Tun Waimar, Celentano David D, Vlahov David, Strathdee Steffanie A
Infectious Disease Program, Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland, USA.
AIDS. 2003 Sep 5;17(13):1953-62. doi: 10.1097/00002030-200309050-00014.
To determine if HIV treatment-related attitudes are associated with unprotected sex and needle sharing among HIV-seropositive and -seronegative injecting drug users (IDU) in Baltimore, Maryland.
IDU participating in a cohort study seen between December 2000 and July 2001 completed an interviewer-administered questionnaire on attitudes toward HIV treatment and risk behaviors (593 HIV-seronegative, 338 HIV-seropositive), including: perceived HIV transmissibility through unprotected sex and needle sharing, and safer sex and injection fatigue. Logistic regression was used to examine the role of attitudinal factors on needle sharing and unsafe sex.
Almost two-thirds of sexually active participants engaged in unprotected sex and approximately half of those injecting drugs shared needles. Among HIV-seropositive IDU, perception of reduced HIV transmissibility through unprotected sex was significantly associated with unprotected sex [adjusted odds ratio (AOR), 3.33; 95% confidence interval (CI), 1.05-10.55). Safer injection fatigue was independently associated with needle sharing among HIV-seropositive IDU (AOR, 6.55; 95% CI, 1.69-25.39). Among HIV-seronegative IDU, safer sex fatigue and safer injection fatigue were independently associated with unprotected sex (AOR, 3.12; 95% CI, 1.17-8.35) and needle sharing (AOR, 5.15; 95% CI, 2.33-11.37), respectively.
Among HIV-seropositive IDU, perceiving that HIV treatments reduce HIV transmission was significantly associated with unprotected sex. Risk reduction fatigue was strongly associated with unsafe sexual and injection behaviors among HIV-seronegative individuals. HIV prevention interventions must consider the unintended impact of HIV treatments on attitudes and risk behaviors among IDU.
确定在马里兰州巴尔的摩市，与艾滋病毒治疗相关的态度是否与艾滋病毒血清阳性和血清阴性的注射吸毒者（IDU）中的无保护性行为及共用针头行为有关。
参与队列研究的注射吸毒者于2000年12月至2001年7月期间接受访谈，完成一份由访谈者管理的关于对艾滋病毒治疗的态度及风险行为的问卷（593名艾滋病毒血清阴性者，338名艾滋病毒血清阳性者），内容包括：对通过无保护性行为和共用针头传播艾滋病毒的认知，以及安全性行为和注射疲劳。采用逻辑回归分析来研究态度因素在共用针头和不安全性行为方面所起的作用。
近三分之二有性行为的参与者有过无保护性行为，约一半注射毒品者共用过针头。在艾滋病毒血清阳性的注射吸毒者中，认为通过无保护性行为传播艾滋病毒风险降低与无保护性行为显著相关[调整优势比（AOR）为3.33；95%置信区间（CI）为1.05 - 10.55]。在艾滋病毒血清阳性的注射吸毒者中，更安全注射疲劳与共用针头独立相关（AOR为6.55；95% CI为1.69 - 25.39）。在艾滋病毒血清阴性的注射吸毒者中，更安全性行为疲劳和更安全注射疲劳分别与无保护性行为（AOR为3.12；95% CI为1.17 - 8.35）和共用针头（AOR为5.15；95% CI为2.33 - 11.37）独立相关。
在艾滋病毒血清阳性的注射吸毒者中，认为艾滋病毒治疗能降低艾滋病毒传播与无保护性行为显著相关。在艾滋病毒血清阴性个体中，降低风险的疲劳与不安全性行为和注射行为密切相关。艾滋病毒预防干预措施必须考虑艾滋病毒治疗对注射吸毒者态度和风险行为产生的意外影响。
