Dumchev Kostyantyn V, Soldyshev Ruslan, Qian Han-Zhu, Zezyulin Olexandr O, Chandler Susan D, Slobodyanyuk Pavel, Moroz Larisa, Schumacher Joseph E
Division of Preventive Medicine, Department of Medicine, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Harm Reduct J. 2009 Aug 23;6:23. doi: 10.1186/1477-7517-6-23.
Ukraine has experienced an increase in injection drug use since the 1990s. An increase in HIV and hepatitis C virus infections has followed, but not measures of prevalence and risk factors. The purposes of this study are to estimate the prevalence of HIV, HCV, and co-infection among injection drug users (IDUs) in central Ukraine and to describe risk factors for HIV and HCV.
A sample of 315 IDUs was recruited using snowball sampling for a structured risk interview and HIV/HCV testing (81.9% male, 42% single, average age 28.9 years [range = 18 to 55]).
HIV and HCV antibodies were detected in 14.0% and 73.0%, respectively, and 12.1% were seropositive for both infections. The most commonly used drug was hanka, home-made from poppy straw and often mixed with other substances including dimedrol, diazepines, and hypnotics. The average period of injecting was 8.5 years; 62.5% reported past-year sharing needles or injection equipment, and 8.0% shared with a known HIV-positive person. More than half (51.1%) reported multiple sexual partners, 12.9% buying or selling sex, and 10.5% exchanging sex and drugs in the past year. Those who shared with HIV positive partners were 3.4 times more likely to be HIV positive than those who did not. Those who front- or back-loaded were 4 times more likely to be HCV positive than those who did not.
Harm reduction, addiction treatment and HIV prevention programs should address risk factors to stop further spread of both HIV and HCV among IDUs and to the general population in central Ukraine.
自20世纪90年代以来，乌克兰注射吸毒现象呈上升趋势。随之而来的是艾滋病毒和丙型肝炎病毒感染率上升，但缺乏患病率和风险因素的相关数据。本研究旨在估计乌克兰中部注射吸毒者（IDU）中艾滋病毒、丙型肝炎病毒（HCV）感染率及合并感染率，并描述艾滋病毒和丙型肝炎病毒的风险因素。
采用雪球抽样法招募了315名注射吸毒者，进行结构化风险访谈和艾滋病毒/丙型肝炎病毒检测（81.9%为男性，42%为单身，平均年龄28.9岁[范围为18至55岁]）。
分别在14.0%和73.0%的研究对象中检测到艾滋病毒和丙型肝炎病毒抗体，12.1%的研究对象两种感染血清学均呈阳性。最常用的毒品是hanka，由罂粟秸秆自制，常与其他物质混合，包括苯海拉明、二氮卓类药物和催眠药。平均注射时间为8.5年；62.5%的研究对象报告过去一年共用过针头或注射设备，8.0%的研究对象与已知艾滋病毒呈阳性的人共用过。超过一半（51.1%）的研究对象报告过去一年有多个性伴侣，12.9%的研究对象有买卖性行为，10.5%的研究对象在过去一年有性与毒品交易行为。与艾滋病毒呈阳性伴侣共用过的研究对象感染艾滋病毒的可能性是未共用过的研究对象的3.4倍。有推注或回抽行为的研究对象感染丙型肝炎病毒的可能性是没有此类行为的研究对象的4倍。
减少伤害、成瘾治疗和艾滋病毒预防项目应针对风险因素，以阻止艾滋病毒和丙型肝炎病毒在乌克兰中部注射吸毒者及普通人群中进一步传播。
