云南省陇川县男性静脉吸毒青年共用注射器具危险因素分析

以１９９４年８～１０月在云南省陇川县１８～２９岁男性青年断面调查中发现的静脉吸毒者为研究对象,运用回顾性队列研究设计,观察期为１９９１年１月１日至１９９４年８月１日,采用单因素及多因素分析方法,研究了静脉吸毒者共用注射器具行为的决定因素。在回顾性队列研究期间,静脉吸毒者中共用注射器具的年新发生率平均为１９．６％。多因素分析结果显示,除民族以外的其它人口学特征、吸烟、饮酒及婚前（婚外）性行为,对静脉吸毒者中共用注射器具的发生无预测作用,而景颇民族则是合用注射器具的主要危险因素（ＯＲ＝５．８,９５％Ｃ．Ｉ．２．５～１３．８）,其人群归因危险度为５８．５％。我们认为,对于景颇族静脉吸毒者中很高的合用注射器具行为需要进一步研究。针对合用注射器具行为的ＨＩＶ预防性干预工作,应以景颇族静脉吸毒者为主要目标人群     

云南省陇川县男性静脉吸毒青年共同注射器具危险因素分析

以１９９４年８￣１０月在云南省陇川县１８￣２９岁男性青年断面调查中发现的静脉吸毒者为研究对象，运用回顾性队列研究设计，观察期为１９９１年１月１日至１９９４年８月１日，采用单因素及多因素分析方法，研究了静脉吸毒者共用注射器具行为的决定因素。在回顾性队列研究期间，静脉吸毒者中共用注射器具的年新发生率平均为１９．６％。多因素分析结果显示，除民族以外的其它人口学特征、吸烟、饮酒及婚前（婚外）性行为，对静脉     

云南省某县男性青年吸毒现象调查

为了解吸毒现象，于１９９４年８～１０月对云南省某县８２个自然村或生产队的１８～２９岁男性青年进行了调查。共调查１５４８人，发现吸毒者４３３人，吸毒率２８％。绝大多数吸毒者是在８０年代中期以后开始吸毒，且新吸毒人数逐年上升。景颇族的吸毒率显著高于汉族和傣族；文化程度与吸毒率呈反向剂量反应关系；吸烟、饮酒和有婚前／婚外性行为男青年的吸毒率显著高于没有这些因素的青年；而且，吸毒率与累计吸烟量和累计饮酒量呈正向剂量反应关系，与开始吸烟年龄、开始饮酒年龄及第一次性生活年龄呈反向剂量反应关系；被朋友、他人鼓励尝试毒品和家庭成员中有人吸毒的青年，吸毒率显著高于没有这些因素的青年。提示，吸毒现象在该县的男青年中比较严重，预防青少年吸毒的工作必须尽快开展起来     

1982—1995年云南省陇川县吸毒情况分析

１９８２～１９９５年云南省陇川县吸毒情况分析董勒弄１柔克明２吴尊友２吸毒已经引起了我国政府和人民的重视。现仅就陇川县公安局注册登记的吸毒资料和人口资料，对陇川县的吸毒情况作一分析。１材料与方法１１材料自１９８２年以来，陇川县公安局组织登记全县吸毒人...     

云南省西双版纳自治州景洪市吸毒人群HCV感染情况及其危险因素

目的 分析吸毒人群丙型肝炎病毒(HCV)的感染情况及其危险因素。方法 研究人员于2021年1—7月依据纳入排除标准招募云南省西双版纳自治州景洪市戒毒所、美沙酮门诊及社区的吸毒人员。采用结构化问卷调查形式,并抽取被调查者3 mL血清样本,使用酶联免疫吸附试验(ELISA)进行HCV血清学筛查测试。分析云南省西双版纳自治州景洪市吸毒人群HCV感染情况及其危险因素。结果 共调查404例吸毒人群,HCV抗体阳性26例,阳性率6.44%。静脉注射吸毒(OR=4.236,95%CI:1.644～10.913,P=0.003)、女性(OR=0.135,95%CI:0.019～0.987,P=0.048)、高中及以上文化程度(OR=6.745,95%CI:1.113～40.890,P=0.038)的吸毒人群HCV感染风险较高,差异均有统计学意义(均P<0.05)。结论 云南省西双版纳自治州景洪市吸毒人群中采用静脉注射吸毒方式是HCV感染的高危因素,同时吸毒者的年龄、文化程度、性别也与HCV感染有关。     

