开展清洁针具交换 预防静脉吸毒感染

目的探索针具交换对干预预防艾滋病在吸毒人群中传播的可行性,为全面开展针具交换干预工作提供经验和科学依据。方法在社区开展针具交换和健康教育活动;比较干预前后艾滋病知晓率、艾滋病传播危险行为学指标和HIV抗体阳性率,以评价干预效果。结果干预后吸毒人群的艾滋病知识知晓率比干预前低。结论在吸毒人群中开展针具交换有助于改变吸毒人群共用针具的危险行为,控制艾滋病传播。     

吸毒人群从首次吸毒到静脉注射吸毒的转变研究

目的:了解四川省某地区吸毒人群从首次吸毒到静脉注射吸毒的发生率及影响因素.方法:于2002年11月在社区招募吸毒人员382人,调查该人群的社会人口学特征,首次吸毒、首次静脉注射吸毒时间等.结果:从首次吸毒到静脉注射吸毒的发生率为32.56/100人年.在多因素分析中,首次吸毒时年龄(HR值为1.66;95%CI为1.35-2.05)、民族(HR值为1.38;95%CI为1.10-1.74)、文化(HR值为0.75;95%CI为0.60-0.93)和收入(HR值为0.64;95%CI为0.52-0.79)与首次吸毒转变为静脉吸毒的发生率有统计学意义.结论:应针对不同的民族、文化、收入及年龄特点,对吸毒人群开展健康教育和行为干预,控制艾滋病病毒的传播.     

贵阳市吸毒人群传播艾滋病的危险行为干预研究

目的：探索贵阳市社区普通人群和吸毒人群传播艾滋病危险行为的有效干预方法，以此提高他们预防艾滋病的知识水平及对毒品和艾滋病的警觉性，提倡百分之百使用安全套，降低吸毒人群共用注射针剂的高危行为。方法：利用调查表对三个社区及两个戒毒所的吸毒人群1192人进行艾滋病知识，态度，行为等基线资料调查，采用发放宣传资料，讲课，放录像，防治咨询，发放安全套和一次性注射器等方法进行教育干扰。结果：通过健康教育干预后，预防STD／AIDS知识比基线调查的回答正确率显著提高；艾滋病是传染病由82．67％上升到92．91％，对艾滋病的三种传播途径的了解由61．83％提高到75．45％，认为一般日常生活接触不会传播艾滋病的由70．50％上升到98．43％，共用注射器静脉吸毒可传播艾滋病由74％上升到89．53％，高危行为时使用安全套可预防性病艾滋病由43．25％上升到65．16％，经χ^2检验差异均具有非常显著意义（P＜0．01),结论：在社区吸毒人群中采用大力宣传，“同伴教育”健康咨询等预防策略及减少伤害等干预措施是吸毒人群中遇到STD／AIDS蔓延的重要干预手段，应在全省各社区广泛开展。     

戒毒所内对吸毒人群进行艾滋病干预的效果研究

目的：评价在戒毒所进行艾滋病咨询及心理干预对吸毒人群戒毒的效果。方法采用自行设计的问卷,以面对面询问方式,对戒毒所内的吸毒人员进行干预前后调查。结果261名吸毒者接受了干预前问卷调查,其中132例自愿参与咨询、接受心理干预,并做了干预后调查。干预后吸毒人群对艾滋病防治、性传播疾病、自愿咨询检测知识知晓率均明显提高;自愿咨询检测利用率、性病就诊行为好转率均有明显提高。结论在戒毒所开展咨询与心理干预,可以提高吸毒人群艾滋病的防治知识,改变相关危险行为,在戒毒所对吸毒人群开展艾滋病咨询与心理干预是预防艾滋病在吸毒人群中传播的有效途径。     

