云南省德宏傣族景颇族自治州HIV感染的注射吸毒者未接受美沙酮维持治疗现况调查

A cross-sectional survey of receiving no methadone maintenance treatment in HIV infected injecting drug users in Dehong Dai and Jingpo autonomous prefecture, Yunnan province

目的了解云南省德宏傣族景颇族自治州（德宏州）HIV感染的注射吸毒者（IDUs）未参加美沙酮维持治疗（MMT）情况及其相关因素。方法从中国疾病预防控制信息系统艾滋病综合防治信息系统中下载2014年12月德宏州现存活的经注射吸毒传播的HIV／AIDS数据并开展专题调查，分析未参加MMT的比例及相关因素，并对其未参加MMT的原因进行分析。结果德宏州应参加MMT的HIV感染的IDUs共987例，以男性、35-44岁、农民为主，分别占94．6％（934／987）、53．0％（523／987）、77.2％（762／987），未参加MMT的比例为60．0％（592／987）。多因素logistic回归分析显示，女性（OR=2．66，95％CI：1．21～5．87）、景颇族（OR=3．05，95％CI：1．97～4．71）等是未参加MMT的危险因素；非农民职业（OR=0．46，95％a：0.31-0．70）、傣族（OR=0．53，95％CI：0．36～0．79）、确证感染时间≥10年（OR=0．60，95％CI：0．45—0．81）等是未参加MMT的保护因素。未参加MMT的原因包括路程远289人（48．8％）、怕暴露124人（20．9％）、不能坚持每天服药59人（10．0％）、担心副作用47人（7．9％）、其他73人（12．3％）。结论德宏州HIV感染的IDUs中未参加MMT的比例高，女性、农民、景颇族、文化程度低、确证感染时间短等均是未参加MMT的影响因素，需采取针对性干预措施，进一步提高HIV感染的IDUs的MMT入组率。

Objective To understand the current status of receiving no methadone maintenance treatment （MMT） and influencing factors in HIV infected injecting drug users （IDUs） in Dehong Dai and Jingpo autonomous prefectures, Yunnan province. Methods Data of survival of IDUs with AIDS in Dehong were collected from ＂Chinese National Comprehensive HIV/AIDS and Care Information System＂ in December, 2014. Results There were 987 IDUs who should receive MMT, the majority of them were males （94.6%, 934/987）, aged 35-44 years （53.0%, 523/987） and farmers （77.2%, 762/987）. Among the 987 IDUs, 60.2% （592/987） received no MMT. Multivariate logistic regression analysis showed that being female （OR=2.66, 95%CI： 1.21-5.87）, in Jingpo ethnic group （OR=3.05, 95%CI： 1.97-4.71） were the major risk factors for receiving no MMT; not being farmers （OR=0.46, 95%CI： 0.31-0.70）, in Dai ethnic group （OR=0.53, 95%CI： 0.36-0.79）, diagnosed HIV infection history ≥ 10 years （OR = 0.60, 95 % CI： 0.45 -0.81） were the maj or protective factors for receiving no MMT. The reasons for receiving no MMT included long distance journey （289, 48.8%）, fear of exposure （124, 20.9%）, poor daily medication compliance （59, 10.0%）, fear of side effects （47, 7.9%）, others （73, 12.3%）. Conclusions The proportion of receiving no MMT in IDUs with AIDS in Dehong was high. Being female and farmer, in Jingpo ethnic group, low educational level, short diagnosed HIV infection history were influencing factors for receiving no MMT. The effective intervention measures should be taken to further improve MMT coverage according to the different characteristics of the patients.