新疆吸毒人群艾滋病感染现状及其影响因素分析

目的 为了解新疆吸毒人群艾滋病病毒(HIV)感染现状及其影响因素,为艾滋病防治工作效果评价提供科学依据.方法 于2010年8-12月对新疆乌鲁木齐市及伊犁州4 493名吸毒者进行问卷调查和血清学检测.结果 新疆吸毒人群艾滋病感染率为21.4％ (963/4 493),其中男性感染率为20.7％ (864/4 175),女性感染率为31.1％(99/318);维吾尔族感染率为30.1％(800/2 660),汉族感染率为7.0％(74/1 050),回族感染率为11.3％ (64/566);≤30岁者感染率为10.0％(174/1 739),＞30岁者为28.6％(789/2 754);多因素logistic回归分析结果表明,吸毒者感染HIV的风险女性高于男性(OR=2.12,95％CI=1.56～2.88),维吾尔族、回族均高于汉族(OR=7.66、2.06,95％ CI=5.79～10.13、1.41 ～ 3.01),注射吸毒者高于非注射吸毒者(OR=11.95,95％ CI=9.26 ～ 15.42),共用针具者高于非共用针具者(OR =4.02,95％ CI=3.35～4.83).结论 与其他吸毒人群聚集区比较,新疆吸毒人群HIV感染率处于中等水平,吸毒人群感染HIV的主要影响因素包括性别、民族、吸毒方式和是否共用针具等,据此应制定针对性的防治措施.     

直接和间接共用注射器具静脉吸毒方式与HIV感染关系的研究

目的了解四川省凉山彝族自治州地区吸毒人群直接和间接共用注射器具静脉吸毒方式与HIV感染的关系。方法于2004年5月至7月，从社区中招募吸毒人群调查其社会人口学特征、近3个月直接和间接共用注射器具静脉吸毒方式、近6个月性行为情况。采集研究对象的血样进行HIV抗体检测。结果在调查的吸毒人群中HIV感染率为15．1％（68／451），其中静脉吸毒人群HIV感染率为17．8％（66／370）。多因素Logistic分析结果显示，民族（OR为2．40；95％CI为1．39～4．13）、近3个月共用针头和注射器（OR为2．02；95％CI为1．12～3．63）、近3个月共用洗针头或注射器用水（OR，4．00；95％；CI，1．28～12．54）与HIV感染关系有统计学意义。结论四川省凉山彝族自治州吸毒人群HIV感染率高，直接和间接共用注射器具静脉吸毒行为以及高危性行为普遍，应加强对此类行为的干预。     

东莞市吸毒人群艾滋病KABP及感染情况的调查

[目的]了解东莞市吸毒人群HIV感染情况、危险因素及与艾滋病有关的知识、态度和行为,为制定吸毒人群的艾滋病防控措施提供依据。[方法]对2004～2006年在东莞市强制戒毒所戒毒的1 032名吸毒者进行血清HIV抗体检测,同时采用统一的问卷搜集每名研究对象的人口学、行为学等相关资料。将所有资料输入EPIDATA 3.0,采用STATA 10.0软件进行统计分析。[结果]东莞市吸毒人群的HIV感染率为5.04%。男性吸毒人群的感染率（5.53%）高于女性（0.92%）,差异有统计学意义（χ^2=4.3262,P=0.038）;注射吸毒的感染率（7.09%）高于口吸毒品者（0.61%）,差异有统计学意义（χ^2=19.6072,P=0.000）;共用针具吸毒者的感染率（11.84%）高于未共用针具者（4.62%）,差异有统计学意义（χ^2=12.9877,P=0.002）。东莞市吸毒人群注射吸毒率68.31%、针具共用率34.75%;艾滋病防治知识知晓率39.34%;商业性性行为发生率22.09%,买淫和卖淫时每次均使用安全套率50.26%和46.81%。[结论]东莞市吸毒人群HIV感染率持续上升的势头已得到初步遏制,但吸毒人群中仍然存在着共用针具、商业性性行为、安全套使用率低、艾滋病防治知识欠缺等危险因素,建议在吸毒人群中采取宣传教育和行为干预并重的防控措施。     

