四川省西昌市2009-2016年社区吸毒人群HIV感染及高危行为调查  

HIV infection and risk factors among community drug users in Xichang city, Sichuan province from 2009 to 2016

作　　者：宋本莉[1] 张翔[1] 殷俊 边会珍 姜正清 梁姝[2] 邢辉 阮玉华[3] 谢艺红[4] SONG Benli;ZHANG Xiang;YIN Jun;BIAN Huizhen;JIANG Zhengqing;LIANG Shu;XING Hui;RUAN Yuhua;XIE Yihong(Xichang Center for Disease Prevention and Control,Xichang 615000,China;Sichuan Provincial Center for Disease Prevention and Control,Chengdu 610041,Sichuan;The State Key Laboratory of Infectious Disease Prevention and Control,China Center for Disease Control and Prevention,Beijing 102200;Guangxi Medical University,Nanning 530021)

机构地区：[1]西昌市疾病预防控制中心,四川西昌615000 [2]四川省疾病预防控制中心,成都610041 [3]中国疾病预防控制中心,传染病预防控制国家重点实验室,北京102200 [4]广西医科大学公共卫生学院,南宁530021

出　　处：《中国艾滋病性病》2020年第8期844-848,共5页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2017ZX10201101-002-004);国家自然科学基金项目(11471336,11471336,11971479)。

摘　　要：目的了解社区吸毒人群艾滋病病毒(HIV)、梅毒、丙型肝炎病毒(HCV)感染情况及其艾滋病相关知识和高危行为,为艾滋病预防干预提供参考依据。方法对2009-2016年西昌市社区吸毒人群进行横断面调查分析。结果2009-2016年,西昌市共调查了1775名社区吸毒人员,HIV、梅毒和HCV的总体感染率分别为11.4%,8.6%和58.9%,经趋势性卡方检验无年度下降趋势;调查对象对艾滋病危害性和共用针具传播等关键知识的认知率最高为2015-2016年,但仅分别为32.5%和43.7%,2009-2016年,使用新型毒品比例由5.8%上升到26.2%,但对新型毒品可增加HIV感染风险的认识由97.8%下降到87.2%,趋势性检验均有统计学意义,近1年获取社区药物维持治疗/清洁针具提供/交换和同伴教育等艾滋病相关预防服务分别由70.2%和62.5%下降至59.2%和18.6%;多因素分析显示,曾经共用针具是HIV感染的高危因素[比值比(OR):14.4,95%可信区间(CI):9.3~22.2],彝族比汉族和其他民族感染风险更高(OR:1.9,95%CI:1.2~2.9),文化程度高、认识到艾滋病是不可治愈的严重传染病和近1年与配偶或同居者发生性行为是HIV感染的保护因素。结论2009-2016年西昌市社区吸毒人群对艾滋病核心知识的认知率较低,获取艾滋病相关预防服务低且呈逐年下降趋势,HIV、HCV和梅毒感染率在全国相对较高且无年度下降趋势,有针对性的艾滋病干预措施实施力度需加强。Objective To understand the infection rate of HIV,syphilis,HCV and the related knowledge awareness and risk factors of AIDS among the community drug users,and provide scientific evidence for AIDS prevention and control.Methods The drug users in Xichang were investigated from 2009 to 2016 and the data were analyzed accordingly.Results 1775 community drug users were investigated,with the overall infection rates of HIV,syphilis and HCV of 11.4%,8.6%and 58.9%,respectively.The chi-square test showed there was no decrease during the years.The respondents had the highest rate of awareness of key knowledge such as HIV/AIDS and HIV spreading by needle sharing,but only at 32.5%and 43.7%.The proportion of synthetic drug use was increasing from 5.8%in 2009 to 26.2%in 2016.However,the knowledge awareness of synthetic drugs,which increased the risk of HIV infection,was decreasing from 97.8%in 2009 to 87.2%in 2016,with the difference statistically significant.The access to the services of community-based drug maintenance treatment/clean needle exchange and peer education in the past year also declined from 70.2%and 59.2%to 62.5%and 18.6%,respectively.Needle sharing was a high-risk factor for HIV infection(OR:14.4,95%CI:9.3-22.2).The Yi ethnic had a higher risk of HIV infection than the Han and other ethnic groups(OR:1.9,95%CI:1.2-2.9).The protective factors included high education,high awareness of AIDS related knowledge,and having intercourse with spouses or cohabitants in the past year.Conclusion The community drug users in Xichang have insufficient awareness of AIDS related knowledge and access to preventive services.The infection rates of HIV,HCV and syphilis are relatively high.The intervention measures for AIDS prevention and control among drug users should be strengthened.

关 键 词：艾滋病 吸毒人群 感染 危险因素 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]