以社区为基础的女性静脉吸毒人群吸毒行为及性行为特征研究

目的 了解四川省凉山彝族自治州某地女性静脉吸毒人群的吸毒行为和性行为特征。方法 以社区为基础招募女性静脉吸毒人群，调查其人口学、共用注射器具吸毒行为和性行为情况。结果 在静脉吸毒的66名女性中，曾经共用注射器具静脉吸毒的39人(59．1％)，19人(28．8％)首次静脉吸毒即与他人共用注射器具。近3个月使用别人用过的注射器具吸毒的24人(36．4％)，近3个月共用过非直接注射器具的14人(21．2％)。近6个月有商业性行为的39人(59．1％)，近6个月有新性伙伴的36人(54．5％)，近6个月与非主要性伙伴的性交频率每周≥1次的33人(50．0％)。近1个月与主要和非主要性伙伴每次性交均使用安全套的分别为9．7％(3／31)和28，6％(10／35)。结论 需加强健康教育和行为干预措施来提高女性静脉吸毒人群安全吸毒行为和性行为。     

乌鲁木齐市静脉吸毒人群艾滋病病毒感染及危险因素研究

目的了解新疆乌鲁木齐市静脉吸毒人群艾滋病病毒（HIV）感染情况及其相关危险因素。方法2002年7月至12月,以社区为基础,使用标准化问卷调查780名静脉吸毒人群人口学特征和静脉吸毒共用注射器具方式、性行为情况;通过检测HIV抗体,确定是否感染HIV。结果在社区中调查的静脉吸毒人员HIV的感染率为29．1％（227／780）,单因素分析结果显示,男性、维吾尔族、低文化程度、与艾滋病病毒阳性者共用过注射器具和使用前后装入毒品是HIV感染的危险因素（P〈0．05）。多因素Logistic回归分析结果显示,艾滋病病毒感染的主要危险因素是性别（男对女OR=2．24：95％CI,1．16～4．34）、民族（维吾尔族对汉族OR=3．89;95％CI,2．69-5．62）、海洛因静脉注射频率（OR=1．69;95％CI,1．20．2．38）、共用针头或注射器（OR=1．48;95％CI,1．02—2．15）。未见性行为对HIV感染的影响。结论性别、民族、近6个月海洛因注射频率和共用针头或注射器与HIV感染有关。     

乌鲁木齐市海洛因成瘾者社区美沙酮维持治疗基线调查

目的了解进入社区美沙酮维持治疗门诊吸毒人群的吸毒行为、性行为等特征,为艾滋病防制措施的制定提供依据。方法乌鲁木齐市以社区为基础,2005年8~11月,对进入社区药物维持治疗门诊的129名戒毒人员进行问卷调查,调查其人口学、共用注射器具吸毒行为和性行为等情况。结果男性占83.1%,女性占16.2%,平均年龄为33.86±5.39岁,H IV阳性率为19.4%,HCV阳性率为68.5%,注射吸毒者中有39.2%曾与他人共用过注射针具。过去3个月使用他人用过的注射器具吸毒的25人(19.2%),共用过非直接注射器具的16人(12.4%)。过去6个月有商业性行为的8人(32.0%),有新性伙伴的27人(20.9%)。过去1个月与主要和非主要性伙伴每次性交均使用安全套的分别为30.0%(39/86)和13.1%(17/29)。在过去的6个月中,26.4%被公安抓过,22.5%贩卖过毒品;36%(9/25)为了毒品和别人发生过性行为,15.5%为了吸毒而有偷、抢、骗。目前有工作(包括固定、临时)的占48.5%。结论进入维持治疗吸毒者中存在H IV传播的高危性,迫切需要在美沙酮维持治疗的同时进行预防艾滋病的健康教育和行为干预活动。     

