阳江市江城区吸毒者艾滋病相关危险因素调查

目的了解阳江市江城区静脉吸毒者的艾滋病毒的感染状况及高危行为,为制订相应的干预措施提供依据。方法对静脉吸毒者进行面对面问卷调查,并采静脉血检测HIV抗体。结果91.3%静脉吸毒者是小学或初中文化程度;静脉吸毒者HIV感染率为21.9%;静脉吸毒者对艾滋病相关知识总知晓率为40.1%;最近一次性生活时安全套使用率为28.9%;47.4%静脉吸毒者有共用针具行为。结论阳江市部分静脉吸毒者HIV感染率高,对艾滋病相关知识总知晓率低,HIV感染行为率高,应尽快采取有力的干预措施遏制艾滋病在该人群中的传播。     

Increasing prevalence of cocaine as the primary detoxification diagnosis among admissions presenting with current intravenous drug use: a review of detoxification records from northern British Columbia, 1999-2005

OBJECTIVES: This study sought to document the trends in drug use among intravenous drug users (IDUs) in northern British Columbia, and to discuss the public health implications. METHOD: We conducted a 7-year medical-chart review of all IDU-related admissions (n = 2072) to an inpatient alcohol and drug detoxification centre in Prince George, British Columbia. Primary detoxification diagnosis was modeled onto year of admission using generalized estimating equations (GEE). RESULTS: Our study demonstrated an increasing prevalence of cocaine as the primary detoxification diagnosis in IDU-related admissions in northern BC, from 32% of all IDU admissions in 1999 to 64% in 2001, and then a relatively steady elevated rate of approximately 60% between 2001-2005. CONCLUSIONS: Given that needle exchange programs and other harm reduction services for IDUs in British Columbia are not readily available in many northern and rural areas, the risks associated with intravenous cocaine use among northern IDUs represent a serious public health challenge. Tailored harm reduction strategies should take into account the prominence of intravenous cocaine use as an HIV risk factor. In areas without well-established intravenous drug use monitoring programs, such as rural and remote areas, detoxification treatment records may serve as important sentinels for changing drug use patterns among IDUs.     

A participatory intervention to improve the mental health of widows of injecting drug users in north-east India as a strategy for HIV prevention

Background  

Manipur and Nagaland, in the north-east of India, are classified as high prevalence states for HIV, and intravenous drug use is an important route of transmission. Most injecting drug users (IDUs) are men, an estimated 40% are married, and death rates have been high in the last five years, consequently the number of widows of IDUs has increased. Many of these widows and their children are HIV-infected and experience poor health, discrimination, and impoverishment; all factors likely to be compromising their mental health. People with poor mental health are more likely to engage in HIV risk behaviours. Mental health can be promoted by public health actions with vulnerable population groups.     

Injection drug use: harbinger of HIV / AIDS

The spread of HIV infections in southeastern Asia is expected to be significant. In this area, as in other parts of the world, the habits of intravenous drug users (IDUs) who share needles and supplies and engage in high-risk sexual behavior will contribute to the spread of the disease in the general population. Because drug treatment programs that promote abstinence are only successful among the limited number of drug abusers who are motivated to stop taking drugs, a harm-reduction approach to this problem makes the best sense. Reducing HIV risk requires giving priority to HIV prevention rather than to control of drug use. Interventions to prevent HIV transmission among IDUs include counseling for in-treatment drug users, needle and syringe exchange programs, and preventive intervention programs that attempt to change high-risk behavior. In India, drug abuse has a long history, and the northeastern states have experienced a rapid increase in heroin use accompanied by the spread of HIV infection. In other areas, injection of Buprenorphine is increasing. It is important to recognize IDUs as a group at high risk of transmitting HIV infection and to design strategies, such as those that have been successful in New York City, to stabilize sera-prevalence in this rapidly increasing group.     

