2012年昆区吸毒人群艾滋病、梅毒及丙肝感染状况及影响因素分析

目的了解昆区吸毒人群艾滋病、梅毒及丙肝感染状况及影响因素,为本区制定艾滋病防治策略和干预措施及效果评价提供依据。方法对403名哨点监测吸毒人员进行面对面问卷调查,同时采血进行HIV、梅毒及丙肝检测。结果调查的403名人中,艾滋病知识知晓率62．68％,HIV感染率为0．50％,梅毒感染率为1．99％;丙肝感染率为26．05％。人群中注射吸毒占57．82％,共用注射器吸毒者占22．75％,有多性伴行为占15．63％,安全套使用率为34．58％。结论本区被调查的吸毒人群中,艾滋病、梅毒感染率较低,丙肝感染率较高。吸毒人群中艾滋病有广泛流行的潜在危险。这要求必须加强吸毒人员艾滋病预防知识的宣传教育和实施行为进行干预,做好艾滋病哨点监测工作。     

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.     

河北省某市吸毒人群艾滋病病毒感染情况分析

目的獉獉:了解某市吸毒人群中艾滋病病毒的感染情况,及时发现和解决工作中所存在的问题。方法獉獉:采取听取汇报,查看资料、座谈会等方式对市防艾办、公安和司法等相关部门进行了情况调查。结果獉獉:全市通过注射吸毒感染艾滋病病毒占全市所有艾滋患者的39.29%(44/112),有90.91%(40/44)的吸毒感染者分布在市区。6.23专项行动中抓捕的31例自称是艾滋病的吸毒者均是既往感染者。结论獉獉:在吸毒患者中存在HIV传播的高危险行为,应加强艾滋病感染者管理,实施有效干预措施防治艾滋病病毒传播。     

2004—2005年阳泉市吸毒人群监测调查分析

阳泉市是山西省世界银行贷款卫生Ⅸ项目市。2004年经申请被山西省卫生厅列为吸毒人群人类获得性免疫缺陷病毒(HIV)监测哨点,为及时掌握本市吸毒人群的HIV感染状况,采取行之有效的干预措施提供依据,2004—2005年在阳泉市强制戒毒所对被强制戒毒的381名吸毒人员进行了HIV抗体检测     

艾滋病人群社会行为辨析

人类告别２０００年跨入新世纪,强调以人为本的理念。然而毒品与艾滋病 (ＡＩＤＳ)的魔影在大地上浮动,危及人类健康。中国ＡＩＤＳ患者中约６０ % -７０ %来自吸毒人群,在药物滥用防治中有必要了解ＡＩＤＳ高危人群的社会行为,全民联手举起抵御防治毒品与ＡＩＤＳ的盾牌。艾滋病全称为获得性免疫缺陷综合征（ａｃｑｕｉｒｅｄｉｍｍｕｎｅｄｅｆｉｃｉｅｎｃｙｓｙｎｄｒｏｍｅ,ＡＩＤＳ）,其感染源为免疫缺陷病毒（ｈｕｍａｎｉｍｍｕｎｏｄｅｆｉｃｉｅｎｃｙｖｉｒｕｓ,ＨＩＶ）。自１９８１年６月美国在《发病率和死亡率周报》…     

2008～2010年某市手足口病的流行病学分析

目的探讨上饶市近三年来手足口病的流行病学特征,为制定手足口病防控措施提供科学依据。方法利用国家疾病监测信息报告管理系统导出数据进行描述性流行病学分析。结果 2008年至2010年分别报告手足口病380例、663例和1992例,均有明显的季节性,男性发病高于女性,信州区发病率最高,以5岁及5岁以下年龄组为主,分别占96.84%、95.17%和97.09%,均以散居儿童高发。结论上饶市手足口病的发生有明显的季节、年龄、性别及地区差异,开展手足口病流行病学研究,有助于防控疫情。     