安顺市吸毒人群HIV感染及相关危险因素分析

目的了解安顺市吸毒人群艾滋病病毒（HIV）感染情况。方法分别于2004—2006年调查戒毒所内吸毒人群的社会人口学、吸毒和行为方式,并采集血样检测HIV抗体。结果在调查的1471名吸毒者中,有静脉吸毒史者596人,在静脉吸毒者中HIV检出率为6．71％。单因素z。检验分析显示,静脉吸毒、共用注射器吸毒与HIV感染有统计学意义,其OR、（95％CI）、x2、P值分别为6．12、（5．29、6．95）、33．48、P〈O．005,2．68、（1．92、3．44）、9．52、P〈0．005。结论安顺市吸毒人群HIV感染率较高,且共用注射器具行为及不安全性行为较为普遍。     

针具交换结合同伴宣传对注射吸毒人群吸毒行为的影响

目的通过同伴宣传和针具交换项目减少吸毒者的共用注射器行为，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清洁针具并回收污染针具，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，在广西壮族自治区某县注射吸毒者中开展了为期一年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自我报告的高危注射行为等变化情况对于预效果进行评估。结果基线调查205人，终期调查234人。终期调查时吸毒者的针具共用率、水和容器的共用率分别为30．34％、33．33％和11．54％，均显著地低于基线调查(分别为60．59％、62．69％和61．00％)；同基线调查相比，终期调查中吸毒者的每日注射毒品次数也显著减少。结论针具交换结合同伴宣传干预措施不仅能显著减少吸毒者对针具、清洗水和容器等的共用行为，还能有效降低吸毒者的针具共用频率，同时并不会增加吸毒者的毒品注射次数。     

江苏省吸毒人群行为学特征及疾病感染状况

目的 了解江苏省吸毒人群行为学特征及各种疾病的感染状况。方法 通过匿名调查，获得吸毒人群与AIDS有关的KABP情况；结合体检及血清学检测，了解吸毒人群员各种疾病的感染状况。结果 （1）江苏省吸毒现象始于1990年前后，1995-1996年起静脉注射毒品在吸毒者中的比例开始增大；（2）吸毒者主要为20-29岁年龄组有城镇无业人员；（3）吸毒者中59.19%的人有过静脉注射史，其中有46.42%的人曾与他人共用过注射器；（4）性乱问题在男性及女性吸毒者中同样存在；（5）吸毒者中HCV、HBsAg等指标阳性的比例明显高于自然人群。结论 尽管本次调查未发现HIV感染者，但江苏省吸毒人群中有较高比例的人有静脉注射和共用行为，存在艾滋病传播的隐患。     

开远市社区吸毒暗娼艾滋病相关高危行为调查分析

目的 了解社区吸毒暗娼的吸毒及高危性行为特征,为对她们开展行为干预提供参考依据.方法 通过外展招募的方式,对云南省开远市101名社区吸毒暗娼进行了访谈式问卷调查.结果 吸毒暗娼中,92.1%自报有过注射吸毒经历,17.2%的注射吸毒暗娼在最近6个月曾与别人共用过针具,65.4%的吸毒暗娼最近12个月中曾出现过性病症状.70.4%和14.9%的暗娼在与其固定性伴及嫖客的最近一次性行为中,未使用安全套.结论 吸毒暗娼共用针具吸毒的高危行为,使其处在艾滋病病毒(HIV)感染的巨大危险中,而其与嫖客人群及固定性伴的无保护性行为,很容易造成HIV通过性途径向其他人群的传播,加大对此类高危人群的干预力度势在必行.     