2010-2011年乌海市吸毒人群中丙型肝炎病毒感染调查

目的 了解我市吸毒人员中丙肝感染的情况及其高危因素,为控制丙肝流行提供科学依据.方法 对2010-2011年乌海市监测哨点中吸毒人群进行了调查及血清抗-HCV抗体检测分析.结果 2010-2011年合计检测911人,检出血清抗-HCV抗体阳性者580例,阳性率为63.67％.其中血清抗-HCV抗体阳性率青壮年人群显著高于其它人群(x2=40.81,P＜0.05),静脉吸毒人群显著高于口吸人群(x2=312.46,2＜0.01).结论 吸毒人群中血清抗-HCV抗体阳性率远远超过自然人群的感染率,而且通过注射方式吸毒是HCV感染的高危因素,说明该人群存在着丙肝传播与流行的高危因素,是丙肝防治的重点人群.     

自贡市静脉吸毒人群社会网络特点及其与HIV传播关系的研究

[目的]了解城市社区静脉吸毒人群（IDUs）人际网络特点,分析其与HIV传播的关系,以更好的在该人群中开展防制艾滋病工作。[方法]以“滚雪球”方式抽样;采取定性调查为主、定量研究为辅的资料收集方法。[结果]IDUs社会网络的特点：网络中存在“小圈子”并活动频繁;多数“小圈子”有“核心人物”且对圈子成员有重要影响;部分IDUs与家人、朋友保持往来获得经济及生活帮助;IDUs的AIDS高危行为不仅是共用针具,性活动同样值得注意。[结论]IDUs社会网络的特点必然影响HIV在该人群中的传播,并可能使HIV传播曲线呈“S”形。这对制定针对该人群的防制AIDS策略有参考意义。IDUs社会网络特点也要影响HIV从吸毒人群向非吸毒人群的传播;对这种传播途径存在的实际可能性不能低估,且应采取相应对策。     

Injection drug use and the hepatitis C virus: Considerations for a targeted treatment approach-The case study of Canada

Infection with the hepatitis C virus (HCV) is a major public health burden in Canada and globally. The literature shows that injection drug use is currently the primary transmission route for HCV, and that a majority of injection drug users (IDUs) are currently infected with HCV in Canada. This article first reviews the burden of HCV within IDU populations and the transmission risks and the treatment implications speicifc to IDUs. Traditionally, IDUs have been excluded from HCV treatment unless abstaining from illicit drug use. However, recent research suggests that categorical exclusion is not medically necessary. A series of key questions about the feasibility of offering HCV treatment to IDUs in the specific Canadian context are considered, including concerns related to the motivation of treatment for IDUs, treatment delivery, treatment side effects, HCV reinfection, and the social environment. The article concludes that treatment of HCV-infected illicit drug users is both feasible and may be necessary to reduce transmission and adverse outcomes in this high-risk population.     

Using a jail-based survey to monitor HIV and risk behaviors among seattle area injection drug users

Routine monitoring of human immunodeficiency virus (HIV) and risk behaviors among injection drug users (IDUs) is difficult outside drug treatment settings. We developed and implemented a survey of recently arrested IDUs to describe the prevalence of HIV, drug use, and sexual behaviors among them. A probability sampling survey was instituted in the King County Correctional Facility in Seattle, Washington, to sample recently arrested IDUs at the time of booking and in the jail health clinic between 1998 and 1999. Following HIV risk assessment and blood draw, additional information on drug use practices was gathered using a standardized questionnaire. Potential participants who were released from jail early could complete the study at a nearby research storefront office. Of the 4,344 persons intercepted at booking, 503 (12%) reported injection drug use, and 201 of the IDUs (40%) participated in the study. An additional 161 IDUs were enrolled in the study from the jail health clinic. Among the 348 unduplicated subjects, HIV prevalence was 2%; in the past 6 months, 69% reported two or more shooting partners, 72% used a cooker after someone else, 60% shared a syringe to divide up drugs, and 62% injected with used needles. Only 37% reported being hepatitis C seropositive, and 8% reported hepatitis B vaccination. It was feasible to conduct a jail-based survey of recently arrested IDUs that yielded useful information. The high prevalence of reported risky drug use practices warrants ongoing monitoring and illustrates the need for improving prevention programs for HIV and hepatitis B and C in this population, including expansion of hepatitis C screening and provision of hepatitis B vaccination at the jail health clinic.     