南昌地区羁押吸毒人员HIV哨点监测结果分析

目的了解南昌市羁押吸毒人员的流行病学特征,分析该人群丙型肝炎病毒（HCV）感染的危险因素,为制定防治对策提供科学依据。方法利用2010年羁押场所吸毒人员艾滋病哨点监测资料,采用描述性统计方法分析吸毒者800人的人口学、行为学特征;采用非条件logistic回归模型分析HCV感染影响因素。结果被调查的羁押吸毒人员中注射吸毒人员占77.87%,共用针具的占50.08%;有商业性行为者占34.88%;该人群HIV抗体阳性2人,梅毒阳性7人,HCV抗体阳性233人（29.12%）。注射吸毒次数较少,可降低吸毒者感染HCV的危险（OR=0.13,95%CI：0.07～0.25）。结论该地区注射吸毒者的共用针具率和丙肝感染率较高。采取措施减少吸毒者的注射吸毒次数和共针率可以降低该人群的HCV感染的风险。     

新旧注射吸毒人群HIV传播因素研究

目的探讨和分析新旧注射吸毒者的人口学特征及HIV传播因素,为预防控制艾滋病流行提供科学依据。方法选取针具交换点和戒毒所新旧人群为研究对象,采用面对面问卷调查,问卷内容包括新旧人群的人口学特征、艾滋病相关知识、干预服务参号隋况、高危行为学特征及HIV传播影响因素。应用SPSS16．0软件进行统计分析。结果共调查474例注射吸毒者,其中新人群（注射吸毒≤5年）及旧人群（注射吸毒〉5年）分别为157例（33．1％）和317例（66．9％）。调查对象的HIV感染率为20．5％,HIV感染率与吸毒年限呈正相关趋势（_=0．83,P=0．004）,且在5年内的变化速率最快。多因素Logistic回归模型结果显示,在〈30岁的新人群中,男性、重复使用及共用针具是HIV传播的影响因素;在30～40岁的旧人群中,男性、知晓共用注射辅助材料的危害及共用针具是HIV传播的影响因素;在〉40岁的旧人群中,男性、文化程度初中及以上、参加过针具交换及共用针具是HIV传播的影响因素。结论加强对新旧人群的宣传教育力度,倡导针具交换、有套性交、扩大干预服务覆盖面,知而信、信而行,是预防控制HIV传播与流行的有效措施。     

西昌市吸毒人群HIV感染模式研究

目的：了解四川省西昌市吸毒人群吸毒方式及性行为与HIV感染的关系.方法：采用现况调查对四川省西昌市吸毒人群的社会人口学、共用注射器具静脉吸毒方式、伙伴人数和性行为情况与HIV感染的关系进行调查.同时采集血样进行HIV和梅毒抗体检测.结果：吸毒人群619人中,HIV感染率为8.6%（53/619）,其中静脉吸毒者的HIV感染率为10.1%（33/327）.在单因素分析和控制其他因素分析中,至今共用注射器具静脉吸毒的伙伴总人数与HIV感染差异均有统计学意义.趋势性检验发现随着至今共用注射器具静脉吸毒的伙伴人数的增加,吸毒人群HIV感染率也在增加.在多因素Logistic回归模型分析中,发现与HIV感染差异有统计学意义的变量是共用注射器具静脉吸毒的伙伴总人数（1～3人OR=2.47,95%CI为1.21～5.04;≥4人OR=5.13,95%CI为2.30～11.46）和彝族（OR=3.71,95%CI为2.04～6.75）.结论：吸毒人群共用注射器具静脉吸毒的社会网络大小与HIV感染有关.     