阿克苏市吸毒人群HIV感染情况及相关危险因素调查分析

目的了解新疆阿克苏地区吸毒人群HIV感染情况及危险行为分布特征,为吸毒人群有效干预措施的制定提供科学依据。方法使用统一的国家哨点监测吸毒者监测调查表,对每名吸毒人员进行匿名问卷调查,同时采集静脉血采用酶联免疫吸附试验（ELISA）进行HIV抗体初筛,初筛阳性者再用ELISA和明胶颗粒凝集试验（PA）等多种方法进行复核。复核阳性血样送新疆维吾尔自治区疾病预防控制中心艾滋病确认实验室采用免疫印迹法（WB）进行确认。结果被调查的403例吸毒者中查出HIV感染者92例,感染率为22.8%。403例吸毒人员中,有静脉吸毒史者382例,占94.8%（382/403）,在静脉吸毒者中有91例HIV阳性,感染率为23.8%（91/382）;非注射吸毒者（口吸）21例,HIV阳性1例,感染率为4.8%（1/21）;注射吸毒与非注射吸毒感染率比较,差异有统计学意义（χ~2=4.10,P〈0.05）。与他人共用注射器史者感染率为39%（62/159）;未共用注射器史者感染率为13%（29/223）。共用注射器史者与未共用注射吸毒史者HIV感染率差异有统计学意义（χ~2=34.55,P〈0.05）。结论静脉吸毒共用注射器是阿克苏市吸毒人群HIV感染的主要途径,今后应加强针对性干预措施,降低危险行为发生比例,控制艾滋病在该人群中的传播。     

吸毒人群HIV和梅毒及高危行为变化趋势的连续横断面调查研究

目的了解四川省西昌市吸毒人群高危行为的变化情况。方法分别于2004年、2005年和2007年,在四川省西昌市吸毒人员中开展了3次横断面调查,调查其社会人口学、高危吸毒行为和性行为特征。结果2007年与2004年比,该人群中近3个月静脉注射频率≥7次／周的比例（AOR,0．35;95％CI,0．24～0．51,P〈0．01）呈显著性下降,近3个月有共用针头或注射器行为的比例（AOR,0．48;95％CI,0．29～0．78,P〈0．01）虽呈显著性下降,但2007年该比例仍处于较高水平（5．3％）;近3个月口吸海洛因或其他毒品频率≥7次／周的比例有所上升（AOR,1．39;95％CI,1．06-1．82,P〈0．01）;而与固定性伴和临时性伴的高危性行为却无显著的变化。HIV和梅毒的阳性率在3次连续横断面调查中无显著性差异。结论该地区吸毒人群共用注射器吸毒行为仍然处于较高水平,无保护性性行为变化不明显。因此,在艾滋病防治工作中,应继续加大对吸毒人群高危吸毒行为的干预力度,加强对高危性行为的干预,以切断经性途径的传播扩散。     

江苏省吸毒人群行为学特征及疾病感染状况

目的了解江苏省吸毒人群行为学特征及各种疾病的感染状况.方法通过匿名调查,获得吸毒人群与AIDS有关的KABP情况;结合体检及血清学检测,了解吸毒人员各种疾病的感染状况.结果 (1)江苏省吸毒现象始于1990年前后,1995～1996年起静脉注射毒品在吸毒者中的比例开始增大;(2)吸毒者主要为20～29岁年龄组的城镇无业人员;(3)吸毒者中59.19%的人有过静脉注射史,其中有46.42%的人曾与他人共用过注射器;(4)性乱问题在男性及女性吸毒者中同样存在;(5)吸毒者中HCV、HBsAg等指标阳性的比例明显高于自然人群.结论尽管本次调查未发现HIV感染者,但江苏省吸毒人群中有较高比例的人有静脉注射和共用行为,存在艾滋病传播的隐患.     

Correlates of Receptive and Distributive Needle Sharing Among Injection Drug Users in Kabul,Afghanistan

We describe receptive and distributive needle/syringe sharing among injection drug users (IDUs) in Kabul, Afghanistan. In this cross-sectional study, IDUs completed an interviewer-administered questionnaire. Logistic regression identified correlates of needle sharing in the last six months. Receptive and distributive sharing in the last six months were reported by 28.2% and 28.7% of participants, respectively, and were both independently associated with reported difficulty obtaining new syringes (Receptive sharing: AOR = 2.60, 95% CI: 1.66–4.06; Distributive: AOR = 1.56, 95% CI: 1.02–2.39). Receptive and distributive sharing are common among IDU in Kabul; scaling up availability of sterile, no-cost injecting equipment is urgently needed.     