2008年柳州市艾滋病监测结果分析

目的了解柳州市2008年艾滋病流行现状,为采取有效控制措施提供科学依据。方法采用哨点监测、综合监测、自愿咨询检测、重点人群筛查和专题流行病学调查等方法,收集全市艾滋病病毒感染资料和艾滋病病例报告资料。结果2008年全市共筛查监测各类重点人群178565人,检出HIV抗体（初筛）阳性者2356人,检出率1．32％。年龄最小0．5岁,最大84岁,20—44岁者占72．38％,传播途径经静脉吸毒占19．53％,性传播占58．98％,母婴0．89％。结论柳州市HIV流行已经由静脉吸毒人群经性乱人群向一般人群蔓延,静脉吸毒、性乱人群为该市艾滋病传播的重要因素。     

Contraceptive practices of non-HIV-seropositive injecting drug users

Aims: To study the sociodemographic characteristics and sexual behaviours in contraception choices of injecting drug users (IDUs) and to compare the contraceptive practices of non-HIV-positive IDUs to those of the general population. Design: Two surveys were used: a sample of IDUs attending 10 drug abuse treatment centres in the Paris region (IDU) and the Parisian subsample of the National French Survey of Sexual Behaviour (ACSF). Measurements: Percentages of contraception practices were estimated separately for 81 IDU and 130 ACSF women, and for 175 IDU and 168 ACSF men, aged 25–34, not reporting prostitution or HIV seropositivity. Findings: Most IDU (77%) and ACSF (84%) women, and IDU (73%) and ACSF (75%) men currently used a contraceptive method. Male condoms were more widely used by IDUs than by the general population (64 vs. 10% in women, 75 vs. 14% in men), for all subgroups of educational level, marital status, recent multipartnership status and sexual activity. Conclusions: Contraceptives are used as often by IDUs as by the general population aged 25–34. However, the methods employed differ, with higher condom use by IDUs, which suggest that IDUs take into account the risk of HIV contamination in their contraceptive practices.     

北京市昌平区2006-2011年吸毒人群艾滋病哨点监测结果分析

目的了解昌平区吸毒人群中艾滋病病毒(HIV)感染状况及行为特征,为艾滋病综合防治和行为干预提供科学依据。方法每年监测期内对社区吸毒者采用滚雪球方法招募,同时对新进入监管场所的所有吸毒者进行问卷调查并采集外周静脉血进行HIV抗体检测。结果 2006-2011年吸毒人群历年HIV感染率差异无统计学意义(χ2=6.272,P>0.05)。吸毒人群关于艾滋病知识知晓率有逐年增高趋势(χ2=211.899,P<0.001),注射吸毒人群比例有逐年缓慢下降趋势(χ2=46.29,P<0.001),共用针具比例分布差异有统计学意义(χ2=13.549,P<0.05)。结论在吸毒人群中加强开展艾滋病的宣传和干预工作,降低HIV感染率。     

2004～2006年济宁市戒毒人员艾滋病监测分析

[目的]了解济宁市戒毒人员艾滋病病毒(HIV)感染状况及相关危险因素,为制订吸毒人群艾滋病干预措施提供依据。[方法]对2004~2006年进入济宁市戒毒所的吸毒人员进行面对面调查,采集静脉血检测抗-HIV。[结果]调查吸毒者292人,37.33%有注射毒品行为。其中,57.80%曾与他人共用注射器或针头;7.88%曾通过金钱或毒品交易与他人发生过性行为。检测292名吸毒者,抗-HIV阳性率为14.38%,梅毒抗体阳性率为2.74%。抗-HIV阳性率,男性为17.49%,女性为4.35%,差异有统计学意义(P<0.01);外省人员为22.95%,本省人员均为阴性;静脉吸毒、吸毒时间长、共用注射器吸毒者高于口吸毒、静脉吸毒时间短、未共用注射器吸毒者。[结论]济宁市戒毒所的吸毒人员HIV感染率较高,梅毒感染率很低。     

Risk behaviours of young Indo-Chinese injecting drug users in Sydney and Melbourne

