已知和未知自身感染状况的HIV阳性注射吸毒者危险行为分析

Comparison of risk behaviors between injecting drug users who are aware and unaware of their hiv seropositivity

【目的】分析已知和未知自身感染状况的HIV阳性注射吸毒者相关危险行为及接受针具交换服务情况的差异,为进一步开展有效的行为干预措施提供依据。【方法】在3742名参加针具交换效果评估的调查对象中,对其中647名HIV阳性的注射吸毒者进行分析,比较已知与未知自身感染状况的HIV阳性注射吸毒者两组间危险注射吸毒行为、安全性行为和参加针具交换服务情况的差异。【结果】是否得知HIV阳性并未影响到其注射吸毒行为(包括共针比例、吸毒次数和一支注射器的使用次数,P>0.05)。已知自身感染状况的HIV阳性注射吸毒者最近一次性生活使用安全套的百分比显著高于未知自身感染状况的HIV阳性注射吸毒者(P<0.05)。已知自身感染状况的HIV阳性注射吸毒者参加过针具交换的百分比显著高于未知自身感染状况的HIV阳性注射吸毒者(68.4%vs 46.0%,P=0.02),其最近1年参加针具交换的时间在6个月以上的百分比也更高(42.3%vs11.8%,P=0.02)。【结论】应加强对注射吸毒者的HIV检测与HIV阳性结果告知工作,以减少疾病在这一人群中的传播。

[Objective] To assess differences of HIV related risk behavior and use of needle exchange program （NEPs） between injecting drug users（IDUs） who are aware and unaware of their HIV seropositive. [Methods] HIV positive individuals from the evaluation study of China National Needle Exchange Programs carried out in Yunnan, Guizhou, Sichuan, Guangxi, Guangdong, Hunan and Xinjiang, were invited to participate the study from December, 2010 to August, 2011. A total of 3742 injecting drug users were interviewed, among which 647 were HIV positives. 56.4% of 647 HIV positive IDUs knew their seropositive before the investigation, while 43.6% didn＇ t know their serostatus. Comparison was conducted to assess the difference of risk behavior and use of NEP between IDUs aware their HIV seropositive and IDUs unaware their HIV seropositive. [ Results] Among 647 HIV positives, 86.2% （n = 558） were male. The median age of participants was 35 years. About two-thirds of participants （n = 427, 66.1%） were of Han ethnicity, the dominant ethnic group in China. About half of participants （n = 297, 45.9%） were single, one-thirds （n=211, 32.6%） were married. Over half of participants （n = 358, 55.4% ） had completed junior middle school. The majority of participants （n = 566, 87.5% ） were unemployed.IDUs who were aware of their HIV seropositivity had higher education level and higher proportion of being married compared with IDUs who were unaware of their HIV seropositivity. There was no relationship between whether knowing HIVseropositive and injecting behavior of IDUs including needle sharing, frequency of injection, using times for one syringe after stratified by attendance of NEP or methadone maintenance treatment （MMT）. Proportion of condom use was significantly higher in IDUs who were aware of their HIV seropositivity than in IDUs who were unaware of their HIV seropositivity （P 〈 0.05）.Proportion of NEP attendance among IDUs knowing their HIV seropositivity was much higher than that of those without knowing their HIV seropositivity （68.4% vs 46.0%, P = 0.02）. Proportion of longer time （6-12 months） of NEP attendance in IDUs who were aware of their HIV seropositive was also significantly higher than in IDUs who were unaware of their HIV seropositive （42.3% vs 11.8%, P = 0.02）. [ Conclusion ] HIV testing could change risk behavior and NEP attendance of IDUs and should be implemented periodically in order to not only monitor HIV status of IDUs, but also prevent further HIV transmission among this population.