Correlates of receptive and distributive needle sharing among injection drug users in Kabul, Afghanistan

We describe receptive and distributive needle/syringe sharing among injection drug users (IDUs) in Kabul, Afghanistan. In this cross-sectional study, IDUs completed an interviewer-administered questionnaire. Logistic regression identified correlates of needle sharing in the last six months. Receptive and distributive sharing in the last six months were reported by 28.2% and 28.7% of participants, respectively, and were both independently associated with reported difficulty obtaining new syringes (Receptive sharing: AOR = 2.60, 95% CI: 1.66-4.06; Distributive: AOR = 1.56, 95% CI: 1.02-2.39). Receptive and distributive sharing are common among IDU in Kabul; scaling up availability of sterile, no-cost injecting equipment is urgently needed.     

Attitudes toward needle-sharing and HIV transmission risk behavior among HIV+ injection drug users in clinical care

Risky behavior related to injection drug use accounts for a considerable proportion of incident HIV infection in the United States. Large numbers of injection drug users (IDUs) currently receive antiretroviral therapy in clinical settings and are accessible for risk-reduction interventions to reduce transmission of drug-resistant HIV and spread of HIV to uninfected others. The current study examined attitudes toward needle- or equipment-sharing among 123 HIV-positive IDUs in clinical care in an effort to understand the dynamics of such behavior and to create a basis for clinic-based risk-reduction interventions. Results indicate that at baseline, participants who reported extremely negative attitudes toward needle-sharing were less likely to have shared during the past month than those with less-extreme negative attitudes. Demographic, behavioral, and attitudinal variables were entered into a logistic regression model to examine needle-sharing group membership among HIV-positive IDUs. Being female and having less-extreme negative attitudes toward sharing were independent and significant correlates of sharing behavior. Interventions targeting needle-sharing attitudes deployed within the clinical care setting may be well-positioned to reduce HIV transmission among HIV-positive IDUs.     

Hepatitis C virus seroconversion among young injection drug users: relationships and risks

The present study examined reasons for the high incidence of hepatitis C virus (HCV) infection among young injection drug users (IDUs). IDUs <30 years old who tested negative for HCV antibody were enrolled in a prospective cohort. Risk factors for seroconversion were examined using time-dependent regression analyses: 48 of 195 IDUs seroconverted to HCV, for an incidence rate of 25.1/100 person-years (95% confidence interval, 18.7-32.9/100 person-years). Independent risk factors included sharing needles with an HCV-infected sex partner (borderline statistical significance, P=.11) or a person who was not a sex partner, sharing nonsterile drug-preparation equipment, pooling money with another IDU to buy drugs, and exchanging sex for money. Ubiquitous behaviors among young IDUs, such as the forming of injecting or sexual partnerships and consequent sharing of needles and drug preparation equipment, are risk factors for HCV. Interventions to reduce HCV transmission must recognize the importance of relationships on injecting risk.     

Predictors of mortality among injecting and non-injecting HIV-negative drug users in northern Thailand

AIMS: To estimate mortality rates among HIV-negative injecting drug users (IDUs) and non-injecting drug users (non-IDUs), and to assess predictors for mortality among the IDUs. DESIGN: Prospective cohort study in northern Thailand with 2-year follow-up. SETTING: IDUs and non-IDUs who were admitted for detoxification treatment for opiate or amphetamine dependence in a regional drug treatment center were screened. After discharge, HIV-negative individuals were followed-up in the community. PARTICIPANTS: A total of 821 HIV-negative drug users [346 IDUs (42%) and 475 non-IDUs, median age = 32; 51% were ethnic minorities]. MEASUREMENTS: All-cause mortality. FINDINGS: There were 33 deaths over 1360 person-years of follow-up. The all-cause mortality rate was 39 per 1000 person-years among IDUs [standardized mortality ratio (SMR) = 13.9], and was 14 per 1000 person-years among non-IDUs (SMR = 4.4). Among male IDUs, the hazards for all-cause deaths were ethnic minority status [adjusted hazard ratio (HR) = 2.9, 95% CI = 1.2-7.2], incident HIV infection (HR = 2.8, 95% CI = 1.1-7.7) and longer duration of drug injection (HR = 1.07, 95% CI = 1.01-1.14). CONCLUSIONS: The mortality among IDUs is high. Being from an ethnic minority, recent HIV acquisition, and a greater number of years of drug injection are predictors of mortality among the IDUs in this region.     

