新型毒品与传统毒品滥用者接受艾滋病干预服务的差异
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摘要
目的比较新型毒品与传统毒品滥用者的特征和干预现状,分析与接受干预相关的因素。方法采用一对一结构问卷对云南省女子戒毒所和昆明市戒毒所新入所者进行横断面调查并检测艾滋病病毒(HIV)抗体。结果研究共调查1 448人,其中女性350人,新型毒品滥用者268人,传统毒品滥用者1 180人。新型毒品与传统毒品滥用者的主要区别为:年龄较小(≤30岁:67.5%vs. 34.1%,>40岁:6.0%vs. 34.0%,P<0.001)、女性更多(38.4%vs. 20.9%,P<0.001)、既往羁押较少(48.1%vs. 77.2%,P<0.001)、曾接受干预比例较低(38.1%vs. 55.2%;P<0.001)、知晓HIV感染者占比低(20.4%vs. 31.8%;P<0.001)、最感兴趣干预服务为HIV咨询与检测(56.7%)。与新型毒品滥用者接受干预服务相关的因素为吸毒时间长[比值比(OR)=6.3 (1.3～29.8),>10 vs.≤3年]、首次使用新型毒品的年龄大[OR=10.1 (1.9～53.7),≥35 vs.<24岁]。结论新型毒品滥用者更年轻,被现有干预网络覆盖概率低,普遍不知晓自身HIV感染状况,可能存在信息传播与服务提供盲区。亟须从该群体关注点出发,结合人群特点,多方联合,探索有效扩大干预覆盖面的措施,及时发现并控制该群体的HIV流行。
Objective To compare different characteristics in access to intervention services between club drug users and traditional drug users, and to know the factors that associated with HIV intervention services. Methods A face-to-face structure questionnaire-based interview was conducted in Yunnan provincial female detoxification center and Kunming municipal detoxification center, with blood samples collected for HIV sero-antibody tested. Results Of 1 448 drug users interviewed, there were 350 women, 268 club drug users and 1 180 traditional drug users. The main differences between club drug and traditional drug users were that the former group had young age(≤30 years old: 67.5% vs. 34.1%; >40 years old: 6.0% vs. 34.0%; P<0.001), more women(38.4% vs. 20.9%; P<0.001), lower rate of those previously detained(48.1% vs. 77.2%; P<0.001), lower rate of those receiving HIV intervention services(38.1% vs. 55.2%; P<0.001), low awareness rate of HIV infection(20.4% vs. 31.8%; P<0.001), and HIV counselling and testing that club drug users were most interested in(56.7% vs.44.5%;P=0.002). Factors associated with HIV intervention services were a long history of drug use[OR=6.3(1.3-29.8);>10 vs.≤3 years], and older age of the first club drug use[OR=10.1(1.9-53.7); ≥35 vs.<24 years]. Conclusion Compared with traditional drug users, club drug users are younger, less accessible to HIV intervention services, unaware of HIV infection, lack of knowledge and information to access to HIV intervention services. It is necessary to explore measures to expand HIV intervention coverage, and to control HIV infection among drug users based on their characteristics.
Objective To compare different characteristics in access to intervention services between club drug users and traditional drug users, and to know the factors that associated with HIV intervention services. Methods A face-to-face structure questionnaire-based interview was conducted in Yunnan provincial female detoxification center and Kunming municipal detoxification center, with blood samples collected for HIV sero-antibody tested. Results Of 1 448 drug users interviewed, there were 350 women, 268 club drug users and 1 180 traditional drug users. The main differences between club drug and traditional drug users were that the former group had young age(≤30 years old: 67.5% vs. 34.1%; >40 years old: 6.0% vs. 34.0%; P<0.001), more women(38.4% vs. 20.9%; P<0.001), lower rate of those previously detained(48.1% vs. 77.2%; P<0.001), lower rate of those receiving HIV intervention services(38.1% vs. 55.2%; P<0.001), low awareness rate of HIV infection(20.4% vs. 31.8%; P<0.001), and HIV counselling and testing that club drug users were most interested in(56.7% vs.44.5%;P=0.002). Factors associated with HIV intervention services were a long history of drug use[OR=6.3(1.3-29.8);>10 vs.≤3 years], and older age of the first club drug use[OR=10.1(1.9-53.7); ≥35 vs.<24 years]. Conclusion Compared with traditional drug users, club drug users are younger, less accessible to HIV intervention services, unaware of HIV infection, lack of knowledge and information to access to HIV intervention services. It is necessary to explore measures to expand HIV intervention coverage, and to control HIV infection among drug users based on their characteristics.
