¿Estamos estudiando adecuadamente las prácticas de inyección de drogas que implican riesgo de transmisión de enfermedades por vía parenteral?

• Autores: María J. Bravo Portela, Arturo Ortiz Castro, Jorge Galván Reyes, Gregorio Barrio Anta , Luis de la Fuente de Hoz
• Localización: Revista española de salud pública, ISSN 1135-5727, ISSN-e 2173-9110, Vol. 72, Nº. 4, 1998, págs. 289-301
• Idioma: español
• DOI: 10.1590/s1135-57271998000400002
• Títulos paralelos:
  • Drug injecting risk behaviour for the transmission of blood-borne diseases: are we studying it in the right way?
• Enlaces
  • Texto completo (pdf)
• Resumen
  • español

    El estudio de las conductas de riesgo de inyección de drogas ha sido uno de los ejes en los que se ha centrado la investigación de los determinantes de la epidemia de infección por VIH en los últimos 20 años. El estudio de estas conductas presenta dificultades metodológicas especiales. Se revisan: 1) los aspectos más relevantes que hacen de ésta un área de trabajo diferenciada del estudio de las enfermedades de transmisión sanguínea en otras poblaciones y 2) las variables básicas utilizadas por la epidemiología para operativizar los comportamientos de riesgo de inyección. Se proponen alternativas para enriquecer los planteamientos y los resultados de investigación en este área mediante la colaboración con otras disciplinas y la optimización de los recursos metodológicos de la epidemiología.

  • English

    In the last 20 years, research on the determinants of the HIV epidemic among drug users has focused mainly on studies of risk behaviour for drug injection. Studies involving human behaviour present special methodological problems. This paper presents a review of 1) the most important features that make this field different from the study of blood-borne diseases in other populations, and 2) the basic variables used in epidemiology to analyse injecting risk behaviour. Alternatives to improve research planning and results are proposed based on collaborating with other disciplines and improving the methodological resources of epidemiology.

