中国吸毒人群HIV感染率的Meta分析

HIV prevalence among drug users in China: a Meta-analysis

目的估计2010-2018年全国和不同地区吸毒人群HIV感染率和变化趋势。方法对2013-2019年发表的关于中国吸毒人群中HIV感染的研究进行了系统综述和Meta分析,分析了各省份、地区、全国范围的吸毒人群HIV合并感染率。结果研究共纳入128篇文献,覆盖全国25个省(自治区、直辖市)。在全国范围内,吸毒人群HIV合并感染率为4.8%(95%CI:4.4%~5.3%),其中注射吸毒人群感染率为11.1%(95%CI:9.0%~13.2%),非注射吸毒人群感染率为1.6%(95%CI:1.1%~2.1%)。研究地点不同是造成异质性的主要原因。西南地区HIV感染率最高,为9.6%(95%CI:7.9%~11.3%),东北地区HIV感染率最低,为0.4%(95%CI:0~1.3%)。结论近十年我国注射吸毒人群中HIV感染率仍处于较高水平,非注射吸毒人群HIV感染率相对较低,地域差异大。应继续加强吸毒人群HIV动员检测和促进感染者发现,以控制艾滋病在中国吸毒人群中的流行。

Objective This paper aims to estimate the magnitude and changing trends of HIV among drug users at the national and subnational levels in China during 2013-2019. Methods We undertook a systematic review of studies published from 2013-2019 on HIV among drug users in China. Meta-analysis was conducted to generate pooled prevalence estimates by province, region, and nationally. Results A total of 128 studies which cover 25 provinces, were selected. Nationally, the pooled prevalence of HIV among drug users was 4.8%(95%CI:4.4%~5.3%), with the prevalence of HIV among intravenous drug users as 11.1%(95%CI:9.0%~13.2%) and the prevalence of HIV among non-intravenous drug users as 1.6%(95%CI: 1.1%~2.1%). The study location appeared the major contributor of heterogeneities of HIV prevalence among drug users in China. HIV prevalence was the highest in the Southwest, 9.6%(95%CI: 7.9%~11.3%),while the lowest in the Northeast 0.4%(95%CI:0.0%~1.3%). Conclusion In China, the overall HIV prevalence among intravenous drug users was high in the past ten years. However, the prevalence was low among non-intravenous drug users and with a considerable geographic variation. Enhanced detection of HIV is warranted among drug users to control the HIV epidemic among drug users in China.