2008～2010年某市吸毒人群艾滋病流行病学分析

目的 了解某市1 204例吸毒人群的艾滋病流行病学特点,为制订针对该吸毒人群的艾滋病防制措施提供科学依据.方法 以中国疾病预防控制中心艾滋病预防与控制中心统一编制的健康状况调查表为基础,结合当地实际情况设计调查问卷,于2008～2010年对某社区、戒毒所等随机抽取的1 204例吸毒人员进行面对面问卷调查.结果 发放调查问卷1 204份,回收1 204份,有效回收率100％.人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染率为1.7％.高危人群以男性、18～40岁、初中及以下文化程度、无业人员为主,危险因素主要有针具共用、无套性交、商业性交易等可能导致艾滋病传播流行的因素.该人群对艾滋病三大传播途径、预防知识知晓率高,均大于90％,但是接受过艾滋病相关预防服务的比例较低,仅为1.2％.结论 该市吸毒人群中的HIV感染率较低,但是危险行为因素仍然存在,知信行不一致,存在较高的感染HIV的机会.应该加大干预力度,控制艾滋病的蔓延.     

针具交换结合同伴宣传对吸毒者艾滋病知识及高危性行为的干预效果分析

目的:通过同伴宣传和针具交换项目提高干预对象关于艾滋病知识的知晓率,减少吸毒者传播和感染艾滋病病毒的高危行为,降低吸毒人群中艾滋病病毒的传播流行。方法:通过卫生工作人员和同伴宣传员向吸毒者提供并回收清洁针具、发放宣传折页、张贴宣传画以及对吸毒者进行面对面的宣传等措施在广西壮族自治区百色地区的注射吸毒者中开展了为期1 a的针具交换和同伴宣传项目。在干预前后分别进行基线和终期横断面调查,通过对比两次调查中吸毒者的艾滋病知识和自我报告的高危性行为等变化情况对干预效果进行评估。结果:终期调查时,吸毒者所有艾滋病知识的知晓率均显著高于基线调查时;在终期调查时吸毒者的单一性伴比例为50.5%,显著高于基线调查(27.6%)时,但是他们在婚外性行为中的安全套使用率却显著低于基线调查。结论:同伴宣传结合针具交换干预措施能显著提高吸毒者关于艾滋病方面的知识,显著降低吸毒者多性伴的比例,但是对于提高他们的安全套使用率方面却没有效果。     

心理干预对HIV/AIDS患者心理卫生状况的影响

目的：探讨心理干预对HIV/AIDS患者心理卫生状况的影响。方法：采用90项症状清单（SCL-90）对74例HIV/AIDS患者进行问卷调查分析、心理干预,比较干预前后心理卫生状况的改变。结果：74例HIV/AIDS患者中,62例（86.11%）存在程度不同的心理卫生问题,心理干预前后SCL-90各因子分比较有显著差异。结论：对HIV/AIDS患者进行心理干预可以改善他们的心理卫生状况。建议对HIV/AIDS人群进行心理干预,以改善心理健康状况,配合临床治疗,提高疗效。     

云南省清洁针具交换在全省艾滋病防治工作中的效果及经济成本分析

目的 分析2011-2017年云南省清洁针具交换工作在全省艾滋病防治工作中的效果和经济成本.方法 对云南省清洁针具交换国家数据库和云南省数据库的NSP数据进行描述与分析.结果 清洁针具交换年均服务人数为1.1-1.4万人,年度HIV检测率在50％以上,针具交换服务人群中HIV阳性检出率由2011年的14.2％下降至20...     

