乌鲁木齐市静脉吸毒人群HIV感染及危险因素研究

目的了解乌鲁木齐市静脉吸毒人群艾滋病病毒(HIV)感染情况。方法于2004年9~10月,调查戒毒所等机构内静脉吸毒人群的社会人口学、静脉吸毒和性行为方式,并采集血样检测HIV和梅毒抗体。结果在调查的静脉吸毒者509人中,HIV感染率为37.3%(190人)。多因素logistic回归模型分析结果显示,维族(OR 7.91,95%CI 4.92~12.72)、近3个月内共用注射器具静脉吸毒5次及以上(OR 2.61,95%CI 1.48~4.60)和静脉吸毒5年以上(OR 1.64,95%CI 1.09~2.48)与HIV感染关系有统计学意义。结论乌鲁木齐市静脉吸毒人群HIV感染率高,高危行为普遍,需采取有效的措施来控制HIV的传播流行。     

具有卖淫行为注射吸毒女性艾滋病危险行为调查分析

目的 比较有卖淫行为的女性注射吸毒人群、单纯的社区女性注射吸毒人群、低档场所暗娼的人口学特征和HIV感染相关的危险行为,为制定有效的干预措施提供科学依据.方法 利用2003-2005年四川省综合监测资料,以具有卖淫行为的注射吸毒女性为主要研究对象,采用监测问卷对CSW和IDU进行问卷调查. 结果2003-2005年女性注射吸毒者中有商业性行为的占37.0%～47.1%,IDU-CSW的安全套使用率较低档场所CSW安全套使用率低15%～20%.差异均有统计学意义(P<0.05).结论 HIV高危行为在具有注射吸毒和卖淫双重身份的女性人群中更具普遍性,对其开展有效的行为干预,将成为吸毒严重地区控制艾滋病传播的重要任务.     

云南省德宏州静脉吸毒人群中HIV感染流行危险因素研究

德宏州吸毒者ＨＩＶ感染占全省吸毒及ＨＩＶ感染者的９５％以上，其州内不同县市ＨＩＶ静注感染率明显不同，１９９２年３～４月，对该州２县１市戒毒所中８４３名吸毒者（包括２８２名静注者）调查，ＨＩＶ静注感染率瑞丽市为７９２％，陇川为４７％，潞西为５１％，在瑞丽，影响静注ＨＩＶ感染率的主要因素为跨国吸毒，陇川则为静注频率。而不同地区不同静注感染率的原因则可能为离金三角的地理位置的远近，及与之相关静注行为和ＨＩＶ感染引入时间不一，传染源积累数量不同有关。     

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.     

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。     

南宁市新型毒品吸毒人群性行为特征及相关危险因素

目的了解南宁市新型毒品吸毒者的性行为特点,探索与吸毒者异性性行为可能相关的危险因素。方法在戒毒医院、自愿咨询检测(VCT)门诊对新型毒品吸毒者开展问卷调查,收集基本情况、相关行为信息。结果共招募新型毒品吸毒者113人,平均年龄(26.3±5.6)岁,90天内有固定性伴性行为、临时性行为和商业性行为的比例分别为64.6%(73/113)、53.1%(60/113)和15.0%(17/113)。吸毒者发生临时性行为的危险因素包括甲基苯丙胺[比值比(OR)=4.581,95%可信区间(CI):1.658~12.654]和苯丙胺(OR=3.955,95%CI:1.479~10.571);年龄25岁是吸毒者发生临时性行为(OR=0.292,95%CI:0.119~0.715)和商业性行为(OR=0.265,95%CI:0.060~1.170)的保护因素。结论新型毒品吸毒者性行为活跃,甲基苯丙胺、苯丙胺对吸毒者发生临时性行为起到一定的促进作用。     

广东省静脉吸毒人员共用针具影响因素的Logistic回归分析

目的探讨广东省静脉吸毒人员共用针具的影响因素,以及针具交换项目对预防吸毒人员共用针具的效果。方法采用社区干预研究的方法,选择各方面因素比较类似的两个镇,一个作为干预社区,一个为对照社区。干预区采用针具交换干预措施,对照区不采取任何干预措施,为期10个月。于干预前后分别采用滚雪球的方式抽取注射吸毒者进行断面调查,以评估共用针具的影响因素。影响因素的确定采用Logistic单因素分析,对有显著意义的变量进行多因素Logistic逐步回归分析。结果干预前后分别调查了428和429名静脉吸毒者。干预后干预组和对照组最近30天内共用针具率分别为20.4%和35.3%,差异有显著性（χ^2=11.83,P=0.001）。多因素Logistic逐步回归分析结果显示：知晓艾滋病知识（OR=0.62,95%CI：0.45～0.85）、20～30岁年龄组（OR=1.41,95%CI：1.04～1.91）、使用多种毒品（OR=2.21,95%CI：1.53～3.19）、注射吸毒的年限（OR=2.38,95%CI：1.43～3.99）、重复使用注射器（OR=2.94,95%CI：2.06～4.19）、一次买4支针以上（OR=0.53,95%CI：0.33～0.86）、买针不方便（OR=2.08,95%CI：1.38～3.12）及是否看过艾滋病宣传折页或宣传画（OR=0.59,95%CI：0.42～0.83）,是影响吸毒者共用针具的主要原因。结论针具交换项目有效地降低了静脉吸毒人员共用针具率,知晓艾滋病知识、针具交换项目的宣传及针具的可及性,是针具共用的预防因素;而青年人群、使用多种毒品及注射吸毒时间较长等,是共用针具的危险因素。因此今后的针具交换项目应该针对这些危险因素才能达到控制艾滋病在静脉吸毒人群中的传播。     