• Referencias bibliográficas
  • Strang, J, Stimson, GV, Des Jarlais, DC. (1992). What AIDS is doing to the drug research agenda. Br J Addict. 87. 443-346
  • Stimson, GV, Eaton, G, Rhodes, T, Power, R. (1994). Potential development of community oriented HIV outreach among drug injectors in the UK....
  • Susser, M, Susser, E. (1996). Choosing a future for epidemiology: I. Eras an Paradigms. Am J Public Health,. 86. 668-673
  • Power, R. (1989). Participant observation and its place in the study of illicit drug abuse. Br J Addict. 84. 43-52
  • Rosembaum, M, Murphy, S.. (1990). The collection and interpretation of data from hidden populations. DHHS Publication. Rockville. 98. 120-127
  • Oppenheimer, E.. (1994). Heroin Addiction and Drug Policy: The British System. Oxford University Press. New York. 79-88
  • Neaigus, A, Friedman, S, Curtis, R, Des Jarlais, DC, Furst, RT, Jose, B. (1994). The relevance of drug injectors´social and risk network for...
  • Trotter II, RT, Bowen, Am, Potter, J Jr.. (1995). Social Networks, Drug Abuse, and HIV Transmission. DHHS Publication. Rockville. 151. 144-180
  • Stimson, GV, Donoghoe, MC.. (1996). Aids, drugs and prevention: Perspectives on community action. Routledge. LondonNew York. 10-21
  • Friedman, Sr, Des Jarlais, DC, Sterk, CE. (1990). Aids and the Social Relations of Intravenous Drug Users. Millbank Q. 68. 85-109
  • Ortiz, A.. (1992). Las Adicciones hacia un enfoque multidisciplinario. Secretaria de Salud. 69-78
  • Simpson, DD, Knight, D, Ray, S. (1993). Psychosocial correlats of AIDS-risk drug use and sexual behaviors. AIDS Educ and Prev. 5. 121-130
  • Woody, GE, Metzger, D, Navaline, H, McLellan, O´Brien, CP.. (1997). Social Networks, Drug Abuse, and HIV Transmission. DHHS Publication. Rockville....
  • Leshner, AI. (1997). Addiction is a Brain Disease, and it Matters. Science. 278. 45-46
  • Gossop, M, Griffits, P, Powis, B, Strang, J. (1993). Severity of heroin dependence and HIV risk. II.Sharing injecting equipment. AIDS Care....
  • De la Fuente, L, Barrio, G, Vicente, J, Bravo, MJ, Lardelli, P. (1994). Intravenous administration among heroin users having treatment in...
  • Gamella, JF. (1994). The spread of intravenous drug use and AIDS in a neighborhood in Spain. Med Anthropol Q. 8. 131-160
  • De la Fuente, L, Barrio, G, Royuela, L, Bravo, MJ. (1997). The transition from injecting to smoking heroin in three Spanish cities. Addiction....
  • De la Fuente, L, Lardelli, P, Barrio, G, Vicente, J, Luna, D. (1997). Declining prevalence of injection as main route of administration among...
  • Barrio, G, De la Fuente, L, Royuela, L, Díaz, A, Rodríguez-Artalejo, F. (1998). Cocaine use among heroin users in Spain: the diffusion of...
  • Barrio, G, De la Fuente, L, Bravo, MJ, Colomo, C. (1997). ¿Está extendiendose en España el hábito de fumar crack entre los consumidores de...
  • Feldman, HW, Aldrich, MR.. (1990). The Collection and interpretation of data from hidden populations. DHHS Publication. RocKville. 98. 144-180
  • Bravo, MJ, Barrio, G, de la Fuente, L, Colomo, C, Royuela, L, Estébanez, P. (1996). Conductas de riesgo para la transmisión del VIH entre...
  • Bravo, MJ, Barrio, G, De la Fuente, L, Colomo, C, Royuela, L. (1998). Persistencia de conductas de riesgo para la transmisión de la infección...
  • Ball, A, Des Jarlais, DC, Donoghoe, MC, Friedman, SR, Goldberg, D. (1994). Multi-city Study on Drug Injecting and Risk of HIV Infection (WHO/PSA/94.4)....
  • Hoek, JAR van den, Haastrecht, HJA van, Coutinho, RA. (1989). Risk Reduction among Intravenous Drug Users in Amsterdam under the Influence...
  • Rezza, G, Salmaso, S, Abeni, D, Brancato, G, Anemona, A, Roveta, C. (1994). HIV prevalence and frecuency of risk behavior in injecting drug...
  • Hunter, GM, Donoghoe, MC, Stimson, GV, Rhodes, T, Chalmers, CP. (1995). Changes in the injecting risk behaviour of injecting drug users in...
  • Rodríguez, A, Zunzunegui, MV, Friedman, SR, Romero, JC, Ward, TP. (1996). Sharing syringes in Madrid. A social phenomenon. Eur J Public Health....
  • Bux, DA, Lamb, RJ, Iguchi, MY. (1995). Cocaine use and HIV risk behavior in methadone maintenance patiens. Drug Alcohol Depend. 37. 29-35
