Résumé :
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[BDSP. Notice produite par INIST-CNRS IJoCR0xC. Diffusion soumise à autorisation]. Objectives. We assessed the effects of syringe exchange program (SEP) policy on rates of HIV risk behavior and HIV incidence among injection drug users. Methods. Using a multivariate generalized estimating equation and Cox regression methods, we examined syringe borrowing, syringe lending, and HIV incidence among a prospective cohort of 1228 injection drug users in Vancouver, British Columbia. Results. We observed substantial declines in rates of syringe borrowing (from 20.1% in 1998 to 9.2% in 2003) and syringe lending (from 19.1% in 1998 to 6.8% in 2003) following SEP policy change. These declines coincided with a statistically significant increase in the proportion of participants accessing sterile syringes from nontraditional SEP sources (P<. in multivariate analyses the period following change sep policy was independently associated with a greater than reduction syringe borrowing odds ratio confidence interval and lending ci="0.45,0.60)," as well declining hiv incidence hazard conclusions. widespread distribution appears to be more effective do restrictive policies that limit access. efforts should made ensure program design serve maximize rather hinder>
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