De Prithwish, Cox Joseph, Boivin Jean-Francois, Platt Robert W, Jolly Ann M, Alexander Paul E
Departments of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
Scand J Infect Dis. 2009;41(3):206-14. doi: 10.1080/00365540902721376.
Our objective was to examine the association between HIV and HCV discordant infection status and the sharing of drug equipment by injection drug users (IDUs). IDUs were recruited from syringe exchange and methadone treatment programmes in Montreal, Canada. Characteristics of participants and their injecting partners were elicited using a structured questionnaire. Among 159 participants and 245 injecting partners, sharing of syringes and drug preparation equipment did not differ between concordant or discordant partners, although HIV-positive subjects did not share with HIV-negative injectors. Sharing of syringes was positively associated with discordant HIV status (OR=1.85) and negatively with discordant HCV status (OR=0.65), but both results were not statistically significant. Sharing of drug preparation equipment was positively associated with both discordant HIV (OR=1.61) and HCV (OR=1.18) status, but both results were non-significant. Factors such as large injecting networks, frequent mutual injections, younger age, and male gender were stronger predictors of equipment sharing. In conclusion, IDUs do not appear to discriminate drug equipment sharing partners based at least on their HCV infection status. The results warrant greater screening to raise awareness of infection status, post-test counselling to promote status disclosure among partners, and skill-building to avoid equipment sharing between discordant partners.
我们的目标是研究艾滋病毒和丙型肝炎病毒不一致感染状态与注射吸毒者(IDU)共用吸毒器具之间的关联。IDU是从加拿大蒙特利尔的注射器交换和美沙酮治疗项目中招募的。使用结构化问卷收集参与者及其注射伙伴的特征。在159名参与者和245名注射伙伴中,共用注射器和药物制备器具在感染情况一致或不一致的伙伴之间并无差异,不过艾滋病毒呈阳性的受试者不会与艾滋病毒呈阴性的注射者共用。共用注射器与艾滋病毒感染情况不一致呈正相关(比值比=1.85),与丙型肝炎病毒感染情况不一致呈负相关(比值比=0.65),但这两个结果均无统计学意义。共用药物制备器具与艾滋病毒(比值比=1.61)和丙型肝炎病毒(比值比=1.18)感染情况不一致均呈正相关,但这两个结果也无统计学意义。大型注射网络、频繁相互注射、年龄较小和男性等因素是共用器具更强的预测因素。总之,IDU似乎至少不会根据其丙型肝炎病毒感染状况来区分共用吸毒器具的伙伴。这些结果表明需要加强筛查以提高对感染状况的认识,提供检测后咨询以促进伙伴之间披露感染状况,并开展技能培训以避免感染情况不一致的伙伴之间共用器具。