江苏省吸毒人群HIV感染危险行为及影响因素分析

目的:了解江苏省吸毒人群人类免疫缺陷病毒(HIV)感染相关危险行为状况及其影响因素。方法:通过匿名调查,获得吸毒人群的行为学资料,用Logistic回归模型进行危险因素分析。结果:调查的952名吸毒人群中,静脉注射吸毒占59.66%,其中有44.54%的人曾与他人共用过针具,近20%的人曾与我国艾滋病流行率最高的云南和新疆地区的吸毒者一起吸食过毒品。70.38%的人有多性伴史,59.56%的人从未用过安全套。多因素分析注射吸毒的危险因素包括首次吸毒年龄(OR=0.39),吸毒年限(OR=192),吸毒圈中有云南、新疆人(OR=6.79);共用注射器吸毒的危险因素包括注射史>3年(OR=3),吸毒圈中有云南、新疆人(OR=2.1)。结论:江苏省吸毒人群中存在HIV感染流行的危险,应进一步完善目前的行为监测系统,并加大美沙酮社区维持和针具交换项目的覆盖面。     

鞍山市监管场所内吸毒人员HIV感染及其危险因素

目的了解鞍山市监管场所内吸毒人员艾滋病传播的危险因素,为有效地开展预防和干预措施提供科学依据,以进一步控制该人群中乃至一般人群的艾滋病流行和蔓延。方法由监管场所内的卫生医务人员抽取有吸毒史的在押人员的血液标本,进行人口学和艾滋病相关行为学调查。结果①在调查的402名吸毒者中,人类免疫缺陷病毒(HIV)抗体阳性检出率为0;②40.9%的人有注射吸毒史,其中56.1%的人在注射吸毒时与别人共用过针具。结论共用注射器和不安全性行为等危险因素普遍存在,应该有针对性地加强吸毒人员的艾滋病防治宣传和行为干预等预防措施。     

云南省大理市吸毒者吸毒行为及HIV感染危险因素调查及对策探讨

对云南省大理市275名吸毒者吸毒行为及HIV感染危险因素调查表明:静脉注射毒品、共用注射器、婚外或婚前性生活情况较为严重;开始吸毒及静脉注射毒品人数在近三年明显增多。     

湖南省吸毒人群中HIV感染及其危险因素调查

注射吸毒是传播HIV的主要途径之一.据我国卫生部公布的HIV疫情表明,截止1998年底经注射吸毒感染HIV的占感染人数的75.2%.全国吸毒在册人数超过52万,湖南省同期在册吸毒人数为52000多人,占全国吸毒人数的1/10.吸毒已成为我国、我省当前一个重要的公共卫生问题和社会问题.1998年在中国预防医学科学院的帮助下,我们与公安部门一道,对我省长沙、湘潭、衡阳和怀化四地戒毒所戒毒学员首次开展了HIV感染和相关行为调查.现将情况报告如下.     