引文
[1] Kipke MD, Weiss G, Ramirez M, et al. Club Drug Use in Los Angeles among Young Men Who Have Sex with Men[J]. Subst Use Misuse, 2007, 42(11):1723-1743.
[2] Ostrow DG, Plankey MW, Cox C, et al. Specific Sex-Drug Combinations Contribute to the Majority of Recent HIV Seroconversions among MSM in the MACS[J]. J Acquir Immune Defic Syndr, 2009, 51(3):349-355.
[3] Halkitis PN, Jerome RC. A Comparative Analysis of Methamphetamine Use: Black Gay and Bisexual Men in Relation to Men of Other Races[J]. Addict Behav, 2008, 33(1): 83-93.
[4] Rondinelli AJ, Ouellet LJ, Strathdee SA, et al. Young adult injection drug users in United States continue to practice HIV riskbehaviors[J]. J Acquir Immune Defic Syndr, 2009, 51(3): 349-355.
[5] 中华人民共和国公安部禁毒局.中国禁毒报告(2017)[EB/OL].[2017-3-30] http://www.nncc626.com/2017-03/30/c_129521742.htm.
[6] 林兰珠,杨盈波,李洲林,等.2013—2015年瑞丽市边境地区不同档次缅籍暗娼HIV/梅毒感染及相关行为分析[J].卫生软科学,2018,32(3):66-69.
[7] 覃雄林,朱刚劲,徐志良,等.贵港市艾滋病综合防治措施的效果评价[J].应用预防医学,2017,23(1):23-26.
[8] Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group[J]. N Engl J med, 2000, 342(13): 921-929.
[9] Worth H, Rawstorne P. Crystallizing the HIV Epidemic: Methamphetamine, Unsafe Sex, and Gay Diseases of the Will[J]. Arch Sex Behav, 2005, 34(5):483-486.
[10] Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy[J]. N Engl J med, 2011, 365(6): 493-505.
[11] 夏国美,杨秀石,李骏,等.新型毒品滥用的成因与后果[J].社会科学,2009(3):73-81.
[12] 樊盼英,汪宁. 新型毒品滥用对艾滋病流行的影响[J].中华流行病学杂志,2010,31(3):340-343.
[2] Ostrow DG, Plankey MW, Cox C, et al. Specific Sex-Drug Combinations Contribute to the Majority of Recent HIV Seroconversions among MSM in the MACS[J]. J Acquir Immune Defic Syndr, 2009, 51(3):349-355.
[3] Halkitis PN, Jerome RC. A Comparative Analysis of Methamphetamine Use: Black Gay and Bisexual Men in Relation to Men of Other Races[J]. Addict Behav, 2008, 33(1): 83-93.
[4] Rondinelli AJ, Ouellet LJ, Strathdee SA, et al. Young adult injection drug users in United States continue to practice HIV riskbehaviors[J]. J Acquir Immune Defic Syndr, 2009, 51(3): 349-355.
[5] 中华人民共和国公安部禁毒局.中国禁毒报告(2017)[EB/OL].[2017-3-30] http://www.nncc626.com/2017-03/30/c_129521742.htm.
[6] 林兰珠,杨盈波,李洲林,等.2013—2015年瑞丽市边境地区不同档次缅籍暗娼HIV/梅毒感染及相关行为分析[J].卫生软科学,2018,32(3):66-69.
[7] 覃雄林,朱刚劲,徐志良,等.贵港市艾滋病综合防治措施的效果评价[J].应用预防医学,2017,23(1):23-26.
[8] Quinn TC, Wawer MJ, Sewankambo N, et al. Viral load and heterosexual transmission of human immunodeficiency virus type 1. Rakai Project Study Group[J]. N Engl J med, 2000, 342(13): 921-929.
[9] Worth H, Rawstorne P. Crystallizing the HIV Epidemic: Methamphetamine, Unsafe Sex, and Gay Diseases of the Will[J]. Arch Sex Behav, 2005, 34(5):483-486.
[10] Cohen MS, Chen YQ, McCauley M, et al. Prevention of HIV-1 Infection with Early Antiretroviral Therapy[J]. N Engl J med, 2011, 365(6): 493-505.
[11] 夏国美,杨秀石,李骏,等.新型毒品滥用的成因与后果[J].社会科学,2009(3):73-81.
[12] 樊盼英,汪宁. 新型毒品滥用对艾滋病流行的影响[J].中华流行病学杂志,2010,31(3):340-343.