云南9县清洁针具交换覆盖率及转介情况调查  

Coverage rate and referral status of clean needle-exchange programs in 9 Counties of Yunnan province

作　　者：周勤[1] 张官柏[1] 王晓丹[1] 李昕悦[1] 

机构地区：[1]云南省药物依赖防治研究所,云南昆明650228

出　　处：《现代预防医学》2017年第3期446-450,共5页Modern Preventive Medicine

摘　　要：目的描述云南省清洁针具交换工作现状,了解清洁针具交换服务对象参与美沙酮维持治疗的情况。方法在云南省艾滋病防治重点地区中选取9个清洁针具交换县,通过方便抽样抽取694名清洁针具交换服务对象,采用统一自制问卷进行调查。结果调查发现,清洁针具交换和美沙酮维持治疗在注射吸毒人群中的月覆盖率分别为19.46%和45.03%。清洁针具交换服务对象参与美沙酮维持治疗的比例为76.95%,最近一个月正在参与美沙酮维持治疗的比例为57.35%,从美沙酮维持治疗脱失(脱失时间>1个月)的比例为25.47%。在是否参加过强制戒毒或自愿戒毒(χ~2=39.902,P<0.001)、是否正在参加艾滋病抗病毒治疗(χ~2=5.750,P=0.016)这两方面,清洁针具交换服务对象参与美沙酮维持治疗的比例差异有统计学意义,而不同HIV、HCV感染情况及参加丙肝抗病毒治疗情况的清洁针具交换服务对象参与美沙酮维持治疗的比例差别无统计学意义。结论云南省清洁针具交换工作覆盖面比较局限,且缺少有效的转介机制,建议清洁针具交换工作建立和完善与美沙酮维持治疗、艾滋病抗病毒治疗和丙肝抗病毒治疗之间的转介机制;可采取同伴推介及戒毒机构宣传的方式推动吸毒人群参与美沙酮维持治疗。Objective To describe the current situation of clean Needle - Exchange Programs in 9 counties of Yunnan province and to know the situation of the clients＇ participation in Methadone Maintenance Treatment（ MMT）. Methods 9 counties that conducted NEP project were selected from the Key Areas of HIV/AIDS Prevention and Control in Yunnan province, and 694 NEP clients were recruited in the 9 counties by convenience sampling and a questionnaire investigation was conducted among them. Results The study found that the monthly coverage rates of NEP and MMT in injecting drug users（IDUs） were 19.46% and 45.03% respectively. The proportion of NEP clients participated in MMT was 76.95% ,and the percentage of NEP clients participated in MMT last month was 57.35% ,and the MMT dropout rate of the NEP clients was 25.47%. In the two aspects of whether the clients had participated in compulsory or voluntary detoxification program and whether the clients were receiving Highly Active Antiretroviral Therapy（HAART） of HIV/AIDS ,there were statistically significant differences of participation rate of M MT between clients who participated in N EP project and these who did not, and the statistical results were（χ^2= 39. 902,P 〈0. 001 ）and（ χ^2= 5. 750,P = 0. 016）respectively. There was no statistically significant difference in the MMT participation rate of NEP clients with different HIV and HCV serological status. Conclusion The coverage range of NEP in IDUs of Yunnan province is comparatively narrow, and effective referral mechanism of MMT, HAART, and hepatitis C infection treatment is lacked. We suggested that NEP should build effective referral mechanism of MMT,HAART and hepatitis C infection treatment. Peer referral and publicity in compulsory detoxification centers can be effective strategies to promote MMT among IDUs.

关 键 词：清洁针具交换 现况调查 美沙酮维持治疗 

分 类 号：R195[医药卫生—卫生统计学]