Caiaffa Waleska Teixeira, Bastos Francisco I, Freitas Lívia Leite de, Mingoti Sueli Aparecida, Proietti Fernando Augusto, Carneiro-Proietti Anna Bárbara, Gandolfi Denise, Doneda Denise
Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
Cad Saude Publica. 2006 Apr;22(4):771-82. doi: 10.1590/s0102-311x2006000400016. Epub 2006 Apr 5.
This study assessed 1,144 Brazilian injecting drug users (IDUs) recruited on the street through outreach syringe exchange programs by two multi-center cross-sectional studies: 287 IDUs were recruited during the AjUDE-Brasil I Project and 857 during the AjUDE-Brasil II Project. IDU characteristics related to drug use and sexual behavior, and legal and health conditions for the two studies were compared, using decision tree and logistic regression for each individual study, with HIV infection as the outcome. Fifty-two percent of IDUs were HIV-infected in AjUDE I versus 36.5% in AjUDE II. In both studies, HIV infection was independently associated with: mean background HIV prevalence for each site (OR = 2.17; 10.66), HCV seropositive status (OR = 19.79; 15.48), and men who reported ever having sex with other men (OR = 2.10; 2.09). Incarceration (OR = 1.41) and 8 or more years of injecting drug (OR = 2.13) were also associated with HIV in AjUDE II. The high HIV infection rates and high prevalence of both parenteral and sexual risk behaviors in the context of syringe-exchange programs are of great concern and demand thorough surveillance and renewed prevention strategies.
本研究通过两项多中心横断面研究，对1144名通过外展注射器交换项目在街头招募的巴西注射吸毒者（IDU）进行了评估：在阿朱德 - 巴西I项目中招募了287名IDU，在阿朱德 - 巴西II项目中招募了857名。以HIV感染为结果，使用决策树和逻辑回归对每个单独研究中与吸毒和性行为相关的IDU特征以及两项研究的法律和健康状况进行了比较。在阿朱德I项目中，52%的IDU感染了HIV，而在阿朱德II项目中这一比例为36.5%。在两项研究中，HIV感染均与以下因素独立相关：每个地点的平均背景HIV流行率（OR = 2.17；10.66）、HCV血清阳性状态（OR = 19.79；15.48）以及报告曾与其他男性发生性行为的男性（OR = 2.10；2.09）。在阿朱德II项目中，监禁（OR = 1.41）和8年或更长时间的注射吸毒（OR = 2.13）也与HIV感染相关。在注射器交换项目背景下，HIV高感染率以及经注射和性行为传播的高风险行为发生率令人高度担忧，需要进行全面监测并更新预防策略。