海洛因依赖者HIV抗体检测结果分析及控制 HIV的行为干预

目的分析7558例海洛因依赖者HIV抗体检测结果.方法采用ELISA法进行HIV抗体初检,阳性者送广东省疾病控制中心HIV实验室,用蛋白印迹法(WB)复核确诊.结果 HIV感染者/AIDS病人呈上升趋势,其中以2000年海洛因依赖者阳性率最高.在海洛因依赖者HIV抗体阳性中年龄在30岁以下,多为青少年和青年.7558例海洛因依赖者HIV抗体阳性率中广东和新疆地区较高.讨论本院收治的海洛因依赖者HIV抗体阳性率逐年上升,其中在2000年海洛因依赖者阳性率上升的幅度最大.来自全国自愿戒毒人员以广东和新疆感染人数最多,该区是边境开放地区,与外来人员交往甚密,这说明境外传入和新世纪观念的转变有关.来我院戒毒人员多为青少年和青年,心理承受能力差,缺乏有关艾滋病传播方式和预防方法的知识,共用注射器及不安全性行为普遍存在.戒毒人员出院后往往与社会一般人群形成一体,成为HIV从吸毒人群向一般人群传播的主要途径,应引起防预部门的重视.行为干预是控制艾滋病流行的有效措施,应大力推广正确使用安全套,积极推广清洁针具,减少吸毒人员共用注射器,防止HIV的蔓延和传播.而HIV感染的吸毒人员有反社会的人格倾向,有效的行为干预实施面临新的难题.     

吸毒人群对自身和同伴染患HIV/AIDS的态度调查

目的·· :了解吸毒人群对自身和同伴染患HIV/AIDS后的态度。方法·· :随机抽取正在接受脱毒治疗的500名海洛因依赖者 ,匿名填写问卷进行调查。结果·· :91.6 %的吸毒者担心过去的行为会感染HIV;89 %的人希望接受HIV检测,11 %拒绝检查,其原因依次为:恐惧 (70.9 % )、没必要 (20.0 % )、担心被人知道 (9.1 % ) ;对自身感染HIV后的态度:寻求治疗者66.0% ,报复社会者12.6 % ,有轻生倾向者11.2 % ,希望得到别人的理解和帮助者94.6% ;对同伴感染HIV后的态度 :69.2 %的人采取远离和回避,愿意提供帮助者仅为8.8 %。结论·· :吸毒人群对自身和同伴染患HIV/AIDS存在矛盾的心理 ,HIV感染造成的精神压力和逆反心理 ,有使其产生轻生或违法行为的倾向 ;提供相应的医疗、管理与咨询服务,进行必要的预防教育、行为干预和集中治疗 ,对预防和减少吸毒者感染HIV后对正常人群的威胁具有积极和重要的意义     

Circumstances Surrounding Needle Use Transitions among Injection Drug Users: Implications for HIV Intervention

Injection drug users (IDUs) are at increased risk of infection with the human immunodeficiency virus (HIV). Intervention programs aimed at reducing the spread of HIV in this population typically incorporate a range of risk reduction strategies, including encouragement to move from injection to noninjection. However, very little is known about the factors associated with needle use transitions, either spontaneous or in response to intervention. We report a study in which a cohort of IDUs were asked about the reasons they stopped and restarted injection. Of 855 IDUs, 179 (21%) had had at least one 12-month period of noninjection since they first injected. Almost one-half of the reasons given for stopping injecting related to personal crises, characterized by major shifts in attitude to drugs and/or life more generally, and often generated by pressures in significant relationships. Concerns about HIV were cited by only one respondent. Many of the factors associated with transition out of needle use in the study population are not readily amenable to intervention. The implications of this for HIV risk reduction programs are discussed.     

Models of Medical Care for HIV-infected Drug Users

Abstract

HIV-infected substance users present a variety of challenges to successful health care delivery. Difficulties in care arise from several issues including provider-patient mistrust, lack of education on the part of providers regarding issues related to addiction, and personal disorganization on the part of active users. Each of these issues affects patient adherence to medical regimens and access to care. Standard ambulatory medical settings may not effectively engage addicts in longitudinal comprehensive care. We present an overview and critique of models specifically designed to treat this population.     