赣州市296名吸毒人员HIV、HCV和梅毒感染状况分析

目的通过对赣州市强制戒毒所吸毒人员抗-HIV、抗-HCV和梅毒抗体检测,了解吸毒人群HIV、HCV及梅毒感染状况及相关危险因素,为预防控制这些疾病在该人群的流行提供科学依据。方法于2008—2009年对赣州市强制戒毒所的吸毒人员采集血液标本进行抗-HIV、抗-HCV和梅毒抗体检测,并对结果进行统计和分析。结果共调查296名吸毒人员,HIV感染率为0．68％（2／296）,HCV感染率为35．81％（106／296）,梅毒感染率为4．73％（14／296）。注射吸毒者与非注射吸毒者HCV感染率分别为74．02％（94／127）和7．10％（12／169）,差异有统计学意义（P〈0．01）;共用针具与无共用针具者HCV感染率分别为91．01％（81／89）和34．21％（13／38）,差异有统计学意义（P〈0．01）。结论赣州市吸毒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,以减少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。     

我国西南部彝族聚居区HIV、HBV感染及其影响因素分析

目的 了解我国西南部彝族聚集区人群HIV、HBV感染的流行病学特征及其影响因素.方法 采取整群抽样的方法,在西南部某彝族聚集区艾滋病高流行区抽取1个流行乡镇作为研究现场,进行人群HIV、HBV感染筛查和问卷调查,收集调查对象的社会人口学基本资料、感染相关危险因素,并进行相关实验室检测.结果 共调查2 290名当地成年居民,该乡人群HIV感染率为7.9％,HBV感染率为3.1％,HIV/HBV共感染率为1.2％.对于HIV感染,小学及以上文化程度(OR=3.28,95％CI:1.54 ～ 6.96)、有吸毒史(OR=46.32,95％CI:15.30～140.25)、配偶有吸毒史(OR=3.52,95％CI:1.33 ～ 9.30)、配偶HIV感染史(OR=9.56,95％CI:3.49～26.20)是危险因素,家庭年总收入≥5 000元的人群感染HIV的危险性明显低于家庭年总收入＜1 000元的人群(OR=0.14,95％CI:0.03 ～ 0.66),家庭年总收入1 000 ～3 000元的人群感染HIV的危险性明显低于家庭年总收入＜1 000元的人群(OR=0.28,95％CI:0.11～0.68),有打工史的人群感染HIV危险性明显低于其他人群(OR=0.33,95％CI:0.15～ 0.72).对于HBV感染,有打工史是危险因素(OR=2.48,95％CI:1.16 ～ 3.42).对于HIV/HBV共感染,配偶有HIV感染史是危险因素(OR=6.04,95％CI:1.28 ～ 28.48).结论 该彝族聚居区人群HIV疫情较为严重,应加强艾滋病防治的宣传教育、针具交换以及美沙酮替代治疗等防治工作来控制当地艾滋病的传播.     

2002-2004年东莞市吸毒人群艾滋病监测结果分析

目的 了解东莞市吸毒人群的HIV感染情况及危险因素,预测艾滋病在吸毒人群中的流行趋势,为制定针对吸毒人群的艾滋病防控措施提供依据.方法 对2002-2004年在东莞市强制戒毒所戒毒的3 766名吸毒者检测血清HIV抗体,采用统一问卷搜集每名研究对象的人口学及行为学资料.将所有资料输入EPIDATA 3.0,采用STATA 8.0软件进行统计分析.结果 东莞市吸毒人群的HIV感染率为5.47%,男性吸毒人群的感染率高于女性,流动吸毒人群的感染率高于本地吸毒人群,有共用针具吸毒史者的感染率高于无针具共用史者.吸毒者中注射吸毒率为64.29%,注射吸毒者中针具共用率为44.75%.吸毒者中有商业性性行为者占46.55%,其中坚持每次使用安全套者仅占17.46%.东莞市吸毒人群的HIV感染率有逐年上升趋势.结论 东莞市吸毒人群的感染率有较大幅度上升;吸毒人群中存在着共用针具及商业性性行为等危险因素;应在吸毒人群中尽快推广针具交换、美沙酮替代疗法及100%安全套策略等干预措施.     