知道自己感染状态的HIV阳性人群的危险性行为及其影响因素

到2002年底，全世界有约6千万人感染艾滋病病毒(HIV)，大多数人处在性活跃年龄段。同样，中国报告的HIV感染者和艾滋病(AIDS)病人中，大多数也处在性活跃年龄段，而且男女比例悬殊。为此，了解HIV阳性人群的性行为及其影响因素，对于设计干预措施、控制HIV的性传播有着极其重要的理论和现实意义。本文就已知感染状态的HIV阳性人群的危险性行为及其影响因素作一综述。     

合成毒品使用人群中HIV感染状态及危险因素研究进展

合成毒品使用者中HIV感染率的地区分布变化较大,注射使用合成毒品者及使用合成毒品的男男性接触者中HIV感染的风险较高。在合成毒品使用者中,未婚、无业者,多药滥用,注射使用毒品以及共用注射器等毒品使用行为,多性伴、无保护性行为、性交易及性暴力等不安全性行为以及合并感染多种疾病等因素为HIV感染与传播的危险因素。加强禁毒力度,积极采取有针对性的干预和治疗措施,以期预防和减少HIV在我国合成毒品滥用者中的感染与传播。     

广西注射吸毒人群参与针具交换的影响因素分析

目的探讨和分析广西注射吸毒人群参与针具交换的影响因素,为吸毒人群综合干预策略与模式的建立提供科学依据。方法选取社区及新进入戒毒所的注射吸毒者为研究对象,采用结构式问卷进行面对面调查,采用单因素及多因素Logistic回归分析评估影响参与针具交换的因素。结果共调查474人。近1年内参加过针具交换的比例为67.3%,但维持时间在10-12个月的调查对象仅占25.7%。害怕被抓和路途遥远,是调查对象报告的其本人及毒友不愿参与针具交换的主要原因。单因素Logistic回归分析结果显示：女性、汉族、已婚/同居、注射吸毒年限较长、对共用注射辅助材料的危害有正确认识及最近30天无高危注射行为,是参与针具交换的促进因素。多因素Logistic回归分析显示：除婚姻状况外,上述单因素分析有意义的变量均是注射吸毒者参与针具交换的影响因素。结论进一步向注射吸毒者宣传共用针具及注射辅助材料的危害,重视对注射吸毒年限较低的人群的干预,根据民俗特点加强少数民族注射吸毒者的干预等,有可能促进更多的注射吸毒者参与针具交换。     

Human Immunodeficiency Virus Infection and Associated Factors among Specific Population Subgroups in Cameroon

The objective of this study was to identify factors associated with HIV infection among specific population subgroups and complement the HIV surveillance system in Cameroon. Five subgroups (truck drivers, female-sex-workers, university students, health service providers, and residents along Chad-Cameroon petroleum pipeline) were targeted in 2004. Potential participants were approached at their geographically diverse areas and consented to participate in the study. Anonymous blood samples were collected. 4,011 participants were surveyed (35% students, 25% sex-workers, 20% pipeline residents, 12.5% health service providers, 7.5% truck drivers). HIV prevalence was highest among sex-workers [26.4%, (95% CI, 23.6–29.2)], pipeline residents [19.9% (95% CI, 17.1–22.7)] and truck drivers [16.3% (95% CI, 12.3–20.9))] and lowest among health service providers [5.2% (95% CI, 3.4–7.5)] and university students [3.8% (95% CI, 2.9–5.0)]. Risky sexual behaviours were practiced in all subpopulations. Multivariable analysis shows in female-sex-workers that; older age, residing in the grassland region (Northwest and West Provinces) and inconstant condom use were significantly associated with HIV infection. Despite a moderate HIV prevalence in the general Cameroonian population, some subgroups are at much higher risk for HIV transmission and practicing risky sexual behaviours. There is need for expanded prevention and care programs with emphasis on truck drivers, sex-workers and pipeline residents.     