Prevalence of hepatitis C virus and HIV infection among injection drug users in two Mexican cities bordering the U.S

OBJECTIVE: To estimate the prevalence of the hepatitis C virus (HCV) and HIV infection and associated risk behaviors among injection drug users (IDUs) in two northern Mexican cities. MATERIAL AND METHODS: Between February and April 2005, IDUs were recruited in Tijuana (N=222) and Ciudad Juarez (N=206) using respondent-driven sampling (RDS), a chain referral sampling approach. Interviewer-administered questionnaires assessed drug-using behaviors during the prior six months. Venous blood was collected for immunoassays to detect HIV and HCV antibodies. For HIV, Western blot or immunofluorescence assay was used for confirmatory testing. Final HCV antibody prevalence was estimated using RDS adjustments. RESULTS: Overall, HCV and HIV prevalence was 96.0% and 2.8%, respectively, and was similar in both cities. Most IDUs (87.5%) reported passing on their used injection equipment to others, and 85.9% had received used equipment from others. CONCLUSIONS: HIV prevalence was relatively high given the prevalence of HIV in the general population, and HCV prevalence was extremely high among IDUs in Tijuana and Ciudad Juarez. Frequent sharing practices indicate a high potential for continued transmission for both infections. HCV counseling and testing for IDUs in Mexico and interventions to reduce sharing of injection equipment are needed.     

珠三角社区注射吸毒人群HIV感染及影响因素分析

目的探索珠三角社区注射吸毒者（Injection drug users,IDUs）艾滋病病毒（HIV）感染的影响因素。方法 2008年,选择珠三角两个地区,采用同伴推动抽样法招募社区吸毒人群,进行面对面的问卷调查和HIV抗体检测。SPSS进行数据分析。结果共招募376名IDUs,HIV抗体阳性率8.5%。123人（32.7%）自我报告曾经检测HIV,74人（19.7%）参加美沙酮维持治疗项目。多因素Logistic回归模型提示,少数民族（AOR=11.72,95%CI：4.84~28.37）、针具共用因子（AOR=1.80,95%CI：1.30~2.48）、HIV感染风险评价因子（AOR=1.58,95%CI：1.02~2.43）,是HIV感染的危险因素。结论珠三角社区IDUs HIV流行形势较严峻,针具共用是导致HIV流行的主要因素;应进一步加强健康教育和行为干预工作,在实施过程中,应给予少数民族更多关注。     

Correlates of HIV Risk Among Injecting Drug Users in Sixteen Ukrainian Cities

We present findings from a HIV survey using respondent driven sampling among 3,711 injecting drug users (IDUs) in 16 cities in Ukraine in 2008. Eligible participants were males and females who injected drugs in the past 1 month, ≥16 years and lived/worked in their respective interview area. The impact of injecting and sexual risk behaviors on HIV-infection were analyzed using four logistic models. Overall HIV prevalence was 32%. In the sexual risk model, paying for sex in the past 3 months and condom use during last sex increased the odds of HIV infection. Being female, having greater than 3 years of injection drug use, always sharing equipment and using alcohol with drugs in the past month remained significant in all four models. These findings indicate the urgent need to scale up peer education, needle exchange and methadone substitution programs for IDUs with specific programs targeting the needs of female injectors