静脉吸毒人群3年随访的HIV新发感染率和保持率研究

HIV INCIDENCE AND FACTORS CONTRIBUTED TO RETENTION IN A 36-MONTH PROSPECTIVE COHORT STUDY AMONG INJECTION DRUG USERS

[目的]了解静脉吸毒人群前瞻性研究队列3年随访的HIV血清抗体阳转率和队列保持率情况。[方法]于2002年11月,在四川省西昌市从社区招募了HIV血清抗体阴性的静脉吸毒人群前瞻性研究队列333人,队列每6个月随访1次并采集血样进行HIV抗体检测,以及分析队列本底的社会人口学和HIV高危行为特征与队列保持率的关系。[结果]静脉吸毒人群研究队列3年随访的HIV新发感染率为2.26/100人年(95%CI:1.08～3.45)和保持率为68.8%(229/333)。在多因素logistic回归模型分析中,与队列保持率的关系有统计学意义的变量为:彝族(OR:0.35;95%CI:0.21～0.59;P﹤0.0001)、6个月回访(OR:3.10;95%CI:1.81～5.31;P﹤0.0001)和近3个月静脉吸毒频率高(OR:1.79;95%CI:1.00～3.19;P=0.0485)。[结论]本研究结果表明该地区静脉吸毒人群HIV新发感染率较高,彝族和6个月未随访到的静脉吸毒人群队列保持率低。

[Objective] To investigate the HIV seroconversion, as well as cohort retention and the contributed factors in a 3-year follow-up study among injection drug users （IDUs） . [Methods] In November 2002, a community-based baseline survey was conducted to recruit 333 HIV-seronegative IDUs for a prospective cohort study in Xichang County of Sichuan Province, China. Follow-up visits were conducted every 6 months to analyze risk factors such as sociodemographic and behavioral characteristics at baseline associated with cohort retention, and blood specimens were also collected to test for antibodies against HIV. [ Results] During the 36-month follow-up period, HIV incidence and cohort retention rate were 2.26 per 100 person-years （95% confidence interval [CI] ： 1.08-3.45） and 68.8%, respectively. Multivariate Logistic regression model showed that risk factors significantly associated with cohort retention included Yi Nationality （OR： 0.35; 95%CI： 0.21-0.59; P〈 0.0001）, callback after 6 months （OR： 3.10; 95%CI： 1.81-5.31 ; P〈 0.0001）, and drug injection in the past 3 months （OR： 1.79; 95%CI： 1.00-3.19; P = 0.0485） . [Conclusion] HIV seroconversion is high in this area and cohort retention of Yi Nationality or IDUs with no callback at 6th month was low.