马鞍山市吸毒者美沙酮维持期间梅毒血清阳转及危险因素的研究

Syphilis seroconversion among drug addicts during methadone maintenance treatment in Maanshan city,Anhui province： incidence and risk factors

目的了解美沙酮维持治疗期间吸毒者梅毒血清阳转的具体情况、特征，探讨与阳转相关的危险因素。方法对马鞍山美沙酮门诊成立以来，治疗前梅毒血清阴性，保持治疗且随访梅毒血清2年以上的全部吸毒者，回顾梅毒血清阳转情况、特征，并对相关危险因素进行分析。结果161例研究对象中，2年美沙酮维持治疗期间15例梅毒血清阳转，平均阳转率为4．66／100人年；梅毒血清阳转率呈前期高，后期低的特征；单因素X^2分析和多因素Logistic回归分析结果显示，梅毒血清阳转与“治疗前最近一次性生活没有使用安全套”相关，差异有统计学意义。结论美沙酮门诊应尽早对吸毒者进行安全性行为干预，早期推广安全套使用尤为重要，以更好阻断性传播途径。

Objective To evaluate the incidence of and risk factors for syphilis seroconversion amomg drug addicts during methadone maintenance treatment （MMT）. Methods A retrospective study was performed on drug addicts receiving MMT at MMT clinics in Maanshan, who were seronegative for syphilis before the treatment and followed up by serological tests for syphilis for more than two years. The incidence of and risk factors for syphilis seroconversion during the two years of follow up were analyzed in all the subjects. Results A total of 161 drug addicts were included in this study, of whom, 15 experienced seroconversion for syphilis with the average seroconversion rate being 4.66 per 100 person-years. The seroconversion tended to occurr in the early stage of MMT. Both Chi-square analysis and multivariate logistic regression analysis showed that syphilis seroconversion was independently associated with nonuse of condoms during the last sexual behavior before receiving MMT. Conclusions Interventions should be undertaken as early as possible to promote safe sexual behaviors among drug addicts at methadone clinics, and to promote condom use is especially important for blocking sexual transmission of diseases.