Gender Differences in the Prevalence and Behavioral Risk Factors of HIV in South African Drug Users

South Africa continues to be the global epicenter of HIV infection. Further, extensive gender disparities in HIV infection exist with females four times as likely to be infected with HIV/AIDS as males (UNAIDS, AIDS epidemic update, 2006; WHO, Epidemiological fact sheets on HIV/AIDS and sexually transmitted infections, 2006). A cross-sectional collection of drug users recruited in the Pretoria region of South Africa (N = 385) was used to model HIV infection as a function of sexual risk behaviors and drug use as modified by gender. Receiving money from illicit sources and knowing someone with AIDS were loosely associated with HIV. Gender interactions were observed for age, cocaine use and condom use. Gender stratified analyses revealed that males who used condoms, were younger and tested negative for cocaine use were less likely to test positive for HIV. Findings suggest that males may have more control of risk behaviors and support the need for gender specific prevention strategies.     

湖南省吸毒人群中HIV感染及其危险因素调查

目的 了解湖南省吸毒人群HIV感染及其相关危险因素,为制定预防吸毒传播HIV提供依据。方法 采用血清流行病学和问卷方法,对湖南四地戒毒所809名吸毒者进行调查。结果 检出HIV感染者23例,HIV感染与共用注射器、每日吸毒的频率、职业、共用注射器对象不固定、经济状况和艾滋病知识缺乏有一定关系。结论 在吸毒人群中应加强健康知识教育和行为干预。     

Long-Term Correlates of Childhood Abuse among Adults with Severe Mental Illness: Adult Victimization, Substance Abuse, and HIV Sexual Risk Behavior

The prevalence of childhood sexual and physical abuse among persons with severe mental illness (SMI) is disproportionately high. Adults with SMI also engage in high rates of HIV risk behaviors. This study examined the association between childhood abuse and adult victimization, substance abuse, and lifetime HIV sexual risk in a sample of 152 adults with SMI receiving community mental health services. Structured interviews assessed psychiatric, psychosocial, and behavioral risk factors. Seventy percent reported childhood physical and/or sexual abuse, and 32% reported both types of abuse. Participants with childhood abuse were more likely to report adult victimization and greater HIV risk. A structural equation model found that childhood abuse was directly and indirectly associated with HIV risk through drug abuse and adult vicitimization. Integrated treatment approaches that address interpersonal violence and substance abuse may be necessary for HIV risk reduction in this population.     

脓毒症继发二次感染的危险因素分析

目的:分析脓毒症患者在院期间继发二次感染的危险因素。方法:收集137例脓毒症患者的临床资料,包括:基本信息、既往病史、感染部位、初始病原菌、继发二次感染病原菌及部位、入院后干预措施等。结果:137例脓毒症患者中继发二次感染18例(13. 1%),未继发二次感染119例(86. 9%)。二次感染组病死率为38. 9%(7/18),无二次感染组病死率为1. 7%(2/119),两者比较差异有统计学意义(P 0. 01)。二次感染组继发肺部感染17例(94. 4%),导管相关性血行感染1例(5. 6%)。多个影响因素作为变量行二分类多变量logistic回归分析显示:既往患有慢性阻塞性肺疾病(P 0. 01)、mRS评分高(P 0. 01)、使用机械通气(P 0. 05)及住院时间(P 0. 01)是脓毒症患者继发二次感染的危险因素。结论:既往患有慢性阻塞性肺疾病、mRS评分高、机械通气及住院时间是脓毒症患者继发二次感染的危险因素,且二次感染多发生在肺部。     

Alcohol Use and Human Immunodeficiency Virus (HIV) Infection: Current Knowledge,Implications, and Future Directions

Alcohol use is common among people living with human immunodeficiency virus (HIV). In this narrative review, we describe literature regarding alcohol's impact on transmission, care, coinfections, and comorbidities that are common among people living with HIV (PLWH), as well as literature regarding interventions to address alcohol use and its influences among PLWH. This narrative review identifies alcohol use as a risk factor for HIV transmission, as well as a factor impacting the clinical manifestations and management of HIV. Alcohol use appears to have additive and potentially synergistic effects on common HIV‐related comorbidities. We find that interventions to modify drinking and improve HIV‐related risks and outcomes have had limited success to date, and we recommend research in several areas. Consistent with Office of AIDS Research/National Institutes of Health priorities, we suggest research to better understand how and at what levels alcohol influences comorbid conditions among PLWH, to elucidate the mechanisms by which alcohol use is impacting comorbidities, and to understand whether decreases in alcohol use improve HIV‐relevant outcomes. This should include studies regarding whether state‐of‐the‐art medications used to treat common coinfections are safe for PLWH who drink alcohol. We recommend that future research among PLWH include validated self‐report measures of alcohol use and/or biological measurements, ideally both. Additionally, subgroup variation in associations should be identified to ensure that the risks of particularly vulnerable populations are understood. This body of research should serve as a foundation for a next generation of intervention studies to address alcohol use from transmission to treatment of HIV. Intervention studies should inform implementation efforts to improve provision of alcohol‐related interventions and treatments for PLWH in healthcare settings. By making further progress on understanding how alcohol use affects PLWH in the era of HIV as a chronic condition, this research should inform how we can mitigate transmission, achieve viral suppression, and avoid exacerbating common comorbidities of HIV and alcohol use and make progress toward the 90‐90‐90 goals for engagement in the HIV treatment cascade.