2018—2022年广西宾阳县吸毒人群危险行为变化及HIV感染的影响因素分析

Analysis of risk behavior changes and influencing factors of HIV infection among drug users in Binyang county of Guangxi from 2018 to 2022

目的:分析广西宾阳县2018—2022年吸毒人群危险行为变化趋势及人类免疫缺陷病毒(HIV)感染的影响因素。方法:按照全国艾滋病(AIDS)哨点监测项目要求,在广西宾阳县各监测哨点随机抽取研究对象,开展问卷调查及HIV、梅毒、HCV抗体检测;采用多因素Logistic回归模型分析吸毒人群感染HIV的影响因素。结果:2018—2022年共调查1 615名吸毒人员,以汉族青壮年男性为主;各年度AIDS知识知晓率分别为99.75%、99.75%、100.00%、100.00%、100.00%,总体知晓率为99.88%,呈逐年提高的趋势(χ^(2)_(趋势)=43.77,P<0.001);最近一个月注射毒品(χ^(2)_(趋势)=63.72,P<0.001)、曾经与别人共用针具(χ^(2)_(趋势)=7.04,P=0.008)、最近一年吸毒后发生性行为(χ^(2)_(趋势)=44.06,P<0.001)的比例呈逐年下降的趋势;最近一次吸毒后发生性行为时使用安全套比例(χ^(2)_(趋势)=4.40,P=0.036)、最近一年商业性行为坚持使用安全套比例(χ^(2)_(趋势)=98.30,P<0.001)呈现逐年上升的趋势;2018—2022年,吸毒人群HIV、梅毒、HCV总体阳性率分别为5.70%,10.50%,59.40%;多因素Logistic回归分析显示:文化程度初中及以上(OR=0.52,95%CI:0.29~0.91)、婚姻状态为未婚/离异或丧偶(OR=2.75,95%CI:1.70~4.44)、共用针具(OR=25.21,95%CI:10.69~59.42)、HCV感染(OR=2.78,95%CI:1.70~4.44)是吸毒人群感染HIV的影响因素(均P<0.05)。结论:广西宾阳县吸毒人群AIDS相关危险行为呈减少趋势,针对吸毒人群的不同特征采取指向性的干预手段是遏制AIDS在该人群播散的要点。

Objective:To analyze the trend of risk behavior changes and the influencing factors of human immunodeficiency virus (HIV) infection among drug users in Binyang county of Guangxi from 2018 to 2022.Methods:In accordance with the requirements of the National AIDS Sentinel Surveillance Program,study subjects were randomly selected at sentinel site in Binyang county,and questionnaires and antibody tests for HIV,syphilis and HCV were conducted.Multifactorial Logistic regression model was performed to analyze the influencing factors of HIV infection in drug users.Results:A total of 1,615 drug users were surveyed from 2018 to 2022,and a majority of them were Han Chinese adult males.The knowledge awareness rate of AIDS in each year was99.75%,99.75%,100.00%,100.00%,and 100.00%respectively,with an overall knowledge awareness rate of99.88%,showing a year-on-year increase (χ^(2)_(trend)=43.77,P<0.001).There was a decreasing trend in the proportions of injecting drugs in the last month (χ^(2)_(trend)=63.72,P<0.001),sharing needles with others (χ^(2)_(trend)=7.04,P=0.008),and having sex after drug use in the last year (χ2=trend44.06,P<0.001).Additionally,there was a yearly increasing trend in the proportion of condom use at the most recent sex after drug use (χ^(2)_(trend)=4.40,P=0.036),and the proportion of adherence to condom use at the most recent year of commercial sex (χ^(2)_(trend)=98.30,P<0.001).From 2018 to 2022,the overall positive rates of HIV,syphilis and HCV in drug users were 5.70%,10.50%and 59.40%,respectively.Furthermore,multifactorial Logistic regression analysis showed that educational levels equal to or above middle school (OR=0.52,95%CI:0.29-0.91),single/divorced/widowed(OR=2.75,95%CI:1.70-4.44),needle sharing (OR=25.21,95%CI:10.69-59.42),and HCV infection (OR=2.78,95%CI:1.70-4.44) were influencing factors for HIV infection in drug users (all P<0.05).Conclusion:AIDS-related risk behaviors among the drug users in Binyang county show a significant downward trend,and targeting interventions for different characteristics of the drug users are the key strategies to curb AIDS transmission.