HIV感染高风险男男性行为人群合成毒品使用现况及相关因素分析

目的了解HIV感染高风险MSM的合成毒品使用现况及其影响因素。方法2017年1-8月,在广州市、深圳市和无锡市3个城市开展横断面调查,通过检测门诊、线上广告和滚雪球等方式招募HIV感染高风险MSM。纳入标准为≥18岁男性、最近6个月男性性伴数≥2个或与临时性伴发生无保护肛交或患有STD。自填问卷收集社会人口学、性行为特征、HIV/STD检测、合成毒品使用等信息。采集静脉血检测HIV。结果共招募603名HIV感染高风险MSM,最近6个月合成毒品使用的比例为25.5%(154/603,95%CI:22.0%~29.0%),其中广州市为29.1%(88/302,95%CI:24.0%~34.3%)、深圳市为26.3%(40/152,95%CI:19.2%~33.4%)、无锡市为17.4%(26/149,95%CI:11.3%~23.6%)。吸入性亚硝酸盐(85.1%,131/154)为最常用的物质。校正年龄、文化程度、月收入后,多因素logistic回归分析结果显示,HIV感染高风险MSM合成毒品使用与最近6个月有临时性伴(aOR=3.24,95%CI:1.29~7.43)、饮酒(aOR=1.78,95%CI:1.12~2.80)有关。结论高风险MSM中使用合成毒品的现象较为普遍,使用者的危险行为水平更高,MSM中合成毒品使用应当受到关注。

Study on synthetic drug use and associated factors among men who have sex with men at high risk of HIV infection

Objective To understand the current status of synthetic drug use and associated factors among men who have sex with men(MSM)at high risk of HIV infection.Methods A cross-sectional study was conducted in Guangzhou,Wuxi and Shenzhen through January to August 2017.MSM at high risk of HIV infection were recruited from attendants at the health clinics,through internet advertisement and snowball sampling method.Eligible MSM were the ones who had met the following criteria:≥18 years old,having either 2 male sex partners,or condomless anal sex with a casual male sex partner,or a STD historg during the past 6 months.Data regarding demographic,sexual behavior,HIV/STD testing history and previous drug use were collected by sely-administered questionnaires.Blood was also drawn for HIV testing.Results Of the 603 MSM at high risk of HIV,25.5%(154/603,95%CI:22.0%-29.0%)of them had used drugs in the past 6 months,including 29.1%(88/302,95%CI:24.0%-34.3%)in Guangzhou,26.3%(40/152,95%CI:19.2%-33.4%)in Shenzhen,and 17.4%(26/149,95%CI:11.3%-23.6%)in Wuxi.'Rush’(85.1%,131/154)was the most commonly used drug.Results from the multivariable logistic regression revealed that drug use was associated with the following factors:having multiple casual sexual partners(aOR=3.24,95%CI:1.29-7.43)and alcohol use(aOR=1.78,95%CI:1.12-2.80)in the past 6 months after adjusting for age,education and monthly income.Conclusions Drug use seemed common among MSM population at high risk of HIV infection and was associated with higher risk behavior that leading to HIV infection.Synthetic drug use among MSM deserved more attention.