Emmanuel Faran, Archibald Chris, Razaque Ali, Sandstrom Paul
HIV/AIDS Surveillance Project, AIDS Block, National Institute of Health, Chak Shehzad, Islamabad, Pakistan.
J Acquir Immune Defic Syndr. 2009 May 1;51(1):85-90. doi: 10.1097/QAI.0b013e31819906f3.
During a routine surveillance round, an extremely high prevalence of 51.3% was found among injecting drug users (IDUs) in Sargodha, a small town in Pakistan. This sharp increase of HIV among this group warranted an urgent need to explore the factors leading toward this explosion of HIV infection among IDUs at this very location to direct the policy makers in designing preventive activities, especially in the context of HIV prevention.
In 2007, 400 current IDUs were recruited through multistage cluster sampling based on mapping studies. Participants provided dried blood spot samples for HIV testing and completed a questionnaire on demographic characteristics and sexual/drug injecting behaviors. Logistic regression was used to examine the independent association of multiple variables with HIV infection.
Of the 400 IDUs tested, 205 (51.3%) were HIV positive confirmed through enzyme-linked immunosorbent assay and Western blot. In multivariate analysis, geographical location of IDUs [adjusted odds ratio (aOR) 2.4 for IDUs located in the northern zone vs southern zone, 95% confidence interval (CI) 1.5 to 3.7], injected in groups (aOR 1.8, 95% CI 1.1 to 3.1), and sharing injecting paraphernalia with other IDUs (aOR 1.5, 95% CI 1.0 to 2.4) were strong correlates of HIV infection.
Effective outreach programs need to be developed to provide a comprehensive package of HIV prevention services to IDUs not reached by existing services, entry into drug abuse treatment and medical care needs to be facilitated, and essential legal and social services need to be provided with community participation.
在一次常规监测巡查中，巴基斯坦小镇萨戈达的注射吸毒者中发现了高达51.3%的极高感染率。该群体中艾滋病毒感染率的急剧上升迫切需要探究导致该地区注射吸毒者中艾滋病毒感染激增的因素，以便指导政策制定者设计预防活动，尤其是在艾滋病毒预防方面。
2007年，基于地图研究通过多阶段整群抽样招募了400名现有的注射吸毒者。参与者提供干血斑样本进行艾滋病毒检测，并完成一份关于人口统计学特征以及性/药物注射行为的问卷。采用逻辑回归分析来检验多个变量与艾滋病毒感染之间的独立关联。
在接受检测的400名注射吸毒者中，有205名（51.3%）通过酶联免疫吸附测定和蛋白质印迹法确诊为艾滋病毒阳性。在多变量分析中，注射吸毒者的地理位置（位于北部地区的注射吸毒者与南部地区相比，调整后的优势比[aOR]为2.4，95%置信区间[CI]为1.5至3.7）、群体注射（aOR为1.8，95%CI为1.1至3.1）以及与其他注射吸毒者共用注射器具（aOR为1.5，95%CI为1.0至2.4）与艾滋病毒感染密切相关。
需要制定有效的外展项目，为现有服务未覆盖的注射吸毒者提供一套全面的艾滋病毒预防服务，促进他们接受药物滥用治疗和医疗护理，并在社区参与下提供必要的法律和社会服务。
