2016-2020年延安市吸毒人群HIV和HCV及梅毒的感染现状调查

Investigation of HIV,HCV and syphilis infection among drug users in Yan’an from 2016 to 2020

目的分析延安市吸毒人群艾滋病(HIV)、丙型肝炎(HCV)和梅毒的感染状况及其危险因素,为科学制定吸毒人群感染性疾病防控措施提供依据。方法对2016-2020年延安市强制隔离戒毒所吸毒人员进行问卷调查和血清学检测,通过χ2检验和多因素logistic回归分析疾病的危险因素。结果2016-2020年共调查吸毒人员2105人,其中64人因血清样本不合格被排除,实际分析2041例。男性1830例(89.66%),女性211例(10.34%),平均年龄(37.73±8.44)岁,HIV检出阳性6例,感染率为0.29%,梅毒检出阳性551例,感染率为26.99%,HCV检出阳性763例,感染率为37.38%。多因素logistic回归分析结果显示:性别为女性的吸毒人员(OR=1.41,95%CI:1.02~1.94)、吸食混合毒品(OR=1.72,95%CI:1.30~2.28)、曾经注射过毒品(OR=1.43,95%CI:1.16~1.77)、吸食毒品后发生性行为(OR=1.87,95%CI:1.51~2.32)是梅毒感染的危险因素;年龄越大(OR=0.98,95%CI:0.97~0.99)、文化程度越高(OR=0.49,95%CI:0.36~0.67)的吸毒者HCV的感染率降低,而吸食新型毒品(OR=1.53,95%CI:1.12~2.00)和混合毒品(OR=2.61,95%CI:1.97~3.45)、吸食毒品后发生性行为(OR=2.79,95%CI:2.27~3.44)的吸毒者HCV的感染率升高。结论延安市吸毒人群的HIV感染检出率较低,HCV的感染检出率呈下降趋势,梅毒的感染检出率呈上升趋势。新型毒品的使用人数增多,且危险行为比较普遍,提示应继续加强吸毒人群的健康教育和行为干预,以降低疾病的传播风险。

Objective To analyze the infection status and risk factors of human immunodeficiency virus(HIV),hepatitis Cvirus(HCV)and syphilis among drug users in Yan’an city,and provide basis for disease prevention and control measures.MethodsQuestionnaire survey and serological test were conducted on drug addicts in Yan’an compulsory isolation andrehabilitation center from 2016 to 2020.The risk factors of disease were analyzed byχ2test and multivariate logisticregression.ResultsFrom 2016 to 2020,2105 drug addicts were investigated,of which 64 were excluded due tounqualified serum samples,2041 cases were actually analyzed.There were 1830 males(89.66%)and 211 females(10.34%),with an average age of(37.73±8.44)years old.6 cases were HIV positive,with the infection rate of 0.29%;551 cases were syphilis positive,with the infection rate of 26.99%,and 763 cases were HCV positive,with the infection rateof 37.38%.Multivariate logistic regression analysis showed that female drug users(OR=1.41,95%CI:1.02-1.94),takingmixed drugs(OR=1.72,95%CI:1.30-2.28),injecting drugs(OR=1.43,95%CI:1.16-1.77)and having sex after takingdrugs(OR=1.87,95%CI:1.51-2.32)were the risk factors of syphilis infection.The HCV infection rate of drug users withelder age(OR=0.98,95%CI:0.97-0.99)and higher education(OR=0.49,95%CI:0.36-0.67)decreased,while theHCV infection rate of drug users who took new drugs(OR=1.53,95%CI:1.12-2.00)and mixed drugs(OR=2.61,95%CI:1.97-3.45)and had sex after taking drugs(OR=2.79,95%CI:2.27-3.44)increased.ConclusionsThe detection rate ofHIV infection among drug users in Yan’an city was low;the detection rate of HCV infection showed a downward trend,andthe detection rate of syphilis infection showed an upward trend.The increasing use of new drugs and the prevalence ofdangerous behaviors suggested that we should continue to strengthen the health education and behavioral intervention of drugusers in order to reduce the risk of disease transmission.