中国7省2007～2008年美沙酮维持治疗工作的比较分析  

COMPARISON AND ANALYSIS ON PERFORMANCE OF METHADONE MAINTENANCE TREATMENT(MMT) AMONG SEVEN PROVINCES IN CHINA FROM 2007 TO 2008

作　　者：曾婷婷[1] 马丽萍[2] 王维康 张志刚 曹卫华[1] 

机构地区：[1]北京大学公共卫生学院流行病与卫生统计学系,北京100191 [2]中国疾病预防控制中心 [3]北京软为科技发展有限公司

出　　处：《现代预防医学》2010年第13期2521-2525,2530,共6页Modern Preventive Medicine

基　　金：第四轮中国全球基金艾滋病项目(CHN-405-G05-H)

摘　　要：[目的]描述2007～2008年第四轮中国全球基金艾滋病项目(GF4)覆盖的7省美沙酮维持治疗(MMT)工作的季度变化趋势和地区间差异。[方法]对MMT工作报表及相关资料进行质量评价,描述MMT的覆盖、保持情况及门诊HIV感染者/艾滋病人(PLWHA)的纳入、检测和治疗情况,并分析其纵向变化趋势和横向地区差异。[结果]7省单个MMT门诊的在治人数中位数为106人;平均粗保持率为51.0%,该指标呈降低趋势(P﹤0.01),在江西、四川较高,湖南、新疆等较低(P﹤0.05),并与参与项目的机构组织数正相关(P﹤0.01)。各MMT门诊的平均HIV阳性率为17.9%,在贵州、湖南和云南较高,广西、新疆较低(P﹤0.01),与各县接受VCT的吸毒者的HIV阳性率正相关(P﹤0.01);门诊平均抗病毒治疗率为23.8%,在各季度呈增长趋势(P﹤0.01),在广西、湖南和云南较高,四川、新疆较低(P﹤0.05或0.01),并与门诊CD4检测率正相关(P﹤0.01)、与HIV阳性率负相关(P﹤0.01)。[结论]2007年7月～2008年12月7省MMT覆盖人数不断增加,发现和纳入了较多的HIV阳性吸毒者,且各门诊PLWHA的抗病毒治疗率不断提高;但各MMT门诊存在平均治疗人数较少、覆盖率较低、保持率较低、CD4检测率较低及地区工作情况差异显著等问题。[Objective] To explore the process and inter-provincial diversity of methadone maintenance treatment（MMT） in seven project provinces of The Global Fund AIDS China Program Round 4（GF4） from 2007 to 2008.[Methods] MMT related data from supervision and assessment report forms of GF4 and other sources were arranged,collated and analyzed.The coverage and retention of MMT,the admission,CD4 cell count testing and antiretroviral treatment of People Living with HIV /AIDS（PLWHA） in MMT clinics were described and compared among the quarters and provinces.[Results] The median of patients each MMT clinic was 106 from July 2007 to December 2008.The average retention rate of MMT was 51.0%.It decreased every quarter（P﹤0.001） and had significant difference among the provinces（P﹤0.05）,which was higher in Jiangxi and Sichuan compared with Hunan and Xinjiang（P﹤0.05）.The retention rate showed positive correlation with the number of organizations participating in GF4（P﹤0.01）.The average HIV /AIDS prevalence among the MMT clinic patients was 17.9%,which was higher in Guizhou,Hunan and Yunnan compared with Sichuan and Xinjiang（P﹤0.01）.It showed positive correlation with the HIV-positive rate among drug users who sought for VCT service.The median of CD4 detection rate among PLWHA in MMT clinics was 47.2% and the average antiretroviral treatment rate was 23.8%.The antiretroviral treatment rate increased over time（P﹤0.01） and had significant difference among the provinces（P﹤0.05）,which was higher in Guangxi,Hunan and Yunnan compared with Sichuan and Xinjiang（P﹤0.05 or 0.01）.It also showed positive correlation with CD4 detection rate and negative one with the HIV /AIDS prevalence（P﹤0.01）.[Conclusion] The participation in MMT had been growing constantly,more HIV-positive drug users were included and the antiretroviral treatment rate in each clinic had been rising in seven project provinces of GF4 during July 2007 and Dec 2008.However,there were also some problems and challenge

关 键 词：美沙酮维持治疗 保持率 HIV阳性率 CD4检测率 抗病毒治疗率 

分 类 号：R512.91[医药卫生—内科学]