Rào cản trong tiếp cận bơm kim tiêm của người tiêm chích ma túy: Một số kết quả định tính từ quận Hai Bà Trưng, Hà Nội

RAO CAN TRONG TIEP CAN BUM KIM TIEM CUA NGU&I TIEM CHICH MA TUY:

MOT SO KET QUA DjNH TINH TUT QUAN HAI BA TRUNG, HA NOI

NGUYI N THI TUYET MAI, TTYTqupn Hai Bi Trwng, Hi Ngi

HO THj HIEN, Trw&ng Dai hgc Y te Cong cgng

TOM TAT

Tpi Hi Ngi cic nghien ciru vi can thipp giim hai cho

ngirai tiem chich ma tiiy (TCMT) chira nhiiu mpc dii

vipc triin khai cic ki hopch can thipp phii hgp cho tung

dia phtrang li hit sire cin thiit Nghien ciru niy tim hiiu

nhiing rio cin trong tiip cpn bam kim tiem (BKT) doi v&i

nguoi TCMT tpi qupn Hai Bi Tnmg tir thing 4 din

thing 10 nam 2009. Nghien ciru sir dyng thiit ki dmh

tinh, phong vin siu v&i 31 doi ttrgng TCMT. So lipu

dtrgc phin tich theo chii di.

Kit qua nghien ciru cho thiy cd nhiiu rao can tir

phia nguoi TCMT va hp thong djch vy y te trong tiip cpn

BKT cua nguoi TCMT. Nguoi TCMT rat ngai din hipu

thuoc di mua BKT vi sg bi cdng an "phyc" bat dua di cai

nghipn tpp trung. Hipu thuoc thir&ng li nguon cung cap

BKT chinh nhung nhiiu hipu thuoc khdng muon ban

BKT cho ngtr&l TCMT. Nguon BKT mien phi do cac dy

in cip thdng qua dpi ngu dong ding vien va cin bg y ti,

song vipc phan phit BKT ch! m&i dimg Ipi a so luong it

Nhieu cin bg y ti phit it BKT cho nguoi TCMT vi ngpl

hg mang di bin.

cin tang ctr&ng m& rgng chuong trinh phan phit

BKTdtr&i nhiiu hinh thirc. Cin cd chinh sich khuyin

khich cin bg y ti, nguoi bin thuoc, tmng thi/c hipn

chuong tnnh BKT. Cdng an cung can nang cao nhpn thiio

vi giam hpi, dpc bipt li Igi ich ciia chuong trinh BKT.

Tir khda: tiem chich ma ttiy, ngirai tiem chich ma tuy,

bam kim tiem, tiip cpn. Ha ngi, Vipt nam

SUMMARY

Title: Barriers to accessing needle and syringe

program among injecting dmg users: qualitative findings

Little research has been conducted in Hanoi on hamn

reduction for injecting dmg users (IDUs) in order to find

an appropriate plan and Intervention for locality. This

study draws on the barriers to acessing needle and

syringe (NS) pmgram among IDUs in Hai Ba Tmng

disctrict of Hanoi from April to October 2009. This study

employed qualitative design, interviewing 31 IDUs. Data

was analyzed using thematic analysis method.

Findings showed that there am different barriers for

IDUs to access NS pmgram. For IDUs, they are afraid to

buy NS because they are scared police will anest them

to put in the compulsory detoxification center

Phanvacies are the main soume of NS, however, many

of them did not want to sell for IDUs. Free needles and

syringes could be obtained from peer wori<ers and health

workers, but in a small scale only. Health workers do not

want to give NS to IDUS sometimes because they afraid

they will sell them.

There is an urgent need to expand NSP for IDUs. In

is important to encourage phamnacists, health wori<ers,

and police so that they can support NS pmgram.

