磷酸可待因滥用与MSM人群HIV感染及相关高危行为的关联性

Correlation of codeine abuse with HIV infection and related high-risk behavior among men who have sex with men

目的 了解男男性行为(men who have sex with men,MSM)人群磷酸可待因的滥用情况,分析滥用磷酸可待因与(human immunodeficiency virus,HIV)感染及相关高危行为的关系。 方法 采用访谈式问卷收集2012年6月-2013年6月,中国7城市MSM人群的社会人口学、性行为、磷酸可待因及其他药物滥用行为等信息。采集静脉血检测HIV抗体。 结果 4 492名MSM调查对象中,84名(1.87%)自报近半年内有磷酸可待因滥用经历。滥用者近半年内发生同性商业性行为(AOR=3.431,95%CI:2.104~5.593)、肛门出血(AOR=2.052,95%CI:1.243~3.387)、安全套破裂(AOR=2.735,95%CI:1.578~4.741)、群体性行为(AOR=4.573,95%CI:2.454~8.521)、吸食rush(AOR=2.759,95%CI:1.763~3.387)和存在部分特定性病症状(AOR=4.926,95%CI:2.880~8.426)的风险均显著更高。吸食过rush(AOR=1.509,95%CI:1.219~1.869)、肛门出血(AOR=1.595,95%CI:1.246~2.041)和存在部分特定性病症状(AOR=1.689,95%CI:1.192~2.392)与HIV感染呈正相关。未发现滥用磷酸可待因与HIV感染之间的显著关联性(OR=1.289,95%CI:0.588~2.825)。 结论 尽管MSM群体中磷酸可待因滥用还不普遍,但相关滥用者容易发生与HIV感染相关的各类高危行为,间接增加其HIV感染风险。卫生部门需进一步加强关注和监测MSM群体的磷酸可待因滥用情况,控制该人群HIV的流行和扩散。

Objective To investigate the prevalence of codeine abuse and its relationship with HIV infection and related high-risk behavior among men who have sex with men (MSM). Methods An interview-based questionnaire survey was conducted among MSM in seven Chinese cities from June 2012 to June 2013. The information about socio-demographics, sexual behavior, codeine and other substance use was assembled, and venous blood samples were collected for HIV antibody testing. Results Among 4,492 surveyed MSM, 84 (1.87%) self-reported OTC codeine use in the past 6 months. Homosexual commercial sex (AOR=3.431,95%CI:2.104-5.593), anal bleeding (AOR=2.052, 95%CI:1.243-3.387), condom breakage (AOR=2.735, 95%CI:1.578-4.741), group sexual encounters (AOR=4.573, 95%CI:2.454-8.521), rush poppers use (AOR=2.759, 95%CI:1.763-3.387) andhaving some specificsymptoms of sexually transmitted infections (AOR=4.926, 95%CI:2.880-8.426) were independent predictors of codeine abuse in the past six months. Rush poppers use (AOR=1.509, 95%CI:1.219-1.869), anal bleeding (AOR=1.595, 95%CI:1.246-2.041),having some specificsymptoms of sexually transmitted infections (AOR=1.689, 95%CI:1.192-2.392) were positively correlated with HIV infection. No significant correlation was found between codeine abuse and HIV infection (OR=1.289, 95%CI=0.588-2.825). Conclusions Although codeine abuse is not popular in MSM, codeine abusers are prone to engaging in HIV-related high-risk behavior, which indirectly increases the risk of HIV infection. Public health departments need to further strengthen surveillance of codeine abuse so as to curb the fast spread of HIV among MSM.