社区静脉吸毒人群人类免疫缺陷病毒感染现状

目的　了解四川省凉山彝族自治州静脉吸毒人群人类免疫缺陷病毒 (HIV)感染率及其危险因素。方法　于 2 0 0 2年 11月 8～ 2 9日 ,以社区招募方式调查凉山彝族自治州地区静脉吸毒人群的社会人口学、静脉吸毒共用注射器具和性行为方式与HIV感染的关系。采集血样进行HIV和梅毒抗体检测。结果　提供知情同意和符合纳入标准的 379人 ,HIV感染率为 11 3% (43人 )。在单因素χ2 分析中 ,民族、近 3个月共用注射器具总次数、近 3个月共用棉球和梅毒感染与HIV感染有关。在多因素logistic回归模型分析中 ,近 3个月共用注射器具总次数 (OR =2 2 8;95 %CI为 1 18～ 4 4 3)和梅毒感染 (OR =3 10 ;95 %CI为 1 4 8～ 6 4 8)与HIV感染有关。结论　近 3个月共用注射器具总次数和梅毒感染与HIV感染有关。     

The persistence of risky conduct for HIV transmission among intravenous drug users in Madrid, Seville, and Valencia. The Working Group of the Médicos del Mundo for the Monitoring of HIV Infection and the Risk Practices of Intravenous Drug Users]

OBJECTIVE: To determine the prevalence of HIV infection and risk-taking behavior for infection among intravenous drug users in Madrid, Seville, and Valencia (Spain). To study the main factors associated with such behavior. MATERIAL AND METHODS: Personal interviews were carried out with 821 intravenous drug users recruited in 1994 and 1995 among recent participants in three needle-exchange programs. Subjects were asked about their risk-taking behavior in the 30 days preceding the interview. Bivariate statistical methods and logistical regression techniques were used. RESULTS: In the month before the interview, 13.8% of the subjects in Valencia, 18.1% in Madrid, and 26.9% in Seville used needles that had been used by other people, usually (73-88%) without disinfecting them effectively. Condom use during the reference period was 50% in Seville, 42.5% in Madrid, and 34.2% in Valencia. The prevalence of HIV infection ranged from 30.1% in Seville to 43. 2% in Madrid. Multivariate analysis showed that the factors most closely associated with accepting used needles were: needle sharing (OR = 12.2), residence in Seville (OR = 6.6), and HIV positivity (OR = 4.6). The factors most closely associated with not using condoms systematically were: ignorance of personal HIV serological state (OR = 4.1), needle sharing (OR = 3.7), and HIV negativity (OR = 3.3). CONCLUSIONS: The risk of HIV transmission among intra-venous drug users in Spain is high (infection and risk-taking behavior have a high prevalence), so programs designed to reduce this risk should be increased quickly.     

四川省吸毒人群艾滋病病毒和梅毒新发感染的队列研究

目的调查四川省某地区静脉吸毒人群艾滋病病毒（HIV）和梅毒血清抗体阳转情况及其危险因素.方法2002年11月在四川省西昌市以社区为基础招募HIV血清抗体阴性的静脉吸毒人群前瞻性研究队列333人,在队列每6个月随访时调查静脉吸毒人群高危吸毒行为和性行为情况,并采集血样进行HIV和梅毒抗体检测.结果队列随访2年,静脉吸毒人群队列保持率和HIV血清抗体阳转率分别为75.7%和2.53/100人年（95%CI：1.10～3.97）,在多因素Poisson回归模型分析中,民族（RR=12.42,95%CI：2.72～56.74,P=0.0012）、近3个月共用针头或注射器（RR=4.06,95%CI：1.29～12.81,P=0.0168）与HIV血清抗体阳转的关系有统计学意义.该研究队列梅毒血清抗体阳转率为4.71/100人年（95%CI：2.59～6.82）,在多因素Poisson回归模型中,女性（RR=4.42,95%CI：1.78～10 99,P=0.0014）与梅毒血清抗体阳转的关系有统计学意义.结论该地区静脉吸毒人群HIV和梅毒新发感染率高,应采取有效的干预措施以控制HIV的传播流行.     