云南瑞丽县225例吸毒者吸毒行为及HIV感染危险因素初步调查分析

对云南省瑞丽县L乡225例吸毒者吸毒行为及HIV感染危险因素进行了调查分析。吸毒方式,口吸者占153例(68.0%),静脉注射者72例(32.0%)。采用静注方式吸嗜毒品多数始于近两年,静注者占整个吸毒人群的比例由1988年的13.5%迅速上升至1989年的30.5%和1990年春季的32.0%。从72例静注人群中采集到64份血样,HIV抗体检出率为79.7%(51/64)。对HIV感染情况与吸毒行为进行危险因素分析,结果表明经常合用注射器及通常不消毒注射器为独立危险因素。     

北京市社区吸毒人群艾滋病病毒感染相关因素分析

目的了解北京市社区吸毒人群艾滋病病毒(HIV)感染率及其相关因素,为在该人群中开展监测和行为干预提供依据。方法 2007年9~12月采用滚雪球的方法对北京市社区吸毒者进行专题调查,调查采用结构式问卷,内容包括人口学信息、吸毒行为、性行为的情况等,同时采集静脉血进行HIV抗体检测(WB阳性即判定为阳性)。结果共调查529名社区吸毒者,其中62.8%为京籍,社区吸毒者HIV感染率为2.7%(14/525),社区吸毒者HIV感染的相关因素有维族(OR=21.622,95%CI=3.879~120.521)和共用针头/注射器(OR=8.074,95%CI=1.832~35.589)。结论 应适当调整北京市吸毒人群监测网络,加强社区吸毒人群的监测力度;社区吸毒者的干预重点是美沙酮维持治疗和清洁针具交换。     

注射毒品者丙型肝炎病毒感染率及其危险因素研究

目的了解北京市注射毒品者HCV感染状况及其危险因素,评估注射毒品人群中HIV感染高危行为流行水平,为制定预防和控制艾滋病的策略和措施提供科学依据。方法选择北京市强制戒毒所新收治的注射毒品者和自社区招募的注射毒品者作为研究对象,采用问卷调查的方法进行资料的收集,采集静脉血5ml,实验室检测HCV抗体。资料的分析采用单因素分析、多因素分析。结果北京市注射毒品者的HIV感染率和HCV感染率分别为7.33%和52.59%。多因素分析结果表明HCV感染的危险因素有在强制戒毒所(OR=2.37,95%CI为1.55~5.72)、非北京市户籍(OR=1.94,95%CI为1.05~3.45)和注射次数≥100次(OR=2.60,95%CI为1.54~7.03)。结论北京市注射毒品人群HCV的感染率高达52.59%,标志着HIV感染高危行为在这一人群中广泛存在,应立即采取相应措施控制HIV和HCV感染的进一步扩散。     

医院获得性肺炎危险因素及用药分析

目的 探讨医院获得性感染的危险因素及用药分析,从而指导临床治疗.方法 收集2010年12月-2011年12月住院的43200例患者临床资料,对医院获得性肺炎的危险因素及用药情况进行分析.结果 发生医院获得性感染患者736例,感染率为1.70％;患者年龄≥60岁、住院天数≥21 d、入住重症监护病房、存在基础疾病、抗菌药物的应用＞2种均为医院获得性肺炎的危险因素;青霉素类、抗感染类中成药、头孢菌素类、大环内酯类、氨基糖苷类的使用率分别为27.26％、25.07％、19.96％、16.04％、11.67％,中成药在治疗医院获得性肺炎中占有重要地位.结论 医院获得性肺炎的发生率较低,应根据该病的危险因素给予有针对性治疗,不可盲目联合给药.     

Gender differences in the initiation of injection drug use among young adults

To characterize the circumstances surrounding initiation of injecting drug use, data were collected from 229 young, recently initiated injection drug users enrolled through community-based recruitment in Baltimore, Maryland. Gender differences in the pattern of initiation, the number of persons present at initiation, risky injection, and sexual behaviors at initiation, as well as behaviors after initiation, were examined. Overall, men and women were similar statistically with respect to age at initiation (19.5 years) and risk behaviors at initiation. While men were initiated by men (77%), women were more often initiated by women (65%), most of whom were friends (75%) or relatives (23%). The percentage of women infected with human immunodeficiency virus (HIV) was slightly greater than that of men, 17% versus 11% (P<.2), whether initiated by a man or a woman. Persons who self-initiated had a lower HIV prevalence and fewer HIV-related risk behaviors. Analysis of variance assessed differences in the HIV risk profiles of female and male IDUs who were intiated by someone of the same sex, of the opposite sex, or who self-initiated. These results indicated that (1) young women and men had similar patterns of injection initiation; (2) most women were initiated by female friends, runing counter to earlier literature claims that women were initated to injection drug use by male sex partners; and (3) women initiated by men had a marginally greater mean score on the HIV risk profile.     