Key words: Dmg injection, injecting dmg users,

needles and syringes, access, Hanoi, Vietnam

OAT VAN D &

Djch HIV tgi Vipt Nam tap trung trong cac nhdm qudn

thi chinh cd nguy co cao: ngudi tiem chich ma tiiy

(TCMT), phg nir mgi ddm (PNMD), nam tinh dgc dong

gidi (MSM) [1]. Ti lp tiem chich ma tiiy trong cdc trudng

hpp nhiem HIV Id cao nhat 52% [2]. Ti le nhilm HIV

eCJng rdt cao d nhdm ngudi TCMT, ti le nay tren toan

quoc trung binh Id 28,6% [1].

TCMT va diing chung dgng eg tiem chich lay nhiem

Id yeu to ehinh lan truyen HIV d Vipt Nam. Theo To

chirc Y t l Thi Gidi, hieu qua cua lay truyen HIV theo

dudng tiem chich thudng cao hon 6 lan hieu qua cua

Idy truyln theo dudng quan hp tinh due khde gidi [3].

Dilu ndy giai thieh su lan rpng nhanh chdng HIV trong

cpng dong chich ma tiiy vd chi ra tam quan trpng cua

vipc dy phdng eho doi tupng TCMT.

Da ed rat nhilu bdo cdo vd nghien eiru tren thi gidi

chi ra rang yeu to nguy eo lam lay truyen HIV Id diing

chung tryc tilp vd gidn tiep BKT [4]. Cac ylu to ve an

ninh, lugt phdp dd kit hpp Igi tgo nen mdi trudng tiem

chich khdng an todn vi ngudi TCMT khdng cd dii BKT

d l sir dgng vd dilg ndy Idm tang kha ndng diing chung

BKT vd ma tiiy [5]. Vi vdy, tiep cgn va sir dgng BKT

sgeh se lam giam tinh trgng Idy truyln HIV/AIDS, hgn

chi toe dp Idy truyln ciia vi riit HIV. Day la vipc cap thilt

trong cdng tdc can thipp giam tdc hgi gdp phan ngdn

chgn dgi djch HIV/AIDS Idy lan ra cpng dong.

Qudn Hai Bd Trung cd s6 ngudi nhiim HIV ciia

qudn ludn cao thir hai Thanh pho Hd Npi trong nhieu

ndm gan ddy. Din 25/2/2009 lOy tich ngudi nhiem HIV

eiia qudn Id 1.637 ngudi, da tir vong 316 ngudi. Ti lp

ngudi TCMT d bpnh nhdn nhiem HIV chilm 71,22% [6].

Muc tieu

1. Tim hiiu nh&ng rao can doi vdi viec tiep can va

sir dgng bom kim tiem ciia ngudi tiem ehieh ma tiiy tgi

qugn Hai Bd Trung ndm 2009.

2. De xuat mpt so khuyin nghj, giai phdp thieh hpp

nhdm duy tri, md rpng chuong trinh tilp can sir dgng

bom kim tiem eho ngudi tiem ehieh ma tiiy tgi qugn Hai

Bd Trung.

D 6 | TU'Q'NG, PHU'ONG PHAP NGHIEN CU'U

Nghien ciru dupe tiln hdnh theo phuong phdp

nghien eiru dmh tinh, vdi 31 ngudi TCMT tgi phudng

trong thdi gian tir thdng 4 din thdng 10 ndm 2009 tgi

qugn Hai Ba Trung. Chpn miu trong nqhien ciru la chpn

mau ed ehii dich vd ehpn mau hdn tuyet lan. Cde so lipu

nghien cii'u djnh tinh thu dupc bdng phdng van sdu ban

eau true. So lieu dupc phdn tich theo ehu dl.

K£T QUA

Cd rat nhilu ly do Idm eho Hai Bd Trung ed so lupng

ngudi nhilm HIV cao va tap trung ehu ylu d ngudi

TCMT. Trong dd nhirng rdo can trong tilp cgn vdi nguon

BKT sgch Id mpt trong nhirng van d l y t l cpng cpng can

giai quylt.

Y HOC THl/C HANH (755) - S6 3/2011 31