四川省美沙酮维持治疗门诊首次入组患者HIV感染状况分析

Analysis on HIV Infection Among Patients in the First Time of Entry into Methadone Maintenance Treatment Clinics in Sichuan

目的分析首次入组美沙酮维持治疗门诊患者艾滋病病毒感染状况,为下一步美沙酮维持治疗门诊干预工作以及HIV感染者和患者需开展的工作提供依据。方法收集自2005-2014年以来,四川省49家美沙酮门诊首次入组美沙酮维持治疗门诊患者基本信息表,整理一般人口学资料、HIV检测结果,分析门诊患者的人口学特征,感染状况及不同特征间感染率的差异。结果在调查的门诊患者中,有13%的患者感染HIV,2005年HIV抗体阳性率最高,为33.5%;2007年最低,为8.1%;2011年以后阳性率有所下降。二分类的Logistic回归分析结果显示,男性、20-49岁、初中及以下文化程度、已婚有配偶、凉山州、注射吸毒、共用注射器者HIV抗体阳性率更高。美沙酮门诊新入组人数从2011年的4207人降至2014年的1358人。结论近10年来,四川省除凉山州外的美沙酮维持治疗门诊吸毒人群的HIV抗体阳性率呈逐年下降趋势,提示凉山州仍是吸毒人群艾滋病干预重点地区;美沙酮门诊新入组人数近年呈下降趋势,应采取措施加强美沙酮维持治疗工作质量,以降低吸毒人群HIV感染率。

Objective To analyze HIV infection among patients of the first time to entry into methadone maintenance treatment （MMT） clinics of Sichuan in the last 10 years, and to provide the evidence for intervention. Methods We collected patients＇ basic information forms in the first time of entry into MMT in Sichuan from 2005 to 2014, and analyzed patients＇ social demographic characters, HIV prevalence and influence factors. Results Among 20 275 patients, HIV infection rate was 13% ; the HIV prevalence was the highest （33.5%） in 2005, it reduced to 8. 1% in 2008, and the prevalence decreased after 2011. The results of the binary logistic re- gression showed that male, aged 20 to 49 years old, junior high school or lower education level, married, Liangshan residents, injection drug using, and sharing syringe or needles were risk factors of HIV infection. The number of patients attending MMT in Sichuan declined from 4 207 in 2011 to 1 358 in 2014. Conclusion The rate of HIV prevalence had decreasing tendency in Sichuan except for Liangshan in the last decade, indicating that Liangshan is still the key area of HIV/AIDS intervention among the drug users. The number of patients attending MMT showed a declining tendency in the last several years, it suggested MMT＇s quality should be strengthened to reduce HIV prevalence among drug users.