福州地区吸毒人群高危行为特征和复吸原因调查

目的:了解福州地区吸毒人群的高危行为特征和复吸原因。方法:自行设计问卷对福州地区强制戒毒人员进行相关内容调查。结果:在被调查的870例吸毒人员中,男性占75.2%,女性占24.8%;年龄34.16 a±s0.247 a,26-40 a年龄段占到68.9%(599例);女性低龄吸毒情况比男性严重;86.3%为初中及初中以下文化水平;未婚、离异和丧偶者占61.4%;53.0%为无业人员。静脉注射(552例,占63.4%)和烟枪吸(277例,占31.8%)为主要滥用方式;30.4%(265例)的人回答有共用吸毒器具行为;23.7%(206例)的人有多性伴侣,不使用安全套的比例占40.8%(355例);失眠(113例,13.0%)、身体疲劳(57例,6.6%)、性功能降低(41例,4.7%)是产生复吸的主要身体因素;打发无聊时间(222例,25.2%)、消除烦恼(192例,22.1%)以及被人冷落歧视、破罐破摔(120例,13.8%)是产生复吸的主要心理因素;毒友影响(265例,30.4%)、旧的吸毒环境引发毒瘾(152例,17.5%)是产生复吸的主要社会因素。结论:福州地区吸毒人群中存在注射、共用注射器具、多性伴侣等高危行为;复吸是身体因素、心理因素和社会因素共同作用的结果。开展毒品预防教育,对吸毒人群进行综合干预和戒毒后的后续管理,建立家庭社区综合康复机制,有助于改变吸毒人群的高危行为,预防复吸。     

女性吸毒人群人乳头瘤病毒感染情况调查及相关高危行为的分析

目的　调查女性吸毒人群人乳头瘤病毒（ＨＰＶ）的感染情况及相关高危行为对ＨＰＶ感染的影响,为ＨＰＶ防治提供     

永济市2010—2011年在押吸毒人员人类免疫缺陷病毒丙型肝炎梅毒流行病学检测结果分析

<正>了解山西省永济市在押吸毒人员中艾滋病、梅毒、丙型肝炎感染状况,探讨吸毒人群艾滋病、梅毒、丙型肝炎的相关因素,为制定和实施干预措施提供科学依据。2010—2011年共检测吸毒人员832例,其中人类免疫缺陷病毒(HIV)抗体阳性者1例,感染率0.1%,丙肝抗体阳性102     

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。     

Incidence and risk factors for non-fatal overdose among a cohort of recently incarcerated illicit drug users

Background

Release from prison is associated with a markedly increased risk of both fatal and non-fatal drug overdose, yet the risk factors for overdose in recently released prisoners are poorly understood. The aim of this study was to identify risk and protective factors for non-fatal overdose (NFOD) among a cohort of illicit drug users in Vancouver, Canada, according to recent incarceration.

Methods

Prospective cohort of 2515 community-recruited illicit drug users in Vancouver, Canada, followed from 1996 to 2010. We examined factors associated with NFOD in the past six months separately among those who did and did not also report incarceration in the last six months.

Results

One third of participants (n = 829, 33.0%) reported at least one recent NFOD. Among those recently incarcerated, risk factors independently and positively associated with NFOD included daily use of heroin, benzodiazepines, cocaine or methamphetamine, binge drug use, public injecting and previous NFOD. Older age, methadone maintenance treatment and HIV seropositivity were protective against NFOD. A similar set of risk factors was identified among those who had not been incarcerated recently.

Conclusions

Among this cohort, and irrespective of recent incarceration, NFOD was associated with a range of modifiable risk factors including more frequent and riskier patterns of drug use. Not all ex-prisoners are at equal risk of overdose and there remains an urgent need to develop and implement evidence-based preventive interventions, targeting those with modifiable risk factors in this high risk group.     

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。     

Factorial structure of the Brief Symptom Inventory (BSI)-18 among Chinese drug users

Background

Although the Brief Symptom Inventory-18 (BSI-18) has been widely used for mental health screenings in both clinical and non-clinical populations, the validation of its application to Chinese populations has been very limited. The objective of this research is to assess the factorial structure of the BSI-18 within a Chinese drug using population.

Methods and results

A total sample of 303 drug users recruited via Respondent Driven Sampling (RDS) from Changsha, China was used for the study. Our results show: (1) The BSI-18 item scores are highly skewed; (2) With dichotomous items measures (1 – problem at least moderately caused respondent discomfort during the past week; 0 – otherwise), our findings support the designed 3 – factor solution of the BSI-18 (somatization, depression, and anxiety); (3) The BSI-18 has a hierarchical factorial structure with 3 first-order factors and an underlying second-order factor (general psychological distress); (4) Tentative support should also be given to a single dimension of general psychological distress in Chinese drug using populations. Our study recommends a useful alternative approach for evaluating the factorial structure of the BSI-18 – i.e. CFA with dichotomous item measures. Both the total BSI-18 score and the three subscales (SOM, DEP, and ANX) can be used in applications of the BSI-18.