中国九城市1301名社区美沙酮维持治疗门诊患者偷吸海洛因及影响因素分析

目的 了解社区美沙酮维持治疗患者治疗期间偷吸海洛因的情况及其影响因素.方法 在江苏、安徽、云南3省9个城市社区美沙酮维持治疗门诊中抽取1301名符合条件的患者进行问卷调查与随机尿吗啡定性检测.收集一般人口学、艾滋病/毒品滥用相关高危行为、参加美沙酮维持治疗情况、抑郁与焦虑及偷吸海洛因等信息.结果 1301名调查对象中男性居多(76.2%),年龄(34.6±6.5)岁,受教育程度以初中及以下为主(71.7%).平均维持治疗剂量(48.1±29.4)mg/d,目前治疗剂量自我满意度平均得分为8.6,尿吗啡检测阳性率为27.7%.有抑郁和焦虑症状者比例分别为38.3%和18.4%,抑郁合并焦虑症状的比例为14.2%.婚姻状况、治疗时间的长短、目前治疗剂量自我满意度及是否曾退出治疗对偷吸海洛因影响的差异有统计学意义,而性别、教育程度及治疗剂量对偷吸海洛因的影响差异无统计学意义.不同省份间影响偷吸海洛因的因素有所不同,但对当前剂量自我满意度是共同的影响因素.结论 提高门诊服务质量及服药依从性、延长参加治疗的时间、提高患者对治疗剂量的满意度及避免脱失对减少治疗期间偷吸海洛因有重要意义.     

早产儿视网膜病危险因素分析

目的:探讨早产儿视网膜病变(ROP)的发生率及危险因素。方法:对孕周36周、出生体重2000g的244例早产儿生后4周行眼底检查,根据ROP国际诊断分期法进行诊断分期,分析ROP与孕周、出生体重、窒息、吸氧、母亲妊娠并发症、感染及贫血等因素的关系。结果:244例早产儿中患有不同程度ROP者49例(其中ROPⅠ期37例、ROPⅡ期10例、ROPⅢ期2例),ROP发生率为20.08%。ROP病儿中住院期间有8例自愈,1例成功进行手术治疗,而大部分病例需出院后继续定期进行眼底检查。孕周、出生体重、吸氧、母亲妊娠并发症、酸中毒、呼吸暂停、PO2的变化、机械通气及感染与ROP的发生有关。且孕周越短、出生体重越小,ROP发生率越高。结论:早产儿ROP的发生率较高。ROP的发生与孕周、出生体重、吸氧、母亲妊娠并发症、酸中毒、呼吸暂停、PO2变化及感染、机械通气等因素有关。孕周、出生体重、吸氧、呼吸暂停是ROP的独立危险因素。     

