Bortolotti F, Stivanello A, Noventa F, Forza G, Pavanello N, Bertolini A
Clinica Medica 2, Università di Padova, Italy.
Eur J Epidemiol. 1992 Mar;8(2):264-7. doi: 10.1007/BF00144811.
In the area of Padua, northern Italy, fear of AIDS along with AIDS educational campaigns had reduced risk behaviours for HIV among intravenous drug abusers (IVDA) as early as 1987, although at that time 38% of seropositive cases still shared needles and only 22% of subjects used condoms. The present study has been conducted in the same area and with similar criteria to evaluate the effectiveness and limits of a sustained education campaign. Drug related and sexual risk behaviours and motivations preventing behavioural changes were investigated by direct interview in 190 IVDA. Fourteen percent of the participants, including 16% of the seropositive, were still sharing needles, mainly because they did not have works available at the time they were needed. Demographic features, drug-related characteristics and anti-HIV seroprevalence did not differ significantly between needlesharers and other drug abusers. Condom use was reported by 46% of subjects, but encouragingly enough this figure included 80% of the seropositives. While knowledge of seropositivity seemed to encourage condom use, a higher selectivity about partners and a negative attitude towards condoms were the most frequent motivations preventing safer sex. These results suggest that sustained AIDS education campaigns are being successful in maintaining and reinforcing the trend to risk reduction previously observed among drug abusers in this area. Nevertheless the persistence of risk behaviours in a consistent proportion of participants emphasizes the urgency of additional prevention strategies, such as syringe exchange or supply to the limited number of sharers and counselling to encourage safer sex.
在意大利北部的帕多瓦地区，早在1987年，对艾滋病的恐惧以及艾滋病教育活动就已降低了静脉注射吸毒者（IVDA）感染艾滋病毒的风险行为，尽管当时38%的血清阳性病例仍共用针头，只有22%的人使用避孕套。本研究在同一地区按照类似标准开展，以评估持续教育活动的效果和局限性。通过对190名静脉注射吸毒者进行直接访谈，调查了与毒品相关和性方面的风险行为以及阻碍行为改变的动机。14%的参与者，包括16%的血清阳性者，仍在共用针头，主要原因是在需要时没有可用的注射器。共用针头者与其他吸毒者在人口统计学特征、与毒品相关的特征以及抗艾滋病毒血清阳性率方面没有显著差异。46%的受试者报告使用了避孕套，但令人鼓舞的是，这一数字包括80%的血清阳性者。虽然对血清阳性的了解似乎鼓励了避孕套的使用，但对性伴侣的更高选择性以及对避孕套的消极态度是阻碍更安全性行为的最常见动机。这些结果表明，持续的艾滋病教育活动在维持和强化该地区吸毒者此前出现的降低风险趋势方面取得了成功。然而，相当比例的参与者中风险行为持续存在，这凸显了采取额外预防策略的紧迫性，如注射器交换或向少数共用针头者提供注射器，以及提供咨询以鼓励更安全性行为。
