2008年东莞市社区吸毒人群人类免疫缺陷病毒感染率及影响因素

HIV prevalence and its correlation among the community-based drug users in Dongguan in 2008

目的了解2008年东莞市社区吸毒人群人类免疫缺陷病毒（H1V）感染率及影响因素。方法招募13名有吸毒行为者作为种子，采用同伴推动抽样法（RDS）招募东莞市社区吸毒人群进行面对面的问卷调查，采集血样进行HIV、丙型肝炎病毒（HCV）和梅毒抗体检测；利用RDS分析软件（RDSanalysistool，RDSAT）进行权重处理和双变量分析。结果经过15周，共招募和访谈303名社区吸毒人员，采集和检测血样300份。经RDSAT校正后，东莞市社区吸毒人群HIV抗体阳性率为14．7％（95％CI：6．1％～25．4％），HCV抗体阳性率为63．2％（95％CI：55．7％～71．7％），梅毒抗体阳性率为4．7％（95％CI：1.8％～8．2％）。HCV抗体阳性者、流动人口、第1次吸毒年龄小于26岁及静脉吸毒合并针具共用者的HIV抗体阳性率分别为22．9％（95％CI：10．8％～37．0％）、26．9％（95％CI：11．4％～44．9％）、19．9％（95％CI：8．3％～35．7％）和29．1％（95％C，：12．3％～45．1％）。本地人口和流动人口参加美沙酮维持治疗的比率分别为20．9％（95％CI：4．1％～44．6％）、2．3％（95％凹：0．0％～7．0％）。结论东莞市社区吸毒人群HIV流行形势较严峻；HCV抗体阳性、流动人口、第1次吸毒年龄小于26岁及静脉吸毒合并针具共用者有着更高的HIV感染率。

Objective To understand the HIV epidemic and its correlation among the community- based drug users in Dongguan, Guangdong province. Methods In 2008,13 drug users were identified as seeds in Dongguan. Respondent driven sampling was applied to recruit community-based drug users. A structured questionnaire was used for a face to face interview. Intravenous blood samples were collected for the measurement of HIV, HCV and syphilis antibodies. RDS analysis tool （RDSAT） was applied for adjusting the estinmtes and bivariate analysis. Results A total of 303 drug users were recruited within 15 weeks and 300 blood samples were collected. After RDSAT adjustment,the prevalence rates of HIV, HCV and syphilis were 14.7% （95%CI：6.1% -25.4%）,63.2% （95% CI：55.7% -71.7%）,and 4. 7% （95% CI： 1.8% - 8.2% ） respectively. The HIV prevalence rates among those who were HCV seropositive,migration, younger than 26 years at their first drug use, and ever shared needles or syringes were 22. 9% （95% CI： 10.8%-37.0%）,26.9% （95% CI： 11.4%-44.9%）,19.9% （95%CI：8.3%-35.7%）,and 29. 1% （95% CI：12. 3% -45.1% ） respectively. The proportions of the drug users who were enrolled at methadone maintenance treatment （MMT） of local residency, migration were 20. 9% （95% CI： 4. 1% - 44. 6% ） ,2. 3% （ 95% CI： 0. 0% - 7.0% ） respectively. Conclusion The HIV epidemic among the community-based drug users in Dongguan is serious. Drug users who are HCV seropositive, migration, younger than 26 years at their first drug use, and ever shared needles or syringes are inure likely to be HIV seropositive.