects of SEPs can bias interpretations of programme e ectiveness. Future SEP evaluations should consider behavioural data, the local ethnographic context, the prevalence of infectious disease in the groups under study and the structural components of SEP that are most and least e ective at reducing incidence of blood borne pathogens. Hierarchical models that take into account the ecological dimensions of SEP are recommended as an approach for future studies. Beyond methodologic concerns, the authors discuss social, legal and programmatic obstacles that must be overcome in order to maximise SEP e ectiveness.Oswaldo Cruz Foundation. Center for Scientific and Technological Information. Department of Health Information. Rio de Janeiro, RJ, Brazil.Johns Hopkins University. School of Hygiene and Public Health. Department of Epidemiology. Baltimore, MD, USA.engElsevier Science LtdSyringe-exchange programmesInjecting drug usersHIVBlood borne infectionsEpidemiologyEcological studiesEvaluating e ectiveness of syringe exchange programmes: current issues and future prospectsinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZTEXTBastos_Evaluating Effectiveness os syringe_2000.pdf.txtBastos_Evaluating Effectiveness os syringe_2000.pdf.txtExtracted texttext/plain63922https://www.arca.fiocruz.br/bitstream/icict/612/6/Bastos_Evaluating%20Effectiveness%20os%20syringe_2000.pdf.txt3c1a00ee1a4d9dd630cced5525bfdb2eMD56ORIGINALBastos_Evaluating Effectiveness os syringe_2000.pdfapplication/pdf151776https://www.arca.fiocruz.br/bitstream/icict/612/2/Bastos_Evaluating%20Effectiveness%20os%20syringe_2000.pdf3afdc3927234a015949668b91d37e4e7MD52LICENSElicense.txttext/plain1841https://www.arca.fiocruz.br/bitstream/icict/612/3/license.txt94fc60ed243e752c2053c81ada7b10beMD53THUMBNAILBastos_Evaluating Effectiveness os syringe_2000.pdf.jpgBastos_Evaluating Effectiveness os syringe_2000.pdf.jpgGenerated Thumbnailimage/jpeg1703https://www.arca.fiocruz.br/bitstream/icict/612/5/Bastos_Evaluating%20Effectiveness%20os%20syringe_2000.pdf.jpgba39e8509dd1393885fd0b43a5473c65MD55icict/6122023-08-23 15:29:27.665oai:www.arca.fiocruz.br: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Repositório InstitucionalPUBhttps://www.arca.fiocruz.br/oai/requestrepositorio.arca@fiocruz.bropendoar:21352023-08-23T18:29:27Repositório Institucional da FIOCRUZ (ARCA) - Fundação Oswaldo Cruz (FIOCRUZ)false
dc.title.pt_BR.fl_str_mv Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
title Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
spellingShingle Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
Bastos, Francisco Inácio Pinkusfeld Monteiro
Syringe-exchange programmes
Injecting drug users
HIV
Blood borne infections
Epidemiology
Ecological studies
title_short Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
title_full Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
title_fullStr Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
title_full_unstemmed Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
title_sort Evaluating e ectiveness of syringe exchange programmes: current issues and future prospects
author Bastos, Francisco Inácio Pinkusfeld Monteiro
author_facet Bastos, Francisco Inácio Pinkusfeld Monteiro
Strathdee, Steffanie Anne
author_role author
author2 Strathdee, Steffanie Anne
author2_role author
dc.contributor.author.fl_str_mv Bastos, Francisco Inácio Pinkusfeld Monteiro
Strathdee, Steffanie Anne
dc.subject.por.fl_str_mv Syringe-exchange programmes
Injecting drug users
HIV
Blood borne infections
Epidemiology
Ecological studies
topic Syringe-exchange programmes
Injecting drug users
HIV
Blood borne infections
Epidemiology
Ecological studies
description The authors gratefully acknowledge Dr. T. Valente who provided a critical review of the manuscript and Ms. T.O. Johnson who assisted in manuscript preparation. They thank also Drs. Nick Crofts (Australia)and Fernando Marques (Brazil) for the unpublished information they kindly provided. FIB is partially supported by a National Research Council (CNPq) salary grant (IIA) and is a recipient of an award scholarship from Rio de Janeiro Research Council (FAPERJ).
publishDate 2000
dc.date.issued.fl_str_mv 2000
dc.date.accessioned.fl_str_mv 2010-08-23T16:58:31Z
2010-11-04T14:19:50Z
dc.date.available.fl_str_mv 2010-08-23T16:58:31Z
2010-11-04T14:19:50Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
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dc.identifier.citation.fl_str_mv BASTOS, Francisco Inácio Pinkusfeld Monteiro; STRATHDEE, Steffanie Anne. Evaluating e efectiveness of syringe exchange programmes: current issues and future prospects. Social Science & Medicine, v. 51, p. 1771-1782, 2000.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/612
dc.identifier.issn.pt_BR.fl_str_mv 0277-9536
identifier_str_mv BASTOS, Francisco Inácio Pinkusfeld Monteiro; STRATHDEE, Steffanie Anne. Evaluating e efectiveness of syringe exchange programmes: current issues and future prospects. Social Science & Medicine, v. 51, p. 1771-1782, 2000.
0277-9536
url https://www.arca.fiocruz.br/handle/icict/612
dc.language.iso.fl_str_mv eng
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dc.publisher.none.fl_str_mv Elsevier Science Ltd
publisher.none.fl_str_mv Elsevier Science Ltd
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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