Williams A B, McNelly E A, Williams A E, D'Aquila R T
Adult Health Division, Yale School of Nursing, New Haven, CT 06536-0740.
AIDS Care. 1992;4(1):35-41. doi: 10.1080/09540129208251618.
This study examined whether methadone maintenance treatment decreases drug injection enough to significantly limit HIV-1 transmission among injection drug users (IDU). When HIV-1 seroconversion status among prospectively followed methadone maintenance clients was analyzed by treatment retention, 1/56 (2%) of those who remained continuously in treatment seroconverted while 8/42 (19%) of those whose methadone treatment was interrupted seroconverted. When controlled for length of follow up, the difference in seroconversion rate was not statistically significant. Subjects in continuous treatment had a seroconversion rate of 0.7 per 100 person years (95% Confidence Interval [CI] = 0.1, 5.3) and those with interrupted treatment a rate of 4.3 per 100 person years (95% CI = 2.2, 8.6). Subjects in continuous treatment reported less needle sharing (p less than 0.0002), fewer needle sharing partners (p less than 0.002), fewer sexual partners (p less than 0.03), and were more likely to be women (p less than 0.01). These data indicate the need for larger studies to evaluate both client and drug treatment program characteristics which might concomitantly increase treatment retention and decrease HIV-1 risk.
本研究探讨了美沙酮维持治疗是否能充分减少药物注射，从而显著限制注射吸毒者（IDU）中HIV-1的传播。当按治疗保留情况分析前瞻性随访的美沙酮维持治疗患者的HIV-1血清转化状态时，持续接受治疗的患者中1/56（2%）发生了血清转化，而美沙酮治疗中断的患者中8/42（19%）发生了血清转化。在对随访时间进行控制后，血清转化率的差异无统计学意义。持续治疗的受试者血清转化率为每100人年0.7（95%置信区间[CI]=0.1，5.3），治疗中断的受试者血清转化率为每100人年4.3（95%CI=2.2，8.6）。持续治疗的受试者报告的共用针头情况较少（p<0.0002），共用针头的伙伴较少（p<0.002），性伴侣较少（p<0.03），且更可能为女性（p<0.01）。这些数据表明需要进行更大规模的研究，以评估可能同时提高治疗保留率和降低HIV-1风险的患者及药物治疗项目特征。