某医院广泛耐药结核病住院患者耐药特点及危险因素分析

目的  分析广泛耐药结核病（extensively drug-resistant tuberculosis,XDR-TB）患者对一、二线抗结核药物耐药情况及危险因素。 方法  收集结核分枝杆菌培阳的住院结核患者,采用分枝杆菌微孔板法药敏检测试可信区间剂盒筛出XDR-TB患者,采用Logistic回归分析XDR-TB患者一、二线抗结核药耐药危险因素。 结果  利福平、异烟肼和利福喷丁耐药率100%,链霉素、利福布汀、乙硫异烟肼、左氧氟沙星和卷曲霉素耐药率90~100%,卡那霉素和对氨基水杨酸耐药率70~80%,阿米卡星耐药率60~70%,丙硫异烟肼耐药率50~60%,乙胺丁醇和莫西沙星耐药率40~50%,克拉霉素耐药率10~20%,氯法齐明耐药率5.2%。XDR-TB中有92.1%的患者对10种以上抗结核药物,耐药种类最少的患者耐6种抗结核药物。Logistic回归分析XDR-TB对一、二线抗结核药物耐药的危险因素包括年龄[20~40岁为（OR=6.318,95%CI：1.204~33.15,P=0.029;40~60岁为（OR=4.772,95%CI：0.973~23.392,P>0.05）;60岁以上为（OR=41.366,95%CI：2.909~588.265,P=0.006）]和抗结核治疗史为复治（OR=28.013,95%CI：3.357~233.766,P=0.002）。 结论  XDR-TB患者耐药情况严重,但有药可治,耐药种类多,其危险因素主要来源于年龄和抗结核治疗史。     

Identifying adolescents at risk for hard drug use: racial/ethnic variations

Purpose: To examine early risk factors for initiation of hard drug use by 10th grade in a sample of adolescents drawn from diverse high schools and communities, compares the results across different racial/ethnic groups, and to evaluate the predictive performance of a user-friendly risk scale against the more complex logistic model.

Methods: Using longitudinal data from 4347 adolescents from California and Oregon, we developed and cross-validated logistic and additive prediction models for non-Hispanic white students (the largest group) and assessed how well each model worked for black, Hispanic, and Asian adolescents. We also developed a best logistic model for each group. Predictor variables were measured at Grade 7; the hard drug use outcome was measured at Grade 10.

Results: Major risk factors for initiation of hard drug use included early marijuana and cigarette use, deviant behavior, poor parent–child communication, being offered drugs, and prodrug attitudes and intentions. White adolescents had the most risk factors, followed by Hispanics, Asians, and Blacks. Specific risk factors played more important roles for some groups than others. Early marijuana use provided the strongest warning signal for all groups except Blacks, while exposure to drug offers increased the risk for all but Hispanic youth. Poor communication with parents was particularly important for Hispanic and Asian adolescents, whereas doing poorly in school was a key predictor only for Asians. Social influences to use drugs and intentions to use them were the only predictors for Blacks. Although family disruption and limited parental education were associated with an increase in risk for white adolescents, the latter had the opposite effect for Hispanics and Blacks. The simple additive model worked almost as well as the most complicated logistic model in predicting hard drug use for each group except Blacks.

Conclusions: These results suggest that curbing early initiation of marijuana and cigarettes and reducing prodrug influences and attitudes may dampen initiation of other substances for most youth. They also suggest that drug prevention programs need to be sensitive to differences across racial/ethnic groups and that using social background characteristics as indicators of risk can be very misleading. Carefully constructed risk scales based on simple additive models could help guide program development and provide clinicians with useful information about a troubled adolescent’s likely trajectory.     

Incidence of HIV among injection drug users entering drug treatment programs in four US cities

We estimated seroincidence of human immunodeficiency virus (HIV) and prevalence of risk behaviors among injection drug users (IDUs) who accepted voluntary HIV testing on entry to drug treatment. Record-based incidence studies were conducted in 12 drug treatment programs in New York City (n = 890); Newark, New Jersey (n = 521); Seattle, Washington (n = 1,256); and Los Angeles, California (n = 733). Records of confidential HIV tests were abstracted for information on demographics, drug use, and HIV test results. More detailed data on risk behaviors were obtained by a standardized questionnaire. Although overall incidence rates were relatively low in this population (<1/100 person-years), there was a high prevalence of risk behaviors. Needle sharing was reported by more than one-third of the participants in each of the cities. HIV seroincidence rates were up to three-fold higher among younger ID Us. We found that HIV continued to be transmitted among ID Us who had received both drug treatment and HIV counseling and testing. HIV/AIDS (acquired immunodeficiency syndrome) prevention education should continue to be an important component of drug treatment.