The contribution of two Brazilian multi-center studies to the assessment of HIV and HCV infection and prevention strategies among injecting drug users: the AjUDE-Brasil I and II Projects

This study assessed 1,144 Brazilian injecting drug users (IDUs) recruited on the street through outreach syringe exchange programs by two multi-center cross-sectional studies: 287 IDUs were recruited during the AjUDE-Brasil I Project and 857 during the AjUDE-Brasil II Project. IDU characteristics related to drug use and sexual behavior, and legal and health conditions for the two studies were compared, using decision tree and logistic regression for each individual study, with HIV infection as the outcome. Fifty-two percent of IDUs were HIV-infected in AjUDE I versus 36.5% in AjUDE II. In both studies, HIV infection was independently associated with: mean background HIV prevalence for each site (OR = 2.17; 10.66), HCV seropositive status (OR = 19.79; 15.48), and men who reported ever having sex with other men (OR = 2.10; 2.09). Incarceration (OR = 1.41) and 8 or more years of injecting drug (OR = 2.13) were also associated with HIV in AjUDE II. The high HIV infection rates and high prevalence of both parenteral and sexual risk behaviors in the context of syringe-exchange programs are of great concern and demand thorough surveillance and renewed prevention strategies.     

云南省德宏州静脉注射毒品者HIV新发感染率及其危险因素研究

目的 了解云南省德宏州静脉注射毒品者(IDU)中HIV新发感染率及其危险因素.方法 2004年10月招募HIV检测阴性的245名IDU进入队列,启动IDU人群艾滋病流行病学队列研究,于2006年底进行第一次随访检测确定HIV发病率.自2007年1月起,不断纳入新发现的HIV阴性的IDU,扩大流行病学研究队列,并每半年进行一次有关毒品使用和性行为等暴露因素的随访调查,同时血清学检测确定HIV新发感染率.结果 截止2008年底,共招募入组760名IDU,至少随访1次者有540人,累积观察1153.6人年,新发现HIV感染者47人,HIV新发感染率为4.07/100人年,其中2004-2006年为4.45/100人年,2007年为4.50/100人年,2008年为2.54/100人年.随访期间,研究对象中IDU比例和HIV新发感染率均有显著下降.Cox比例风险回归模型多因素分析显示,景颇族[风险比(HR)=2.56,95%CI:1.06～6.19]和除傣族以外的其他少数民族(HR=3.26,95%CI:0.89～11.96)的HIV感染风险高于汉族;随访期间注射毒品但未共针者(HR=2.27,95%CI:0.98～5.25)以及有共针注射毒品行为者(HR=5.27,95%CI:2.25～12.34)的HIV感染风险高于随访期间没有注射毒品者.结论 云南省德宏州既往IDU人群中注射吸毒的比例和HIV新发感染率近4年来均呈现下降趋势.共用注射器吸毒仍是IDU人群HIV感染的最重要的危险因素,不同民族IDU的HIV感染风险不同.     

Differences between women and men in serial HIV prevalence and incidence trends

To measure trends in HIV incidence and serial prevalence by sex in a intravenous drug users (IDUs) and heterosexuals (HT) cohort recruited in a counselling centre in Valencia (1988-2005). Serial prevalence and incidence rates were calculated and modelled by logistic and Poisson regression respectively. 5948 IDUs and 13343 HT were recruited. Prevalence was higher among female IDUs (46% vs. 41%), and female HT (4.1% vs. 2%). For IDUs, an interaction (P = 0.005) between sex and calendar was detected. Age-adjusted prevalence showed faster yearly decline in men (OR = 0.87 95%CI: 0.85-0.88) than in women (OR = 0.91 95%CI: 0.88-0.93). Incidence was higher in female IDUs (9.79% p-y) than in men, (5.38% p-y) with an annual decrease for both of 11%. HIV incidence was higher in female HT (0.62% p-y) compared to men 0.23% p-y with a 21% yearly decline. Gender differences in HIV prevalence and incidence trends have been detected. Women showed an increased vulnerability to infection in a country whose HIV epidemic has been largely driven by IDUs.     

Do Supervised Injecting Facilities Attract Higher-Risk Injection Drug Users?

