| Titre : | Ignoring'downstream infection'in the evaluation of harm reduction interventions for injection drug users. (2001) |
| Auteurs : | Harold-A POLLACK |
| Type de document : | Article |
| Dans : | European journal of epidemiology (vol. 17, n° 4, 2001) |
| Pagination : | 391-395 |
| Langues: | Anglais |
| Mots-clés : | Toxicomanie ; Sida ; Virose ; Infection ; Hépatite virale C ; Epidémiologie ; Incidence ; Facteur risque ; Homme ; Prévention santé ; Lutte contre toxicomanie ; Lutte contre sida ; Programme santé ; Evaluation ; Immunopathologie ; Appareil digestif [pathologie] ; Foie [pathologie] ; Etats Unis ; Amérique ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS rR0xsyhb. Diffusion soumise à autorisation]. Harm reduction interventions to reduce blood-borne disease incidence among injection drug users (IDUs). A common strategy to estimate the long-term impact of such interventions is to examine short-term incidence changes within a specific group of individuals exposed to the intervention. Such evaluations may overstate or understate long-term program effectiveness, depending upon the relationship between short-term and long-term incidence and prevalence. This short paper uses steady-state comparisons and a standard random-mixing model to scrutinize this evaluation approach. It shows that evaluations based upon short-term incidence changes can be significantly biased. The size and direction of the resulting bias depends upon a simple rule. For modest interventions, such analyses yield over-optimistic estimates of program effectiveness when steady-state disease prevalence exceeds 50% absent intervention. When steady-state prevalence is below 50%, such analyses display the opposite bias. |
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