浙江省台州市美沙酮维持治疗就诊者性行为及其网络特征研究

目的　了解浙江省台州市美沙酮维持治疗(MMT)就诊者性行为和性网络特征,探讨其危险性行为的影响因素.方法 采用横断面研究,通过问卷和全国MMT信息系统收集数据,采集尿液快速检测海洛因、冰毒、摇头丸、K粉,采集血液检测HIV、丙型肝炎病毒(HCV)和梅毒.结果 共调查362人,以男性(88.7％)、31～岁组(54.5％)、已婚(61.6％),初中(56.6％)为主;共308人(85.1％)参加尿检,其中82人(26.6％)吗啡阳性,21人(6.8％)冰毒阳性,19人(6.2％)摇头丸阳性,未发现K粉检测阳性者;共279人(77.1％)参加血液检测,HIV、HCV、梅毒阳性率分别为1.1％、36.7％和3.6％;过去6个月内有性行为的MMT就诊者多性伴发生率为19.5％(56/287),与亲人一起居住为其保护因素(aOR=0.30,95％CI:0.13～0.71),新型毒品尿检结果阳性为其危险因素(aOR=5.92,95％CI:1.12～31.34),差异有统计学意义(P＜0.05);该人群的性网络多数呈双元、线性、非循环,性网络与吸毒网络重叠交叉.结论 台州市MMT就诊者仍存在一定的偷吸毒品行为和HIV/性传播疾病(STD)相关危险性行为,性网络与吸毒网络有所交叉,存在一定的HIV/STD疾病传播风险,应加大关注并采取相关措施进行有效防控.

Prevalence and network-characteristics of risky sexual behaviors among clients receiving methadone maintenance treatment at clinics in Taizhou prefecture of Zhejiang province

Objective To investigate the risky sexual behaviors, associated factors and characteristics of sexual network among clients receiving methadone maintenance treatment (MMT) at the clinics in Taizhou prefecture of Zhejiang province. Methods A cross-sectional survey was conducted. Data was collected through questionnaire and from the national unified MMT system. Urine was collected to test heroin, methamphetamine, 3, 4-methylenedioxymethamphetamine (MDMA) and ketamine. Blood was collected to test infections on HIV, hepatitis C virus(HCV) and syphilis. Results Totally, 362 clients were recruited. Most of the clients were male (88.7%), 31-40 year-olds (54.5%), married (61.6%) and having received junior high school education (56.6%). 85.1% of them received urine test with 82(26.6%) positive for heroin, 21(6.8%) positive for methamphetamine, 19(6.2%) positive for MDMA and none for ketamine. 77.1% of them received blood test, and prevalence rates for HIV, HCV and syphilis were 1.1%, 36.7% and 3.6%. 19.5% of the clients who had sex in the past 6 months. Factors as having multiple sexual partners and positive for club drugs were under higher risk. Sexual networking seemed to be loose, linear and acyclic among this population but overlapping with the drug-using network. Conclusion Effective and targeted interventions should be taken among the MMT clients since continuing drug use and HIV/STD related sexual behavior were found common in them, suggesting there was a risk of HIV/STD transmission in this population.