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加拿大温尼伯市注射吸毒者中与丙型肝炎、乙型肝炎和艾滋病毒现患感染相关的人口统计学、风险行为及个人网络变量

Demographic, risk behaviour and personal network variables associated with prevalent hepatitis C, hepatitis B, and HIV infection in injection drug users in Winnipeg, Canada.

作者信息

Wylie John L, Shah Lena, Jolly Ann M

机构信息

Department of Medical Microbiology, University of Manitoba, Winnipeg, Manitoba, Canada.

出版信息

BMC Public Health. 2006 Sep 13;6:229. doi: 10.1186/1471-2458-6-229.

Abstract

BACKGROUND

Previous studies have used social network variables to improve our understanding of HIV transmission. Similar analytic approaches have not been undertaken for hepatitis C (HCV) or B (HBV), nor used to conduct comparative studies on these pathogens within a single setting.

METHODS

A cross-sectional survey consisting of a questionnaire and blood sample was conducted on injection drug users in Winnipeg between December 2003 and September 2004. Logistic regression analyses were used to correlate respondent and personal network data with HCV, HBV and HIV prevalence.

RESULTS

At the multivariate level, pathogen prevalence was correlated with both respondent and IDU risk network variables. Pathogen transmission was associated with several distinct types of high-risk networks formed around specific venues (shooting galleries, hotels) or within users who are linked by their drug use preferences. Smaller, isolated pockets of IDUs also appear to exist within the larger population where behavioural patterns pose a lesser risk, unless or until, a given pathogen enters those networks.

CONCLUSION

The findings suggest that consideration of both respondent and personal network variables can assist in understanding the transmission patterns of HCV, HBV, and HIV. It is important to assess these effects for multiple pathogens within one setting as the associations identified and the direction of those associations can differ between pathogens.

摘要

背景

以往研究利用社交网络变量来增进我们对艾滋病毒传播的理解。对于丙型肝炎(HCV)或乙型肝炎(HBV),尚未采用类似的分析方法,也未用于在单一环境中对这些病原体进行比较研究。

方法

2003年12月至2004年9月期间,对温尼伯市的注射吸毒者进行了一项横断面调查,包括问卷调查和血样采集。采用逻辑回归分析将受访者及个人网络数据与HCV、HBV和HIV感染率相关联。

结果

在多变量层面,病原体感染率与受访者及注射吸毒者风险网络变量均相关。病原体传播与围绕特定场所(射击馆、酒店)形成的几种不同类型的高风险网络或因吸毒偏好而相互关联的使用者群体有关。在更大的人群中,似乎也存在较小的、孤立的注射吸毒者群体,其行为模式构成的风险较小,除非或直到某种特定病原体进入这些网络。

结论

研究结果表明,考虑受访者及个人网络变量有助于理解HCV、HBV和HIV的传播模式。在单一环境中评估多种病原体的这些影响很重要,因为所确定的关联及这些关联的方向在不同病原体之间可能有所不同。

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