OBJECTIVE: To investigate patterns of drug use and injection-related risk behaviours among young Indo-Chinese injecting drug users (IDUs). METHOD: Cross-sectional survey. A structured questionnaire was administered to 184 Indo-Chinese IDUs aged 15 to 24 in Sydney and Melbourne. Participants were recruited using snowball sampling techniques; measures included patterns of heroin and other drug use, injection-related risk behaviours, perceived susceptibility to HIV and HCV infection and access to services. RESULTS: Despite perceived high availability of sterile injecting equipment, 36% had ever shared a needle and syringe and 22% had done so in the preceding month. Lifetime sharing was significantly associated with duration of injecting, history of incarceration and residence in Sydney. Sharing of injecting paraphernalia other than needles and syringes was also common, with young women and Sydney residents significantly more likely to report sharing equipment in the preceding month. CONCLUSIONS: Young Indo-Chinese IDUs are at high risk of infection with hepatitis C and other blood-borne viruses. Results indicate an urgent need for culturally appropriate and sustainable risk reduction programs which specifically target this population. Implications: Health services must respond swiftly to implement effective blood-borne virus prevention programs for young Indo-Chinese IDUs. Failure to do so may sustain the current epidemic of hepatitis C among IDUs.     

Effects of race, neighborhood, and social network on age at initiation of injection drug use

OBJECTIVES: We investigated individual- and neighborhood-level factors associated with adolescent initiation of injection drug use. METHODS: Injection drug users (IDUs) who had been injecting 2 to 5 years underwent HIV testing and completed a sociobehavioral risk survey. Modeling techniques accounting for intraneighborhood correlations were used in data analyses. RESULTS: Adolescent-initiating IDUs were less likely than adult-initiating IDUs to report high-risk sex and injection behaviors and more likely to report high-risk networks. African American IDUs from neighborhoods with large percentages of minority residents and low adult educational levels were more likely to initiate injection during adolescence than White IDUs from neighborhoods with low percentages of minority residents and high adult education levels. CONCLUSIONS: Racial segregation and neighborhood-level educational attainment must be considered when drawing inferences about age at initiation of injection drug use and related high-risk behaviors.     

Use of fake identification to purchase alcohol amongst 15-16 year olds: a cross-sectional survey examining alcohol access,consumption and harm

Objectives

Injection drug users (IDUs) are at high risk for HIV, hepatitis, overdose and other harms. Greater drug treatment availability has been shown to reduce these harms among IDUs. Yet, little is known about changes in drug treatment availability for IDUs in the U.S. This paper investigates change in drug treatment coverage for IDUs in 90 metropolitan statistical areas (MSAs) during 1993-2002.

Methods

We define treatment coverage as the percent of IDUs who are in treatment. The number of IDUs in drug treatment is calculated from treatment entry data and treatment census data acquired from the Substance Abuse and Mental Health Service Administration, divided by our estimated number of IDUs in each MSA.

Results

Treatment coverage was low in 1993 (mean 6.7%; median 6.0%) and only increased to a mean of 8.3% and median of 8.0% coverage in 2002.

Conclusions

Although some MSAs experienced increases in treatment coverage over time, overall levels of coverage were low. The persistence of low drug treatment coverage for IDUs represents a failure by the U.S. health care system to prevent avoidable harms and unnecessary deaths in this population. Policy makers should expand drug treatment for IDUs to reduce blood-borne infections and community harms associated with untreated injection drug use.     

HIV / STDs and drug use

Unprotected sexual intercourse and sharing drug injecting equipment are the two major ways in which HIV is transmitted among adults. Despite considerable cultural disapproval of illicit drug injection, the health hazards associated with it, and expensive law enforcement efforts, there has been an enormous diffusion of illicit drug injection during the second half of the 20th century. HIV infection has spread very fast among some populations of injecting drug users (IDUs), with incidence rates of 10-50% observed in both developing and developed countries. Needle sharing occurs among large numbers of IDUs within short periods of time, promoting the rapid and efficient transmission of HIV within the IDU population. HIV and STDs are spread from IDUs to non-IDUs through unprotected sexual intercourse. Effective HIV prevention programs for IDUs provide ongoing and trusted communication links between health workers and IDUs. Such programs also provide ready access to the means of changing behavior. The relationships between sexual behavior and drug use are complex. Prevention efforts should be focused upon people who exchange sex to support an addiction, the partners of addicted sex workers, and people who have multiple problems in living. The successful prevention of HIV infection among drug users requires that politicians admit that drug use exists in the community, that such use is likely to persist indefinitely, and that it is necessary to work with drug users to change risk behaviors.     

