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Do Needle and Syringe Programs Reduce Risky Behaviours Among People Who Inject Drugs in Kermanshah City, Iran? a Coarsened Exact Matching Approach Publisher Pubmed



Noroozi M1 ; Marshall BDL2 ; Noroozi A3, 4 ; Armoon B5 ; Sharifi H6 ; Farhoudian A7 ; Ghiasvand H1 ; Vameghi M8 ; Rezaei O9 ; Sayadnasiri M9 ; Pouya RH10
Authors
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Authors Affiliations
  1. 1. Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  2. 2. Department of Epidemiology, Brown University School of Public Health, Providence, United States
  3. 3. Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
  5. 5. Student Research Committee, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
  6. 6. HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
  7. 7. Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  8. 8. Social Welfare Management Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  9. 9. Psychosis Research Center, Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
  10. 10. Food Health Research Center, Hormozgan University of Medical Sciences, Bandar Abbas, Iran

Source: Drug and Alcohol Review Published:2018


Abstract

Introduction and Aims: In this study, we used a ‘coarsened exact matching’ method to evaluate the relationship between two levels of needle and syringe program (NSP) utilisation and HIV-related risk behaviours among people who inject drugs (PWID). Design and Methods: Using snowball sampling, we recruited 500 PWID (all male) in Kermanshah City, Iran between September and December 2014 in a cross-sectional survey. We categorised participants into two groups, including high (i.e. receiving 60% or more of their syringes from an NSP) and low (i.e. receiving less than 60% of their syringes from NSP) NSP users. Then, we applied coarsened exact matching to match the two groups based on confounding covariates (age, place of residence, income, receiving methadone maintenance treatment) and made statistically equivalent comparison groups to estimate the effect of the NSP on injection risk behaviours. Results: Participants with low NSP use were more likely to report borrowing syringes in past 2 months (odds ratio [OR] 1.71; 95% confidence interval [CI] 1.30, 1.86; P < 0.04), in comparison with participants with high NSP use. Regarding recent syringe lending, low NSP use was also significantly and positively associated with this outcome (OR 3.34; 95% CI 1.70, 5.20; P < 0.02). Reusing one's own syringe was reported more frequently in low NSP use group (OR 1.40; 95% CI 1.22, 3.97; P < 0.03). Discussion and Conclusions: NSPs are a promising approach to reduce injection-related risk behaviours among PWID in Kermanshah, Iran. Expanded coverage of high-quality NSPs is recommended. © 2017 Australasian Professional Society on Alcohol and other Drugs
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