BACKGROUND: In Western Europe and elsewhere, medically supervised safer injection facilities (SIFs) are increasingly being implemented for the prevention of health- and community-related harms among injection drug users (IDUs), although few evaluations have been conducted, and there have been questions regarding SIFs' ability to attract high-risk IDUs. We examined whether North America's first SIF was attracting IDUs who were at greatest risk of overdose and blood-borne disease infection. METHODS: We examined data from a community-recruited cohort study of IDUs. The prevalence of SIF use was determined based on questionnaire data obtained after the SIF's opening, and we determined predictors of initiating future SIF use based on behavioral information obtained from questionnaire data obtained before the SIF's opening. Pearson's chi-square test was used to compare characteristics of IDUs who did and did not subsequently initiate SIF use. RESULTS: Overall, 400 active injection drug users returned for follow-up between December 1, 2003 and May 1, 2004, among whom 178 (45%) reported ever using the SIF. When we examined behavioral data collected before the SIF's opening, those who initiated SIF use were more likely to be aged <30 years (odds ratio [OR]=1.6, 95% confidence interval [CI]=1.0-2.7], p=0.04); public injection drug users (OR=2.6, 95% CI=1.7-3.9, p<0.001); homeless or residing in unstable housing (OR=1.7, 95% CI=1.2-2.7, p=0.008); daily heroin users (OR=2.1, 95% CI=1.3-3.2, p=0.001); daily cocaine users (OR=1.6, 95% CI=1.1-2.5, p=0.025); and those who had recently had a nonfatal overdose (OR=2.7, 95% CI=1.2-6.1, p=0.016). CONCLUSIONS: This study indicated that the SIF attracted IDUs who have been shown to be at elevated risk of blood-borne disease infection and overdose, and IDUs who were contributing to the public drug use problem and unsafe syringe disposal problems stemming from public injection drug use.     

静脉注射吸毒人群HIV和HCV感染现状及影响因素的Meta分析

目的 了解中国内地静脉注射吸毒人群（injecting drug users,IDUs）中人类免疫缺陷病毒（human immunodeficiency virus,HIV）和丙型肝炎病毒（hepatitis C virus,HCV）感染状况及相关影响因素。方法 通过相应检索策略收集2000-2015年期间针对该人群的HIV和HCV感染状况的文献,提取数据建立数据库后进行Meta分析。结果 中国内地IDUs中HIV感染率为7.00%（95%CI:6.10%~8.00%）,HCV感染率为67.10%（95%CI:61.00%~73.20%）。亚组分析显示,不同地区、不同人群和不同时间段HIV和HCV感染率不同;单因素Meta回归分析显示HCV感染率是HIV感染率的主要影响因素,高HCV感染率组HIV感染率高于低HCV感染率组。结论 2000-2015年中国内地IDUs HIV和HCV感染率较高,HIV感染率与HCV感染率关系密切,在IDUs中可用HCV感染率的高低来评估该人群中HIV的感染和流行风险。     

Injecting drug use is associated with HIV risk perception among Mexican Americans in the Rio Grande Valley of South Texas, USA

OBJECTIVES: Injecting drug use (IDU) remains an actual risk variable in human immunodeficiency virus (HIV) infection in most ethnic populations, and the association between actual risk and individual perception of HIV risk varies across studies and samples. This study aimed to examine the relationship between IDU and HIV risk perception among Mexican Americans residing in Rio Grande Valley, South Texas. STUDY DESIGN: A cross-sectional study of IDU as a predictor of HIV risk perception. METHODS: Two hundred and seventy-five participants [IDUs 11.9%, non-IDUs 88.1%] were assessed for an association between IDU and individual risk perception for HIV infection, as well as history of drug use and HIV risk perception, using Chi-squared statistic for independence and a logistic regression model for the prevalence odds ratio (POR). RESULTS: There was no statistically significant difference between IDUs and non-IDUs with respect to the sociodemographic variables, except for income and gender (P<0.05). The results indicated a statistically significant decrease in HIV risk perception among IDUs compared with non-IDUs, after adjustment for age, gender, sexual preference, history of drug use and marital status [POR 0.26, 95% confidence intervals (CI) 0.11-0.65]. Likewise, history of drug use was associated with decreased HIV risk perception (POR 0.44, 95% CI 0.22-0.98). CONCLUSIONS: These results suggest an inverse correlation between actual risk of HIV infection, such as IDU, and HIV risk perception. Therefore, assessment of HIV risk perception, which is a significant determinant of behaviour change, is essential to reduce the prevalence of HIV infection in the targeted population.     

