新疆静脉注射吸毒人群HIV新发感染率及其影响因素分析  

Incidence and influencing factors of HIV infection among injection drug users in Xinjiang

作　　者：周军 倪永康 陈学玲[2] 马媛媛[2] 胡晓远[2] 倪明健[2] ZHOU Jun;NI Yong-kang;CHEN Xue-ling(Department of Epidemiology and Health Statistics, College of Public Health, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region,830011, China)

机构地区：[1]新疆医科大学公共卫生学院流行病与卫生统计学教研室,新疆乌鲁木齐市830011 [2]新疆维吾尔自治区疾病预防控制中心性艾中心

出　　处：《中国公共卫生》2018年第12期1587-1591,共5页Chinese Journal of Public Health

基　　金：国家科技重大专项(2013ZX10004907;2011ZX10001–001;2009ZX10001–019)

摘　　要：目的了解新疆静脉注射吸毒人群艾滋病病毒(HIV)新发感染状况及其危险因素。方法 2010年6月—2015年3月在新疆HIV疫情较为严重的6个地区招募HIV抗体阴性静脉注射吸毒者,建立前瞻性研究队列,每3个月进行定位随访,每6个月进行吸毒行为调查和HIV抗体检测。结果截止2015年3月,队列共纳入1 253名调查对象,总观察人时为2 416.3人年,HIV新发感染67例,HIV新发感染率约为2.77/100人年。多因素Cox风险比例模型分析结果显示,静脉注射吸毒者中维吾尔族高于其他民族(HR=2.80,95%CI=1.10～7.17);文化水平小学及以下高于高中及以上(HR=3.68,95%CI=1.30～10.39);无收入高于≥2 000元(HR=4.77,95%CI=1.36～16.71);单用海洛因频率每周1～3次、每周4～6次、每天≥1次高于每周<1次(HR=11.84、10.70、32.09,95%CI=1.59～88.39、1.40～81.78、4.27～241.30);共用针具且不了解对方HIV感染状况者高于不共用者(HR=4.89,95%CI=2.48～9.65)。结论新疆静脉注射吸毒人群HIV新发感染率处于较高水平,高危行为普遍存在,需采取有效的预防措施控制该人群内HIV的传播以及向一般人群的蔓延。Objective To examine incidence rates and impact factors of human immunodeficiency virus(HIV)infection among injection drug users(IDUs)in Xinjiang Uygur Autonomous Region(Xinjiang).Methods We recruited HIV-negative IDUs in 6 regions with higher prevalence of HIV infection in Xinjiang from June 2010 to March 2015 for a prospective cohort study. The participants of the study were followed-up every 3-month and were surveyed with a questionnaire interview on drug behavior and HIV antibody test every 6-month.Results Among a total of 1 253 participants, 67 HIV infections were identified during the 3 year's follow-up of 2 416 person years by the end of March 2015 and the incidence rate of HIV infection was 2.77 per 100 person-years. Multivariate Cox proportional hazards regression model analysis revealed higher risk of HIV infection among Uygur IDUs(hazard ratio[HR]= 2.80, 95% confidence interval [95% CI]: 1.10-7.17), IDUs with primary school and lower education(HR=3.68, 95% CI: 1.30-10.39), and IDUs without income(HR=4.77, 95% CI: 1.36-16.71)compared to the IDUs of other ethnic groups, with the high school and higher education, and with the monthly income of 2 000 RMB yuan or more. In contrast to the IDUs having the drug less than one time per week, the IDUs having the drug 1-3, 4-6, and≥7 times per week had significantly increased HIV infection risk, with the HRs(95% CI)of 11.84(1.59-88.39), 10.70(1.40-81.78), and 32.09(4.27-241.30), respectively. The IDUs sharing needles with others and not knowing the sharer's HIV infection status had a significantly increased risk of HIV infection(HR=4.89, 95% CI: 2.48-9.65)in comparison with the IDUs not sharing needles with others.Conclusion Both the incidence of HIV infection and high risk behavior relevant to HIV infection are at a high level among intravenous drug users in Xinjiang and the results indicate effective measures for HIV infection control should be implemented in the population.

关 键 词：静脉吸毒人群 HIV新发感染率 前瞻性队列 

分 类 号：R512.91[医药卫生—内科学]