Depression as an Antecedent of Frequency of Intravenous Drug Use in an Urban,Nontreatment Sample

The present study examined the relationship between depressive symptoms and frequency of drug use in 91 low income nontreatment intravenous drug users in Baltimore, Maryland. The majority of participants were injecting both heroin and cocaine. Scores on the depression scale at both waves were correlated with frequency of injection at wave two. Depression at wave one had a higher correlation with frequency of injections at wave two than did concurrent depression at wave two. Even after accounting for several confounds between depression and frequency of injection, depression at wave one remained highly correlated with frequency of injection at wave two.     

436例吸毒人员HIV、HCV和梅毒检测结果的分析

目的通过对新会区戒毒所吸毒人员HIV、HCV和梅毒的检测,了解吸毒人群经血传播疾病的危险因素,为预防控制艾滋病在吸毒人群的流行提供科学依据。方法对新会区2011年戒毒所的436例吸毒人员进行问卷调查,采取静脉血的方法抽取血样,进行HIV、HCV和梅毒抗体检测,并对结果进行统计和分析。结果 436例吸毒人员HIV感染率为3.4%(15/436),HCV感染率为36.9%(161/436),梅毒感染率为9.4%(41/436)。HIV、HCV的感染途径以共用注射器静脉吸毒为主。结论被调查人群中存在血源性疾病传播和流行的风险,应加强对吸毒人群的监测,同时开展防病知识宣传教育和行为干预,以降低HIV、HCV和梅毒在该人群中的传播和扩散,控制艾滋病等血源性传染病的蔓延和流行。     

Prevalence of Infections,HIV Risk Behaviors and Factors Associated with HIV Infection Among Male Injecting Drug Users Attending a Needle/Syringe Exchange Program in Dhaka,Bangladesh

Injecting drug users (IDU) in Bangladesh are at the early stages of an HIV epidemic. To understand the dynamics of the HIV epidemic, male IDU (n = 561) were recruited from the needle/syringe exchange program in Dhaka in 2002, who underwent a risk-behavior survey and were tested for HIV, syphilis, hepatitis C, and hepatitis B. Correlates of HIV infection were determined by conducting bivariate and multiple regression analyses. The median age of the IDU was 35 years, 39.6% had no formal education, approximately half were married and/or living with their regular sex partner and 26% were currently homeless. The median age at first injection was 29 years. HIV was detected in 5.9% of the IDU and homelessness was the only factor independently associated with HIV (OR = 5.5). Urgent measures must be undertaken to prevent escalation of the HIV epidemic. The study's limitations are noted.     

联合用药干预对门诊抗菌药物注射剂应用安全性的影响

目的:提高门诊抗菌药物注射剂应用的安全性。方法:采用前瞻性随机对照方法,选取我院门诊2007年应用抗菌药物注射剂的患者为研究对象,随机分为对照组与干预组,针对联合用药因素,采用宣传教育、行政干预、监督检查等措施进行临床干预,观察干预前、后的联合用药合理性、不良反应发生率等变化情况。结果:与对照组相比,干预组联合用药合理性明显提高(P<0.01),干预后不良反应发生率降低。结论:针对联合用药因素进行干预,可提高门诊抗菌药物注射剂应用的安全性。     

Advantageous Features of Plant-based Systems for the Development of HIV Vaccines

Plants have recently become an attractive option for the production of recombinant proteins. Plant-based systems can be used to produce many classes of foreign proteins including candidate vaccine antigens. The selected antigen can be purified from plant material prior to delivery by the preferred route, or alternatively delivered orally in edible plant material that has been processed to give a homogeneous and stable product. Several plant species have been used to express a wide range of vaccine candidates with tobacco, potato and corn being particularly favored. Corn seed is especially well suited to various food processing technologies that generate dry homogeneous material suitable for extended storage and refrigeration-free transport and distribution. Many antigens have been expressed in corn and assessed for efficacy in trials with generally positive results. Candidate HIV vaccines are particularly good targets for plant-based oral delivery since there is a great need for an easily distributed affordable vaccine that could be administered without injection and induce strong mucosal immune responses. As a first step in evaluating plant expression technology with a relevant antigen that might easily be tested in an animal system, we expressed the SIV major surface glycoprotein gp130 (analogous to HIV gp120) in corn seed. Expression levels were achieved that are compatible with conducting oral delivery trials in animals.     

