Strathdee Steffanie A, Lozada Remedios, Pollini Robin A, Brouwer Kimberly C, Mantsios Andrea, Abramovitz Daniela A, Rhodes Tim, Latkin Carl A, Loza Oralia, Alvelais Jorge, Magis-Rodriguez Carlos, Patterson Thomas L
Division of International Health and Cross Cultural Medicine, University of California San Diego School of Medicine, La Jolla, CA 92093, USA.
J Acquir Immune Defic Syndr. 2008 Mar 1;47(3):369-76. doi: 10.1097/QAI.0b013e318160d5ae.
We examined correlates of HIV infection among injection drug users (IDUs) in Tijuana, Mexico, a city bordering the United States, which is situated on major migration and drug trafficking routes.
IDUs aged > or =18 years were recruited using respondent-driven sampling. Participants underwent antibody testing for HIV and syphilis and structured interviews. Weighted logistic regression identified correlates of HIV infection.
Of 1056 IDUs, the median age was 37 years, 86% were male, and 76% were migrants. HIV prevalence was higher in female participants than in male participants (8% vs. 3%; P = 0.01). Most IDUs testing HIV-positive were previously unaware of their serostatus (93%). IDUs reported injecting with a median of 2 people in the prior 6 months and had been arrested for having injection stigmata (ie, "track-marks") a median of 3 times. Factors independently associated with HIV infection were being female, syphilis titers consistent with active infection, larger numbers of recent injection partners, living in Tijuana for a shorter duration, and being arrested for having track-marks.
Individual, social, and environmental factors were independently associated with HIV infection among IDUs in Tijuana. These findings suggest the need to intervene not solely on individual risk behaviors but on social processes that drive these behaviors, including problematic policing practices.
我们调查了墨西哥蒂华纳市注射吸毒者（IDU）中艾滋病毒感染的相关因素。蒂华纳市与美国接壤，位于主要移民和贩毒路线上。
采用应答者驱动抽样招募年龄≥18岁的注射吸毒者。参与者接受了艾滋病毒和梅毒抗体检测以及结构化访谈。加权逻辑回归确定了艾滋病毒感染的相关因素。
在1056名注射吸毒者中，年龄中位数为37岁，86%为男性，76%为移民。女性参与者的艾滋病毒感染率高于男性参与者（8%对3%；P = 0.01）。大多数艾滋病毒检测呈阳性的注射吸毒者此前并不知道自己的血清学状态（93%）。注射吸毒者报告在过去6个月中平均与2人一起注射，并且因有注射痕迹（即“针眼”）而被捕的中位数为3次。与艾滋病毒感染独立相关的因素包括女性、梅毒滴度与活动性感染一致、近期注射伙伴数量较多、在蒂华纳居住时间较短以及因有针眼而被捕。
个体、社会和环境因素与蒂华纳市注射吸毒者中的艾滋病毒感染独立相关。这些发现表明不仅需要干预个体风险行为，还需要干预驱动这些行为的社会过程，包括有问题的治安做法。
