我国15个城市吸毒人群HIV、梅毒螺旋体、丙型肝炎病毒感染现况

目的 了解中国卫生部-比尔盖茨基金会AIDS防治国际合作项目(简称中盖AIDS项目)实施地区15个城市吸毒人群的HIV感染现况及相关行为特征.方法 查询公安部门资料、结合专家咨询,了解吸毒人员规模,问卷调查了解吸毒人群AIDS行为相关特征,采血检测HIV、梅毒螺旋体及丙型肝炎病毒(HCV)感染状况.结果 中盖AIDS项目地区15个城市2007年登记在册和估计吸毒人数分别为176 004、477 989名,吸食毒品以海洛因和冰毒为主,AIDS防治知识知晓率为41.0%(2685/6155),其中杭州97.6%(410/420)、青岛85.5%(342/400)、武汉69.7%(308/442)、昆明63.8%(255/400)、上海45.4%(237/522)、西安44.5%(178/400)、南京38.8%(155/400)、北京36.5%(237/650)、广州 29.5%(122/413)、哈尔滨25.4%(114/447)、海口23.8%(96/402)、重庆22.4%(90/401)、三亚20.0%(80/400)、天津16.2%(41/253)、沈阳9.8%(20/205),各城市之间AIDS防治知识知晓率差异具有统计学意义(x2=1482.833,P＜0.05).最近1次共用注射器吸毒率仅为10.8%(665/6155),其中杭州10.8%(45/420)、重庆26.4%(106/401)、广州2.6%(11/413)、沈阳31.3%(64/205)、上海0.4%(2/522)、昆明10.8%(43/400)、北京10.6%(69/650)、天津5.4%(14/253)、西安3.3%(13/400)、武汉17.9%(79/442)、三亚20.0%(80/400)、海口2.2%(9/402)、哈尔滨8.5%(38/447)、南京21.4%(86/400)、青岛1.5%(6/400),城市间差异有统计学意义(x2=483.044,P＜0.05);仅5.0%(8737/176 004)的吸毒人员和1.2%(155/12 611)HIV阳性的吸毒人员参加了针具交换;现场调查HIV、梅毒螺旋体及HCV感染率分别为2.76%(155/5620)、3.38%(190/5620)和32.35%(1818/5620),各城市HIV感染率为:杭州0.4%(1/273)、重庆7.5%(30/401)、广州2.9%(12/413)、沈阳0.5%(1/205)、上海0.32%(1/316)、昆明16.25%(65/400)、北京2.6%(16/624)、天津2.0%(5/253)、西安1.25%(5/400)、武汉0.24%(1/411)、三亚1.75%(7/400)、海口0.2%(1/402)、哈尔滨1.1%(5/447)、南京1.1%(3/275)、青岛0.5%(2/400),城市间差异有统计学意义(x2=354.203,P＜0.05).结论 15个城市中重庆、昆明等部分城市吸毒人群HIV感染率超流行警戒线,但总体稳中有降,因共用注射器感染HIV的危险性处于下降趋势,但要防范新型毒品如冰毒带来的不安全性行为传播HIV的危险.

Analysis of HIV/syphilis/HCV infection among drug users in 15 cities, China

Objective To study the HIV infection rate and relevant behavioural characteristics among drug users (DUs) in the 15 cities of China-Gates HIV/AIDS Program. Methods By literature review from the public security sector and expert consultations, the size of drug using population was estimated,questionnaire was used to survey relevant behavioural characteristics of DUs, and blood specimens were collected for HIV, syphilis and HCV testing. Results In 2007, the number of registered DUs in the 15 cities was 176 004, while the estimated number was 477 989. DUs mainly used heroin and crystal meth. Of the survey subjects, 41.0% ( 2685/6155 ) had correct knowledge about HIV/AIDS, and Hangzhou 97.6% ( 410/420), Qingdao 85.5% ( 342/400 ), Wuhan 69.7% ( 308/442 ), Kunming 63.8% ( 255/400 ), Shanghai 45.4% ( 237/522 ), Xi'an 44.5% ( 178/400 ), Nanjing 38.8% ( 155/400 ), Beijing 36.5% ( 237/650 ),Guangzhou 29.5% ( 122/413 ), Haerbin 25.4% ( 114/447 ), Haikou 23.8% ( 96/402 ), Chongqing 22.4% (90/401), Sanya 20.0% ( 80/400 ), Tianjin 16.2% ( 41/253 ), Shenyang 9.8% ( 20/205 ), and the difference among the cities has statistical significance ( x2 = 1482.833, P ＜ 0.05 ). The rate of needle sharing at the last injection was 10.8% ( 665/6155 ), and Hangzhou 10.8% ( 45/420 ), Chongqing 26.4% (106/401), Guangzhou 2.6% ( 11/413 ), Shenyang 31.3% (64/205), Shanghai 0.4% (2/522), Kunming 10.8% (43/400), Beijing 10.6% ( 69/650), Tianjin 5.4% ( 14/253 ), Xi'an 3.3% ( 13/400 ), Wuhan 17.9% ( 79/442 ), Sanya 20.0% ( 80/400 ), Haikou 2.2% ( 9/402 ), Haerbin 8.5% ( 38/447 ), Nanjing 21.4% (86/400),Qingdao 1.5% (6/400), and the difference among the cities has statistical significance (x2= 483.044, P＜ 0.05).Only 5.0% (8737/176 004) of DUs and 1.2% of HIV positive DUs participated in needle exchange. The HIV, syphilis and HCV infection rates were respectively 2.76% (155/5620) ,3.38% (190/5620) and 32.35% (1818/5620). The HIV infection rates of different city was:Hangzhou 0.4% ( 1/273 ), Chongqing 7.5% ( 30/401 ), Guangzhou 2.9% ( 12/413 ), Shenyang 0.5% (1/205) ,Shanghai 0.32% (1/316) ,Kunming 16.25% (65/400), Beijing 2.6% (16/624) ,Tianjin 2.0% (5/253), Xi'an 1.25% ( 5/400 ), Wuhan 0.24% ( 1/411 ), Sanya 1.75% ( 7/400 ), Haikou 0.2% ( 1/402), Haerbin 1.1% ( 5/447 ), Nanjing 1.1% ( 3/275 ), Qingdao 0.5% ( 2/400 ), and the difference among the cities has statistical significance ( x2 = 354. 203, P ＜ 0.05 ). Conclusion The HIV prevalence rate of IDUs in 15 cities slowly decreased although the HIV prevalence rate of IDUs in Chongqing and Kunming and other cities had surpassed the international warning level. The risk of sharing needles for HIV infection was droped, and more attention should be paid to the potential risk of HIV transmission via unsafe sex due to the use of new drugs,such as amphetamin chloride.