Factors associated with drug-related harms related to policing in Tijuana, Mexico

Background

A nascent HIV epidemic and high prevalence of risky drug practices were detected among injecting drug users (IDUs) in Kabul, Afghanistan from 2005-2006. We assessed prevalence of HIV, hepatitis C virus (HCV), hepatitis B surface antigen (HBsAg), syphilis, and needle and syringe program (NSP) use among this population.

Methods

IDUs were recruited between June, 2007 and March, 2009 and completed questionnaires and rapid testing for HIV, HCV, HBsAg, and syphilis; positive samples received confirmatory testing. Logistic regression was used to identify correlates of HIV, HCV, and current NSP use.

Results

Of 483 participants, all were male and median age, age at first injection, and duration of injection were 28, 24, and 2.0 years, respectively. One-fifth (23.0%) had initiated injecting within the last year. Reported risky injecting practices included ever sharing needles/syringes (16.9%) or other injecting equipment (38.4%). Prevalence of HIV, HCV Ab, HBSAg, and syphilis was 2.1% (95% CI: 1.0-3.8), 36.1% (95% CI: 31.8-40.4), 4.6% (95% CI: 2.9-6.9), and 1.2% (95% CI: 0.5-2.7), respectively. HIV and HCV infection were both independently associated with sharing needles/syringes (AOR = 5.96, 95% CI: 1.58 - 22.38 and AOR = 2.33, 95% CI: 1.38 - 3.95, respectively). Approximately half (53.8%) of the participants were using NSP services at time of enrollment and 51.3% reported receiving syringes from NSPs in the last three months. Current NSP use was associated with initiating drug use with injecting (AOR = 2.58, 95% CI: 1.22 - 5.44), sharing injecting equipment in the last three months (AOR = 1.79, 95% CI: 1.16 - 2.77), prior incarceration (AOR = 1.57, 95% CI: 1.06 - 2.32), and greater daily frequency of injecting (AOR = 1.40 injections daily, 95% CI: 1.08 - 1.82).

Conclusions

HIV and HCV prevalence appear stable among Kabul IDUs, though the substantial number having recently initiated injecting raises concern that transmission risk may increase over time. Harm reduction programming appears to be reaching high-risk drug user populations; however, monitoring is warranted to determine efficacy of prevention programming in this dynamic environment.     

女性吸毒者HIV相关危险行为特征研究

目的 了解广东省女性吸毒艾滋病相关危险行为特征以及HIV、HCV和梅毒感染情况。方法 自拟调查表以匿名方式对广东省某妇教所143名女性吸毒进行面对面调查，同时采集静脉血5m1进行HIV、HCV和梅毒血清学检测。结果 (1)共收集女性吸毒血液标本143份，其中7例经确认试验证实为HIV阳性，感染率为4．9％，HCV感染率为83．2％(119／143)，梅毒感染率为32．9％(47／143)。其中115名注射吸毒(IDUs)的HIV感染率为6．1％(7／115)，HCV感染率为95．7％(110／115)，梅毒感染率为32．8％(42／115)。(2)115名IDUs有72．2％曾共用注射器，44．5％的人在进妇教所前1个月里曾共用注射器，其中48％的人曾与固定性伴共用注射器。(3)进妇教所前1年里有性交史的128名，其中40．6％的人有多性伴(性伴数＞1)，有57．8％的人有IDU性伴，有27．3％的人有以性换毒品／金钱的情况。在进所前一个月有74．1％的人与固定性伴性交不用安全套。(4)进妇教所前1年里有14％的人自述有性病，50％的人自述有性病相关症状。结论 女性吸毒中已经有较高的HIV感染率和梅毒感染率，并且与艾滋病相关的吸毒行为和不安全性行为普遍存在，应该尽快采取有效干预措施以防止艾滋病在女性吸毒人群流行并通过此人群向一般人群的蔓延。