开展针具交换工作所遇到的困难和风险及对策

Difficulties and risks faced during the implementation of syringe exchang program and relevant strategies to overcome them

目的旨在分析开展针具交换工作所遇到的困难和风险,为探讨克服困难、规避风险的策略和措施提供参考。方法对江西省18名针具交换专家、6名工作人员、16名同伴教育员和160名静脉注射毒品者(IDU)进行了调查。结果针具交换工作中存在的困难包括:开展针具交换工作的支持性环境有待改善,可利用资源有限;工作人员对IDU情况了解不多,对工作质量没有直接控制权,对同伴教育员控制力不够和缺乏有效的监督手段;同伴教育员工作积极性不高,开展工作的时间和精力有限等。风险包括:工作人员受到吸毒人员的恐吓、威胁和伤害;存在被污染针具划伤的危险等。结论加强领导开发,部门协调,社区宣传;提高同伴教育员数量和质量;加强工作过程监督;加强安全防范,保障工作人员和同伴教育员人身、财产安全等措施有利于困难和风险的应对。

Objective To analyze difficulties and risks faced during the implementation of syringe exchange program and provide information for overcoming potential difficulties and risks and development of relevant strategies. Methods Interviews were conducted for 18 syringe exchange experts, 6 working staff. 16 peer educators and 160 injecting drug users （IDUs） in Jiangxi province. Results The difficulties faced during the implementation of syringe exchange program included：imperfect supporting environment, insufficient usable resources, poor understanding of IDU among working staff, absence of direct quality control, inadequate control of peer education and lack of effective tool of supervision, low motivation of peer educators who had limited time and energy to fulfill their missions. The risks faced included：threats and injuries potentially imposed by drug users and possibility of being injured by contaminated injection devices. Conclusion To overcome potential difficulties and risks it is important to strengthen leadership development, sector coordination and community education, increase the quantity and quality of peer educators, reinforce supervision of the syringe exchange process and safety preparedness, protect personal and property safety for working staff.