Abstracts
Résumé
La dernière décennie a été marquée par une augmentation importante du nombre de pays rapportant que l’injection de drogues est présente dans leur population. Et, dans plusieurs pays, particulièrement dans ceux en voie de développement, la plupart des nouveaux injecteurs ont entre 15 et 24 ans. De nombreuses conséquences sociales et sanitaires sont associées à l’injection de drogues, les principales conséquences de type infectieux étant l’hépatite C et l’infection par le virus de l’immunodéficience humaine (VIH). Nous présenterons dans cet article les comportements d’injection et les comportements sexuels des injecteurs adolescents et jeunes adultes qui en font des personnes à risque pour ces deux infections. Nous y décrirons également des caractéristiques de ces jeunes injecteurs, qui sont liées à leur âge, dont il faut tenir compte dans l’élaboration de programmes de prévention : besoins liés au développement cognitif, physique et psychologique et aux contraintes d’ordre légal. Finalement, nous exposerons les résultats d’une vaste recherche que nous avons menée dans la littérature en vue de trouver des projets de prévention de l’infection par le VIH et de l’hépatite C qui ont répondu aux besoins spécifiques des jeunes injecteurs et qui ont fait l’objet d’une évaluation. Cette recherche a démontré qu’il existe très peu d’interventions satisfaisantes dans ce domaine. Selon nous, il est urgent que de telles interventions soient développées, évaluées et diffusées afin de contrer les épidémies de VIH et d’hépatite C qui sévissent chez les jeunes injecteurs.
Abstract
The last decade has been marked by a rapid rise in the number of countries reporting injection drug use in their population. The majority of persons initiating injection are youth 15 to 24 years of age. Many social and health problems are a result of injection drug use, and the main infectious consequences are viral infections due to Human Immunodeficiency Virus (HIV) and Hepatitis C virus (HCV). This article will review the sexual and injection behaviors of young injection drug users that put them at risk of acquiring these infections. Certain cognitive, physical and psychological age-related characteristics of youth will be reviewed. These specific developmental aspects, as well as the legal constraints facing many young people, need to be taken into consideration when developing and implementing prevention programs. Finally, we will present the results of an extensive literature search aimed at identifying HIV and HCV prevention projects that were developed specifically for youth and that had an evaluation component. This search shows that there exist very few evaluated interventions that specifically address the needs of young injection drug users. There is an urgent need for youth-specific interventions to be developed, evaluated and diffused given the growing epidemic of HIV and HCV infection among young injection drug users.
Resumen
La última decada fué marcada por un aumento importante del número de países que reportan la inyeccción de drogas en su populación, y que la mayoría de los que les las inyectan tienen entre 15 y 24 años. Numerosas consecuencias sociales y sanitarias están asociadas a la inyección de drogas, las principales, de tipo infeccioso, siendo la hepatitis C y la infección por el virus de inmunodeficiencia humana (VIH). Este artículo pasa en revista los comportamientos de inyección y los comportamientos sexuales de éstos adolescentes y jóvenes adultos, que les hacen correr el riesgo de atrapar éstas dos infecciones. Describiremos igualmente ciertas características de éstos jóvenes que se inyectan drogas, que se tienen que tomar en consideración en la elaboración de programas de prevención. En razón de su edad estas personas tienen necesidades relacionadas con el desarrollo cognitivo, físico y psicológico, y con las coacciones de orden legal que deben ser tomadas en consideración.. Finalmente, presentaremos los resultados de un amplio informe de la literatura cuyo objetivo es la identificación de los proyectos de prevención de la infección por la VIH y de la hepatitis C que responden a las necesidades específicos de los jóvenes que se inyectan drogas y que ya han sido evaluados. Este informe muestra que existent muy pocas intervenciones que respondan específicamente a las necesidades de éstos jóvenes. Consideramos que es urgente que tales intervenciones sean desarrolladas, evaluadas y difundidas afín de contrar las epidemias de VIH y de hepatitis C que hacen estragos en los jóvenes que se inyectan drogas.
Appendices
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