Tran Thu Minh T, Nguyen Hien T, Yatsuya Hiroshi, Hamajima Nobuyuki, Nishimura Akio, Ito Katsuki
Planning Department, National Institute of Hygiene and Epidemiology, 1 Yersin Hai Ba Trung, Hanoi, Vietnam.
BMC Public Health. 2006 Oct 10;6:248. doi: 10.1186/1471-2458-6-248.
Sufficient targeted HIV prevention activities aiming at reducing HIV transmission within and from an extremely marginalized population of injection drug users (IDUs) must urgently and efficiently be implemented in Vietnam. This study was conducted to facilitate the development of such activities by describing transmission risks of young IDUs and evaluating factors in association with HIV infection.
Thirty clusters were selected from 29 hotspot communes in Long An province by probability proportional to size (PPS) sampling method. The snowball technique was used for enrolling participants in each cluster. The cross-sectional association of factors obtained during direct structured interviews to 248 male IDUs aged 14 to 29 years old and with their HIV test results were examined.
The HIV prevalence among the studied IDUs was 32%. Age range of 18-20 years old, low educational level, sharing injection equipment or injection drug use in the other cities were independently associated with HIV serostatus in the multivariate analysis. Sexual behaviors did not differ between HIV-positive and -negative IDUs. Among HIV seropositive IDUs who had sexual contact with primary (n = 37), casual (n = 6), and commercial (n = 15) partners, only 5.4% (n = 2), 33.3% (n = 2), and 46.7% (n = 7), respectively, responded that they had used condoms every time.
About one-third of young IDUs aged less than 30 identified in the hotspot communes in Long An, Vietnam was found to be infected with HIV, and socio-demographic and injection-related factors might account for the infection risk. Prevailing risky sexual behavior of this extremely marginalized population highlights the need to reduce their high transmission risks as a public health priority.
越南必须紧急且高效地开展足够的针对性艾滋病毒预防活动,以减少在注射吸毒者这一极度边缘化人群内部及其向外传播艾滋病毒的情况。本研究旨在通过描述年轻注射吸毒者的传播风险并评估与艾滋病毒感染相关的因素,来推动此类活动的开展。
采用按规模大小成比例的概率抽样方法(PPS),从隆安省29个热点公社中选取30个群组。在每个群组中使用滚雪球技术招募参与者。对248名年龄在14至29岁的男性注射吸毒者进行直接结构化访谈,获取相关因素,并将这些因素与他们的艾滋病毒检测结果进行横断面关联研究。
在研究的注射吸毒者中,艾滋病毒感染率为32%。在多变量分析中,年龄在18至20岁、教育程度低、共用注射器具或在其他城市注射毒品与艾滋病毒血清学状态独立相关。艾滋病毒阳性和阴性的注射吸毒者之间性行为无差异。在与主要性伴侣(n = 37)、临时性伴侣(n = 6)和商业性伴侣(n = 15)有性接触的艾滋病毒血清阳性注射吸毒者中,分别只有5.4%(n = 2)、33.3%(n = 2)和46.7%(n = 7)表示每次都使用了避孕套。
在越南隆安省热点公社中确定的年龄小于30岁的年轻注射吸毒者中,约三分之一被发现感染了艾滋病毒,社会人口统计学和与注射相关的因素可能是感染风险的原因。这一极度边缘化人群普遍存在的危险性行为凸显了将降低其高传播风险作为公共卫生优先事项的必要性。