Secondary Syringe Exchange as a Model for HIV Prevention Programs in the Russian Federation

Effective prevention of syringe-borne transmission of HIV and the hepatitis viruses can be undermined if contact between injection drug users and the staff of prevention programs is impeded by police harassment, limited program resources, and the absence of an open “drug scene.” All these are commonplace in the Russian Federation. In response, “Project Renewal,” the harm reduction program of the AIDS Prevention and Control Center of the Tatarstan Ministry of Health in Kazan, has created a hybrid syringe exchange program that as its primary focus recruited and trained volunteers to provide secondary syringe exchange. To compensate for operational barriers, the program staff identified private venues and trained responsible individuals to work through their own and related networks of injectors to provide clean syringes, other harm reduction supplies, and educational materials, while facilitating the collection and removal of used and potentially contaminated syringes. Program staff developed a detailed set of tracking instruments to monitor, on a daily and weekly basis, the locations and types of contacts and the dissemination of trainings and materials to ensure that the secondary distribution network reaches its target audience. Data show that these secondary exchange sites have proven more productive than the primary mobile and fixed-site syringe exchanges in Kazan. Beginning in 2001, Project Renewal has trained other harm reduction programs in the Russian Federation to use this model of reaching injectors, identifying and training volunteers, and monitoring results of secondary syringe exchange.     

Predictors of Sharing Drugs Among Injection Drug Users in the South Bronx: Implications for HIV Transmission

Abstract

HIV may be transmitted in the process of sharing injected drugs, even if all participants have their own syringes. In an effort to gain understanding of the extent and predictors of drug sharing, data were obtained via personal interviews with 1,024 injection drug users from four neighborhoods in the South Bronx. The relationship between drug-sharing and demographic, sexual, and drug-related variables was first examined in a bivariate analysis, and then via multiple logistic regression. Individuals who split drugs were more likely to be female, have had sex with a casual partner, exchanged sex for drugs or other needs, recently smoked crack cocaine, and shared needles. They were less likely to live or inject at their own home or have used a new needle the last time they injected. In a final logistic model, correlates of drug sharing included trading sex, injecting outside one's home, and using borrowed, rented or shared needles. Despite the lack of significance for gender in the final logistic model, females were at high risk of drug sharing because they constituted the great majority of those who exchanged sex. Continuing research is needed to understand how drug-sharing contributes to the spread of HIV and other infections, as are studies of approaches to reducing drug sharing. Prevention strategists and outreach organizations should be aware of the HIV risks inherent in the widespread practice of drug sharing.     

Implications of Systems Dynamic Models and Control Theory for Environmental Approaches to the Prevention of Alcohol- and Other Drug Use-Related Problems

The approach described in this article is premised on the idea that drug and alcohol use-related problems are heterogeneously distributed with respect to population and geography, and therefore, are essentially local problems. More specifically, it is argued that viewing a local community as an interacting set of systems that support or buffer the occurrence of specific substance misuse outcomes, opens up to research two important prospects. The first of these involves creating adequate systems models that can capture the primary community structures and relationships that support public health problems such as alcohol and drug misuse and related outcomes. The second entails rationally testing control strategies that have the potential to moderate or reduce these problems. Understanding and controlling complex dynamic systems models nowadays pervades all scientific disciplines, and it is to research in areas such as biology, ecology, engineering, computer sciences, and mathematics that researchers in the field of addictions must turn to in order to better study the complexity that confronts them as they try to understand and prevent problems resulting from alcohol and drug use and misuse. Here we set out what such a systems-based understanding of alcohol- and drug use-related problems will require and discuss its implications for public policy and prevention programming.