Crime, drugs and distress: patterns of drug use and harm among criminally involved injecting drug users in Australia

Objective: Explore demographic characteristics, patterns of drug use and psychological distress among regular injecting drug users (IDUs) in Australia, as a function of recent criminal activity.
Methods: Structured, face-to-face interviews with 909 regular IDUs recruited from every capital city in Australia, between June and August 2007, as part of the annual Illicit Drug Reporting System (IDRS). Criminal activity in the past month was assessed using the Opiate Treatment Index (OTI); psychological distress was assessed using the Kessler psychological distress scale (K10).
Results: Forty-three per cent of IDUs reported recent (past month) criminal activity. Those who had committed crime recently were younger, exhibited riskier patterns of drug use, reported more drug-related problems and were more likely to exhibit significant psychological distress. In a multivariate model the most important correlates of recent criminal activity were use of more than three drug types recently (OR=2.66, 95% CI 1.96-3.61), initiation to injecting before age 18 (OR=1.93, 95% CI 1.42-2.61) and daily drug injection (OR=1.55, 95% CI 1.13-2.13).
Conclusions and Implications: Criminal activity among regular IDUs in Australia is not restricted to a particular demographic group, and is a marker for riskier patterns of drug use, greater drug-related harm and psychological distress. Contact between IDUs and the criminal justice system provides opportunities for the delivery of targeted harm reduction messages, and for screening and diversion into appropriate treatment services.     

Profiles of risk: a qualitative study of injecting drug users in Tehran, Iran

Background  

In Iran, there are an estimated 200,000 injecting drug users (IDUs). Injecting drug use is a relatively new phenomenon for this country, where opium smoking was the predominant form of drug use for hundreds of years. As in many countries experiencing a rise in injecting drug use, HIV/AIDS in Iran is associated with the injection of drugs, accounting for transmission of more than two-thirds of HIV infections. This study aimed to: describe the range of characteristics of IDUs in Tehran, Iran's capital city; 2) examine the injecting-related HIV risk behaviors of IDUs, and 3) suggest necessary interventions to prevent HIV transmission among IDUs and their families and sex partners.     

2 468名中山市吸毒者HIV感染状况调查分析

目的对中山市某强制戒毒所2 468名吸毒人员HIV感染状况进行调查,探讨吸毒人员的不同吸毒方式感染艾滋病毒危险度的状况,为制定艾滋病预防控制措施提供科学依据。方法采用调查表对吸毒人员进行问卷调查,同时采血用ELISA法进行HIV抗体检测,初筛试验阳性者采用WB法确认,并对吸毒人员HIV感染的危险因素进行分析。结果2 468名吸毒人员HIV抗体检测阳性85人,阳性率3.44%。吸毒行为中单纯口吸吸毒者占31.7%(783/2 468),有5名HIV抗体检测阳性,阳性率0.64%(5/783);静脉注射吸毒者占68.3%(1 685/2 468),有80名HIV抗体检测阳性,阳性率为4.75%(80/1 685),经χ2检验,两者有统计学意义(χ2=27.144,P<0.001);1 685名静脉注射吸毒者有701名有共用注射针具史,共用针具史占41.6%,有67名HIV抗体阳性,阳性率9.56%,984名无共用针具静脉吸毒者,有13名HIV抗体阳性,阳性率为1.32%,经χ2检验,两者有统计学意义(χ2=61.411,P<0.001);而单纯口吸吸毒者与不共用针具静脉吸毒者HIV感染情况比较,经χ2检验,两者无统计学意义(χ2=2.015,P=0.156>0.05)。结论静脉注射吸毒特别是共用针具静脉注射吸毒是HIV感染的主要因素,应在吸毒人群中持续开展艾滋病预防知识的宣传和干预措施。