我国针具交换预防吸毒人员艾滋病传播效果评价的Meta分析

Meta-analysis on the Effect of Needle Exchange on Prevention and Control of HIV/AIDS Among Injecting Drug Users

目的综合评价我国针具交换预防吸毒人员艾滋病传播效果,为在吸毒人群中开展针具交换综合干预决策提供依据。方法用计算机检索中国生物医学文献光盘数据库（CBM）、万方数据库、中文科技期刊全文数据库（VIP）、中国期刊全文数据库（CNKI）,并结合文献追溯的方法,共收集35篇1999-2010年国内外公开发表的关于我国吸毒人员针具交换艾滋病预防随机对照队列干预研究的文献。对符合入选标准的7篇文献使用RevMan 5软件进行Meta分析。用RD作为效应指标,对纳入研究进行一致性检验后,采取固定效应模型或随机效应模型进行综合定量分析。结果吸毒人群针具交换干预后艾滋病防治知识知晓率提高了42%（30%~53%）、最近一次和最近一个月共用注射器吸毒率分别下降17%（9%~26%）和23%（16%~31%）,最近一次婚外性行为安全套使用率提高了16%（12%~20%）,HIV感染率下降了7%（3%~12%）。结论针具交换对控制艾滋病在吸毒人群中传播具有较好的效果。

Objective To evaluate the effect of needle exchange for preventing and controlling HIV/AIDS in injecting drug users.Methods A computerized literature search was carried out in CBM（Chinese Biomedical Database）,CNKI（Chinese National Knowledge Infrastructure）,Wanfang（Chinese） and VIP（Chinese） databases to collect 35 cohort study articles published between 1999 and 2010 concerning the effect of needle exchange for prevention and control of HIV/AIDS in injecting drug users.We also checked the reference lists of relevant articles.And Meta-analyses of 7 articles were performed using RevMan 5.Fixed and random effect models were employed to combine the results after a heterogeneity test,with rate difference（RD） used as the indicator of intervention effect.Results The analysis showed that the RD for knowledge of HIV/AIDS prevention and control,rate of last time sharing needle to inject drug,rate of last month sharing needle to inject drug,rate of last time condom use during extramarital sex behavior,rate of HIV positive were increased or decreased respectively by 42%（30%~53%）,17%（9%~26%）,23%（16%~31%）,16%（12%~20%）,and 7%（3%~12%）.Conclusions Needle exchange is effective in preventing and controlling HIV/AIDS among injecting drug users.