Conclusion

Overall, our findings suggest the BSI-18 is useful with Chinese drug users, and shows potential for use with non-Western and substance using populations more generally.     

High-risk drug use and sexual behaviors among out-of-treatment drug users: An aging and life course perspective

High-risk injection drug use and its accompanying sexual behaviors have large social and financial costs. However, little is known about how age and age at first drug use are related to high-risk injection or sex behaviors. The current study draws on life course perspectives and data from the NIDA Cooperative Agreement to examine the relationship between eight high-risk behavior variables and age and age at first drug use. Random effects negative binomial regression models reveal that the frequency of high-risk sexual behaviors in the past month decreases up to 28% with each decade of age, although the frequency of high-risk injection behaviors in the past month increases by up to 62% with each decade of age. Both high-risk injection and high-risk sex behaviors are lower among those who initiated first drug use at later ages. Previous research has indicated the importance of interventions to reduce the high-risk sexual behaviors of older drug users. The current study suggests a refocusing of public health efforts on their high-risk injection habits.     

Examining factorial structure and measurement invariance of the Brief Symptom Inventory (BSI)-18 among drug users

The purpose of this study is to examine the factorial structure of the Brief Symptom Inventory 18 (BSI-18) and test its measurement invariance among different drug using populations. A total sample of 710 drug users was recruited using respondent-drive sampling (RDS) from three states: Ohio (n = 248), Arkansas (n = 237), and Kentucky (n = 225). The results of confirmatory factor analysis (CFA) show: 1) the BSI-18 has a three-factor structure (somatization, depression, and anxiety) with an underlying second-order factor (global severity index of distress); and 2) its factorial structure and metric (factor loadings) are invariant across populations under study. However, the scalars (intercepts) of the BSI-18 items are not invariant, and the means of the latent factors also varied across populations. Our findings provide evidence of a valid factorial structure of the BSI-18 that can be readily applied to studying drug using populations.     

Predictors of non-fatal overdose among a cohort of polysubstance-using injection drug users

BACKGROUND: Non-fatal overdose is a major determinant of morbidity among injection drug users (IDU). We sought to evaluate factors associated with non-fatal overdose among IDU in Vancouver. METHODS: We examined non-fatal overdose among participants in the Vancouver Injection Drug Users Study. Correlates of non-fatal overdose occurring between 1996 and 2004 were identified using generalized estimating equations (GEE). RESULTS: There were 1587 participants included in this analysis, including 576 (36%) women. At baseline, 750 (47%) reported a history of non-fatal overdose. In total, 985 reports of non-fatal overdose were made during follow-up by 519 (32.7%) participants. In multivariate GEE analyses, factors independently associated with non-fatal overdose included: heroin injection (AOR=2.67), cocaine injection (AOR=2.01), benzodiazepine use (AOR=2.00), requiring help injecting (AOR=1.58), binge drug use (AOR=1.52), homelessness (AOR=1.38), alcohol use (AOR=1.32), street injecting (AOR=1.22), non-injectable opiate use (AOR=1.16), speedball use (AOR=1.15), and recent incarceration (AOR=1.14). Younger age (AOR=0.99) and methadone use (AOR=0.51) were protective. CONCLUSIONS: We found that non-fatal overdose was common among local IDU. Non-fatal overdose was associated with several factors that may be amenable to intervention, including opiate and stimulant use, and the characteristic of requiring help with injecting. These findings indicate the need for the ongoing development of structural interventions to address this common cause of morbidity among IDU.     

