云南省美沙酮维持治疗门诊受治者共用针具的相关影响因素分析

目的了解云南省参与美沙酮维持治疗的吸毒人员共用针具的相关影响因素,为美沙酮受治人员进一步综合干预工作提供科学依据。方法采用项目设计并经预实验修正后的问卷进行现场调查,内容包括人口学特征、参与美沙酮维持治疗前后高危注射行为、共用针具高危影响因素,并进行个人深入访谈。结果共调查12个县美沙酮门诊1 935名维持治疗人员,HIV抗体阳性731人,阳性检出率为39.3%（731/1 860）。72.50%的受治人员治疗期间曾偷吸海洛因及其他毒品,在偷吸毒品人员中有69.14%的人是注射毒品,在注射毒品人员中有29.69%的人共用针具。共用针具的影响因素中,第一次注射吸毒的年龄越大,与他人共用针具的概率越低（OR值=0.831）;注射吸毒的频率低者不易与他人共用针具（OR值=0.254）。结论美沙酮治疗人群中仍然普遍存在偷吸现象和共用针具等高危行为,需在美沙酮门诊加强对注射吸毒年龄较小及频率较多的受治人员进行心理咨询,强化干预活动,以减少共用针具现象。

An analysis of the impact factors related with needle sharing among MMT clients

Objective To understand factors related with needle sharing among injecting drug users in Yunnan during methadone maintenance treatment（MMT） and to provide evidence for further implementation of comprehensive HIV/AIDS prevention and control interventions among MMT clients.Method A pretest revised questionnaire was used to investigate socio-demographic characteristics of the MMT clients,their high risk behaviors before and after MMT,and the needles sharing related high risk factors.In-depth interviews were also conducted among them.Result A total of 1 935 individuals were interviewed in MMT clinics in 12 counties,and of them 731 samples were HIV positive,with a positive rates of 39.3%;72.50% of the individuals continued heroin use（relapse） during MMT,among whom 69.13% injected drugs,and 29.69% of the injecting drug user shared needles.As to factors related with needle sharing,the elder the age of first injecting drugs,the lower the rate of needle sharing（OR=0.831）;and the lower frequency of injecting drugs,the less probability of sharing needles with others（OR=0.254）.Conclusion Continued heroin use or relapse and needle sharing are still common among MMT clients.In order to decrease the needle sharing among them,psychological counseling and intensified interventions will be required among MMT clients with younger age starting drug injection and higher frequency of drug use.