美沙酮维持治疗人群高危性行为相关因素及交互作用分析

目的 了解美沙酮维持治疗人群高危性行为的发生情况,并探讨相关因素。方法 对2014年9-11月在广西壮族自治区3所美沙酮维持治疗门诊的636名治疗者进行面对面问卷调查,收集其一般人口学特征、高危性行为及相关的行为因素等资料。通过χ²检验和多因素回归分析探讨高危性行为的相关因素及其交互作用。结果 636名美沙酮维持治疗者中最近3个月发生过高危性行为的比例高达80.2%(510/636)。单因素分析结果显示,性别、年龄、婚姻状况、户籍所在地、乙肝疫苗接种史、首次吸毒年龄和HIV感染可能与高危性行为的发生有关(P<0.05);多因素回归分析表明,男性、未接种乙肝疫苗/接种史不详、未感染HIV的美沙酮维持治疗者发生高危性行为的风险较高,OR值(95%CI)分别为1.668(1.021~2.725)、1.730(1.068~2.801)和2.880(1.697~4.888)。未接种乙肝疫苗/接种史不详与未感染HIV之间存在相加交互作用。结论 美沙酮维持治疗人群高危性行为的发生率较高,其相关因素为男性、未接种乙肝疫苗/接种史不详以及未感染HIV。建议加强对美沙酮维持治疗者的干预,降低高危性行为的发生。

Related factors and interaction on high-risk sexual behaviors among patients under the methadone maintenance treatment

Objective To estimate the incidence of high-risk sexual behaviors and to explore the related factors among patients receiving methadone maintenance treatment. Methods Face to face interviews were conducted on 636 patients at 3 methadone maintenance treatment clinics in Guangxi Zhuang Autonomous Region, in China, from September to November, 2014. General demographic characteristics and behavioral factors associated with high-risk sexual behavior of patients were collected through questionnaires. Both univariate and multivariate logistic regression analysis were used to analyze the related factors of high-risk sexual behaviors and the interactions between them. Results 636 participants were included in this study. Majority of the patients (80.2%) practiced high-risk sexual behaviors in the past three months. Data from the univariate analysis showed that factors as:gender, age, marital status, registered residence, history of hepatitis B (HepB) vaccination, age started drug use and HIV infection etc. might be associated with high-risk sexual behaviors (P<0.05). Data from the multivariate logistic regression analysis showed that factors as:being male, histories with non-or unknown HepB vaccination and free of HIV infection etc., were likely to have high-risk sexual behaviors, with OR (95%CI) as 1.668 (1.021-2.725), 1.730 (1.068-2.801) and 2.880 (1.697-4.888), respectively. Additive interactions were observed between non-or unknown histories of HepB vaccination and free of HIV infection. Conclusion The incidence rates on high-risk sexual behaviors appeared high in patients under the methadone maintenance treatment. Patients with factors as:being male, histories with non-or unknown HepB vaccination and free of HIV infection were significantly associated with high-risk sexual behaviors. It is necessary to emphasize on behavioral intervention among patients under the methadone maintenance treatment, in order to reduce the occurrence of high-risk sexual behaviors.