AIDS and injecting drug use: very risky behaviour in a Perth sample of injecting drug users

This research was carried out in 1990 to examine high-risk injecting and sexual behaviour in a sample of injecting drug users (IDUs) in Perth. The study was a cross-sectional survey with a convenience sample drawn from drug treatment (54%) and non-treatment (46%) populations. In the sample of 150 IDUs, there were 11 very risky drug behaviour (VRDB) and 63 very risky sex behaviour (VRSB) respondents. Four respondents fell into both categories. Independent comparisons were made between each risk group and the rest of the sample. The VRDB respondents were heterosexual men, most of whom were in long-term monogamous relationships, with heavier levels of drug use than the rest of the sample. The VRSB respondents were largely single and mainly heterosexual, with more sexual partners than the rest of the sample. It was concluded that there was little evidence that very risky behaviour was related to a general risk-taking dimension, to inadequate knowledge about AIDS or to a low assessment of personal vulnerability to AIDS. However, situational influences in association with heavy drug use appeared to be a major component of high-risk injecting behaviour, while high-risk sexual behaviour appeared more to be a reflection of community norms about heterosexual sexual behaviour. The study should be replicated with larger samples, particularly as the VRDB group was so small, but if the findings are reproduced in other studies, it suggests that serious attention should be paid to the promotion of safer sex among injecting drug users.     

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Aim: The study investigated the attitudes of intravenous drug users (IDUs) towards the provision of drug consumption rooms (DCRs) in the UK and their willingness to use DCRs. Methods: Participants were 90 methadone-maintained outpatients recruited from a London clinic. A questionnaire asked about their willingness to use a DCR, their views on various rules commonly-implemented by DCRs, and how they believed DCRs might impact on the drug-taking behaviours of drug users and their peers. Findings: A large majority (89%) expressed willingness to use a DCR and accepted the need for rules such as no drug sharing (84.3%), no assistance with injecting (81.8%), compulsory supervision (76.7%) and compulsory hand washing (92.1%). However, the IDUs were split over whether injection in the neck or groin should be disallowed and whether certain categories of IDUs (e.g. juveniles, pregnant women) should be excluded from DCRs. Majorities thought it unlikely that DCRs would encourage users to try risker drug preparations (76.6%), or encourage non-injectors to inject for the first time (74.5%). Conclusions: In a country where DCRs are not available, the study highlights the willingness of IDUs to use a DCR and accept its rules, even for a sample most of whom were not homeless.     

Harm reduction intensity-Its role in HAART adherence amongst drug users in Amsterdam

Background

Opioid substitution treatment seems to improve adherence to highly active antiretroviral therapy (HAART) in drug users (DU). DU in Amsterdam receive methadone within a harm reduction programme. We hypothesized that not only receiving methadone, but joining this complete comprehensive programme would improve HAART adherence.

Methods

Included were 102 HIV-positive DU attending the Amsterdam Cohort Study (ACS), reporting HAART use at multiple visits between 1999 and 2009. Non-adherence was defined as taking less than 95% of medication in the past 6 months (self-reported). Harm reduction intensity (HR) was measured by combining injecting drug use, methadone dosage and needle exchange, in different levels of participation, ranging from no/incomplete HR, complete HR to low or no dependence on HR. We studied the association between non-adherence and harm reduction intensities with logistic regression models adjusted for repeated measurements.

Results

Non-adherence was reported in 11.9% of ACS visits. Non-injecting DU with low dependence on HR were less adherent than DU with complete HR (aOR 1.78; CI 95% 1.00-3.16), although there was no overall effect of HR. No difference was demonstrated in adherence between DU with complete HR and incomplete HR. Unsupervised housing (no access to structural support at home) (aOR 2.58; CI 95% 1.40-4.73) and having a steady partner (aOR 0.48; CI 95% 0.24-0.96) were significantly associated with respectively more and less non-adherence.

Conclusions

In Amsterdam, still-injecting DU who are exposed to systematic and integrated care, although not practising complete harm reduction, can be just as adherent to HAART as DU who make use of complete harm reduction and non-injecting DU with no dependence on harm reduction. These findings suggest the importance of a systematic and comprehensive support system including supervised housing and social and medical support to increase HAART adherence rates amongst all HIV-infected DU. When such programmes are introduced in settings where injecting drug use is highly prevalent, access to HAART for drug users in these settings can and should be increased.     

The use of benzodiazepines among injecting drug users

Benzodiazepine use among injecting drug users (IDUs) presents a major clinical and public health problem that may increase in importance. The current paper examines the research on the extent of benzodiazepine use among IDUs and the harmful consequences associated with such use. Numerous studies have found benzodiazepine use to be widespread among IDUs, and to be associated with greater levels of risk-taking and polydrug use, and poorer psychosocial functioning than other IDUs. The injection of benzodiazepines has also been reported, and presents problems in itself. The implications of existing research for both clinical practice and research are discussed.