抗病毒治疗对美沙酮门诊HIV感染者吸毒和高危性行为影响的定性研究  

Impact of antiretroviral therapy on drug-using and high risk sexual behaviors among HIV-positive methadone maintenance treatment clients： a qualitative study

作　　者：钱小爱 曹晓斌[2] 赵燕[2] 金莹莹[2] Willa Dong 罗巍[2] 王常合[2] 柔克明[2] 张波[3] 段松[4] 唐仁海[4] 吴尊友[1,2] 

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]中国疾病预防控制中心性病艾滋病预防控制中心 [3]云南省药物依赖防治研究所 [4]云南省德宏州疾病预防控制中心

出　　处：《中华流行病学杂志》2015年第1期49-51,共3页Chinese Journal of Epidemiology

基　　金：国家科技重大专项（2012ZX10001007-002）;中国艾滋病/结核病多学科研究培训项目（4U2RTW006918-10）（感谢云南省药物依赖防治研究所、德宏州CDC及各MMT门诊现场工作人员的大力支持）

摘　　要：目的 了解美沙酮门诊HIV感染者参加抗病毒治疗（ART）后高危行为是否变化,探索变化及发生高危行为的原因.方法 对云南省美沙酮门诊参加ART的34名HIV感染者进行调查,包括一般情况,HIV感染情况,美沙酮维持治疗（MMT）情况,接受ART情况,ART前后性伴数量、性行为频率、安全套使用、毒品使用、针具共用情况.结果 受访者平均年龄38.5岁,男性居多（70.6％）,均表示参加ART后不安全性行为和共用针具等行为未增加,主要原因是获得HIV相关知识培训、免费安全套、清洁针具并受到MMT影响,存在偷吸（12/34）和不坚持使用安全套（3/19）等高危行为,同时出现ART药物与美沙酮相互作用导致偷吸、对ART的态度乐观导致不安全性行为等新挑战.结论 参加ART未引起MMT门诊HIV感染者高危行为增加,但高危行为仍然存在,应重视ART高期望引起的新挑战.Objective To understand that whether initiation of antiretroviral therapy （ART） would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment （MMT）.Methods In-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART.The related contents would include information on general demographic charicteristics,HIV infection,MMT,number of sexual partners before and after ART,sexual behavior and frequency of condom use,drug use,needle sharing,changes in risk behaviors before and after the ART,reasons for high-risk behavior,of the clients.Results The average age of the interviewees was 38.5 years,and most of them were male （70.6%）.The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation,with the main reasons as increasing HIV related awareness,the use of methadone,high accessibility of free condoms and access to clean needles etc.However,12 of 34 reported being relapsed and 3 reported inconsistent condom use.The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use.Conclusion No evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients.However,attention needs to be paid to the new challenges caused by high expectation of ART.

关 键 词：抗病毒治疗 人类免疫缺陷病毒 美沙酮维持治疗 高危性行为 

分 类 号：R512.91[医药卫生—内科学]