云南省美沙酮维持治疗人员12例HIV阳转原因分析

目的分析美沙酮维持治疗过程中,受治人员艾滋病病毒(HIV)阳转的原因,为提高美沙酮受治人员长期治疗效果,改进相关门诊服务提供建议。方法选取云南省13个美沙酮点所有HIV抗体阴性在治人员为研究对象,随访观察半年,对其中HIV阳转人员以问卷及个人深入访谈的方式,收集人口学、相关高危行为、美沙酮门诊相关服务及HIV阳转原因等方面资料。结果 1 129名HIV阴性初始研究对象中,半年后894人中12例HIV阳转,其中共用针具6人,高危性行为3人,共用针具及高危性行为共存3人,HIV年新发感染率为每百人年2.68。结论美沙酮受治者治疗期间不时注射海洛因现象普遍,共用针具及不使用安全套的情况时有发生,美沙酮门诊强化提供安全套,相关咨询及同伴教育十分重要。综合干预手段才能保证美沙酮维持治疗的长期效果。

Causes of HIV sero-conversion in 12 cases receiving methadone maintenance treatment (MMT) in Yunnan

Objective To analyze the causes of HIV seroconversion in clients receiving MMT in Yunnan province,to increase long-term effectiveness and provide suggestions for improving MMT services.Methods All HIV negative clients from 13 MMT clinics were selected for a prospective cohort study for half a year in Yunnan province.High risk behaviors and causes of HIV seroconversion were collected by questionnaires and in-depth interview.Results Of the 1129 original HIV negative subjects,12 cases were HIV sero-converted among 849 subjects after half a year.Of them six shared needles,three had unprotected sexual behavior and three had both drug injection and unprotected sex.The annual HIV seroconversion rate was 2.68% per 100 persons.Conclusion MMT clients sometimes had risky drug injection and unprotected sex,such as sharing needles and without using condoms.It was important to provide condoms in MMT clinics along with the consultation and peer education.Only comprehensive interventions can guarantee long-term treatment outcomes in MMT clinics.