我国基于社区招募的吸毒人群艾滋病流行影响因素的多水平分析

Multilevel Model Analysis on the Influence of HIV /AIDS Infected among Community-based Recruitment of Drug User in China

目的利用多水平模型从群体和个体水平探讨我国社区吸毒者艾滋病流行的影响因素。方法收集我国2011年艾滋病哨点监测的吸毒者数据,利用三水平logistic模型,分析我国社区吸毒者艾滋病流行的影响因素,计算相关变量的参数估计值及OR值。结果 2011年我国哨点监测共调查社区吸毒人员42011人,HIV感染率为5.01%(95%CI:4.80%,5.22%)。零模型分析结果显示社区吸毒者艾滋病感染在区县水平、省份水平上均有聚集性。进一步通过三水平logistic模型分析影响因素,结果显示,感染丙肝(OR=6.404,95%CI:5.411,7.580)、共用针具(OR=4.043,95%CI:3.545,4.618)、注射吸毒(OR=1.736,95%CI:1.391,2.167)、少数民族(OR=1.728,95%CI:1.446,2.065)等因素是社区吸毒者感染艾滋病的危险因素。结论多水平模型可以用于处理我国艾滋病哨点监测数据,但仍需在群体水平继续探索相应的影响因素。

Objective Using multilevel model to explore the influencing factors of HIV/AIDS epidemic among drug users who were recruited through community from the level of populations and individuals. Methods The Research collected of an annual sentinel monitoring data among community-based drug user,using three-level logistic model to analyze the impact of the HIV /AIDS epidemic factors of China＇s drug user,computing variable parameter estimates and the value of OR. Results42011 drug users were recruited from community and the HIV /AIDS prevalence was 5. 01%（ 95% CI： 4. 80%,5. 22%）. Null model analysis showed that HIV /AIDS infected drug users clustered in country and province. Further analysis through three levels of Logistic model showed infected with hepatitis C（ OR = 6. 404,95% CI： 5. 411,7. 580）,sharing needles（ OR = 4. 043,95%CI： 3. 545,4. 618）,injection drug use（ OR = 1. 736,95% CI： 1. 391,2. 167）,minorities（ OR = 1. 728,95% CI： 1. 446,2. 065）and other demographic characteristics and behavioral factors are risk factors of community drug users infected with HIV /AIDS.Conclusion Multilevel model can be used to handle our HIV /AIDS sentinel surveillance data,but still need to explore the appropriatelevel factors.