  • Grund, JP, Kaplan, CD, Adriaans, NFP. (1991). Needle sharing in the Netherlands: and ethnographic analysis. Am J Public Health. 81. 1602-1607
  • Grund, J-PC, Friedman, SR, Stern, LS, José, B, Neaigus, A, Curtis, R. (1996). Syringue-mediated drug sharing among injecting drug users: patterns,...
  • Stark, K, Müller, R, Bienzle, U, Guggenmoos-Holzmann, I. (1996). Frontloading: a risk factor for HIV and hepatitis C virus infection among...
  • (1997). Memoria 1996. Ministerio del Interior. Madrid.
  • Samuels, JF, Vlahov, D, Anthony, JC, Chaisson, RE. (1992). Measurement of HIV risk behaviors among intravenous drug users. Br J Addict. 87....
  • Loimer, N, Werner, E, Presslich, O. (1991). Sharing spoons: a risk factor for HIV-1 infection in Vienna. Br J Addict. 86. 775-778
  • Hunt, N, Shelley, H, Jones, K.. Relative risks of different types of sharing: implications for research and practice. Abstract Book. Fourth...
  • (1987). Recommendations for prevention of HIV transmission in health-care settings: Enviromental Considerations for HIV transmition. MMWR....
  • (1991). Infección por VIH en usuarios de drogas. Ministerio de Sanidad y Consumo. Madrid.
  • Zunzunegui, MV, Rodríguez, MA, Sarasqueta, C. (1993). Drogadicción por vía intravenosa y riesgo de infección por VIH en Madrid, 1990. Gac...
  • Druce, JD, Locarnini, SA, Birch, CJ. (1995). Syringe cleaning techniques and transmission of HIV. AIDS. 9. 1105-1107
  • (Apri).
  • Gleghorn, AA, Doherty, MC, Vlahov, D, Jones, Ts, Celentano, DD., Jefferson, M, Garfein, R, Abdel-Tawab, N.. Insufficient bleach contact time...
  • Mandell, W, Vlahov, D, Latkin, C, Oziemkowska, M, Cohn, S. (1994). Correlates of Needle Sharing among Injection Drug Users. Am J Public Health....
  • Myers, T, Millson, M, Rigby, J, Ennis, M, Rankin, J, Mindell, W. (1995). A comparison of the determints of safe injecting and condom use among...
  • Bird, GA, Gore, SM, Hutchinson, SJ, Lewis, SC, Cameron, S, Burns, S. (1997). Harm reduction measures and injecting inside prison versus mandatory...
  • Dolan, K, Wodak, A, Penny, R. (1995). AIDS behind bars: preventing HIV spread among incarcerated drug injectors. AIDS. 9. 825-832
  • Bellis, MA, Weild, AR, Beeching, NJ, Mutton, JK, Syed, Q. (1997). Prevalence of HIV and injecting drug use in men entering Liverpool prison....
  • Martín, V, Caylá, JA, Morís, MK, Alonso, LE, Pérez, R. (1997). Evolución de la prevalencia de infección por virus de la inmunodeficiencia...
  • Müller, R, Stark, K, Guggenmoos-Holzmann, Wirth, D, Bienzle, U. (1995). Imprisoment: a risk factor for HIV infection counteracting education...
  • Donoghoe, MC, Stimson, G, Dolan, K, Alldritt, L. (1989). Changes in HIV risk behaviour in clients of syringe-exchange schemes in England and...
  • Friedman, SR.. (1995). Social Networks, Drug Abuse, and HIV Transmission. National Institute on Drug Abuse. Rockville. 151. 196-215
  • Trotter II, RT, Bowen, Am, Potter, J Jr.. (1995). Social Networks, Drug Abuse, and HIV Transmission. DHHS Publication. Rockville. 151. 144-180
  • Rhodes, T, Stimson, GV, Quirk, A. (1996). Sex, Drugs, Intervention, and Research: From the Individual to the Social. Subst Use Misuse. 31....
  • Rodés, A, Pérez, K, Cagliero, S, Sabbatini, A, Casabona, J, Edwige, A. (1997). Syringe Exchange Programmes for HIV Prevention in Southern...
  • Koester, S. (1996). Perspectives on individual and community action. Routledge. London. 133-148
  • Pearce, N. (1996). Traditional Epidemiology, Modern Epidemiology, and Public Health. Am J Public Health. 86. 687-683
  • McKeganey, N. (1995). Quantitative and qualitative research in the addictions: an unhelpful divide. Addiction. 90. 749-751
  • Agar, M. (1996). Recasting the ?Ethno? in ?Epidemiology?. Med Anthropol. 16. 391-403
  • Agar, M. (1997). Ethography: an Overview. Subst Use Misuse. 32. 1155-1173
  • Hartnoll, R. (1995). A difficult bussines. Addiction. 90. 749-751
  • Friedman, SR, Neaigus, A, Des Jarlais, D, Sotheran, JO L, Woods, J, Sufian, M. (1992). Social intervention against AIDS among injecting drug...
  • Stimson, GV, Jones, S, Chalmers, C, Sullivan, D. (1998). A short questionnaire (IRQ) to asses injecting risk behaviour. Addiction. 93. 337-347