社区静脉吸毒人群高危行为相关疾病重叠感染的影响因素分析

Analysis on Influencing Factors of High Risk Behaviors Related to Diseases Superinfection Among Injection Drug Users of Community

目的了解社区静脉吸毒人群(IDU)高危行为相关疾病重叠感染状况及影响因素,为开展行为干预工作提供基线资料。方法采用同伴推动抽样法(RDS)在清城区和连州市招募社区IDU;于2009年4-12月对调查对象进行问卷调查,并采集血样检测HIV、HBV、HCV和梅毒。结果共问卷调查社区IDU203人,62.07%曾与别人共用针具吸毒,最近6个月、最近1月以及最近1次与别人共针的比例分别为38.92%、26.11%、15.27%;40.87%最近1年有商业性行为,与商业性伴从不和每次使用安全套的比例分别为15.66%、33.73%,最近1次与商业性伴使用安全套的比例为57.83%;HIV、HBsAg、HCV和梅毒感染率分别为6.59%、18.56%、65.27%、11.38%,二重、三重和四重感染率分别为17.96%、6.59%、0;多因素Logistic回归模型分析结果表明本市户籍、累计入戒毒所次数多和曾共用针具吸毒是社区IDU高危行为相关疾病重叠感染的危险因素,商业性行为每次使用安全套和最近一年接受过性病艾滋病相关服务是保护因素。结论清远市社区IDU高危吸毒和性乱行为仍较普遍,安全套使用率较低,高危行为相关疾病感染率较一般人群高,不安全注射吸毒和不安全性行为是主要危险因素,有必要广泛、持久地在吸毒人群中开展艾滋病性病相关知识宣传教育和行为干预活动。

Objective To investigate the status and the influencing factors of high risk behaviors related to diseases superinfection among injection drug users of community,and to provide the baseline data for developing the work of behavior intervention.Methods The respondent driven sampling（RDS）was used to recruit injection drug users（IDUs）of community in Qingcheng District and Lianzhou City.The questionnaire surveys were conducted among the IDUs from April to December,2009.The blood samples were collected to test for antibodies of HIV,HBV,HCV and syphilis.Results Among the 203 IDUs,62.7% had ever shared the syringes and needles with others.The proportions of whom had ever shared the syringes and needles with others in the last six months,the last one month and the last time were 38.92%,26.11%,and 15.27%.40.87% of the IDUs had had commercial sexual behaviors in recent one year,the proportions of never using condoms and always using condoms in the commercial sexual behaviors were 15.66% and 33.73%,respectively.The condom use rate of the last time commercial sexual behavior was 57.83%.The infection rates of HIV,HBsAg,HCV and syphilis were 6.59%,18.56%,65.27%,and 11.38%,respectively;and the rates of double-,triple-and quadruple-infections were 17.96%,6.59%,and 0,respectively.The results of multivariate Logistic regression analysis showed that local household registration,the more accumulated times of drug detoxification and ever shared the syringes and needles with others were the risk factors for the high risk behaviors related to diseases superinfection among IDUs,while using condoms when having commercial sex behavior and accepting HIV/AIDS related services in the recent one year were the protective factors.Conclusions The high risk behaviors and sexual promiscuity still exist among the IDUs of community in Qingyuan.The main risk factors for high risk behaviors related to diseases superinfection include the lower condom use rate,drug injection,commercial sex behaviors,and the infection rates of the high risk behaviors related to diseases are higher than those in general people.It is urgent to widely and everlastingly provide drug addicts with HIV/STDs related health education and intervention activities.