Tulane University, School of Public Health & Tropical Medicine, Department of International Health & Development, Center for Global Health Equity, New Orleans, LA, USA.
Int J Drug Policy. 2010 Nov;21(6):485-92. doi: 10.1016/j.drugpo.2010.06.001. Epub 2010 Jul 16.
Men who have sex with men and inject drugs (MSM-IDU) are particularly vulnerable to HIV infection and have the potential to transmit HIV across multiple populations through their male and female sexual partners and injection drug-using partners.
Respondent-driven sampling was used to recruit men who reported engaging in anal sex with another man in the past 3 months, aged ≥15 years, and living in Unguja, Zanzibar. Participants responded to a face-to-face interview about their HIV and injecting risk behaviours and were tested for HIV, Hepatitis B (HBV) and C (HCV) and syphilis.
Among the 509 MSM who enrolled in the survey, 14% (n=66) reported injecting drugs in the past 3 months among which 66% used heroin, 60% used a needle after someone else had and 68% passed a needle to someone else after using it. MSM-IDU were significantly more likely to have two or more non-paying male receptive sex partners and to have engaged in group sex in the past month, to have symptoms of a sexually transmitted infection in past 6 months, to have been arrested or beaten in the past 12 months and to be infected with HIV and co-infected with HIV and HCV compared to MSM who did not inject drugs. MSM-IDU were less likely to have used a condom at last sex with a non-paid female partner, to know where to get a confidential HIV test and to have ever been tested for HIV compared to MSM who did not inject drugs.
MSM-IDU, and MSM in general, in Unguja practice multiple high-risk behaviours that put them at risk for blood-borne and sexual transmission of HIV and HCV infection. Targeted interventions for MSM-IDU must account for the overlap of high-risk sexual and drug-using networks and integrate injection drug use and HIV services.
男男性行为者和注射毒品者（MSM-IDU）特别容易感染 HIV，并且有可能通过他们的男性和女性性伴侣以及注射毒品使用者伴侣将 HIV 传播到多个人群。
采用应答者驱动抽样法招募过去 3 个月内与另一名男性发生过肛交、年龄≥15 岁且居住在桑给巴尔 Unguja 的男性。参与者接受了关于 HIV 和注射风险行为的面对面访谈，并接受了 HIV、乙型肝炎（HBV）和丙型肝炎（HCV）以及梅毒检测。
在 509 名参与调查的 MSM 中，14%（n=66）报告在过去 3 个月内注射过毒品，其中 66%使用海洛因，60%使用过他人用过的针头，68%在使用后将针头传递给他人。MSM-IDU 更有可能有两个或更多非付费的男性接受性伴侣，并且在过去一个月内发生过群交，在过去 6 个月内有过性传播感染的症状，在过去 12 个月内被逮捕或被殴打，以及感染 HIV 并同时感染 HIV 和 HCV 的风险明显更高，与未注射毒品的 MSM 相比。MSM-IDU 与未注射毒品的 MSM 相比，在上一次与非付费女性伴侣发生性行为时使用安全套的可能性较低，知道在哪里可以获得保密的 HIV 检测，并且曾经接受过 HIV 检测的可能性也较低。
在 Unguja，MSM-IDU 和一般 MSM 都存在多种高危行为，使他们面临血液传播和性传播 HIV 和 HCV 感染的风险。针对 MSM-IDU 的干预措施必须考虑到高危性行为和吸毒网络的重叠，并将注射吸毒和 HIV 服务整合在一起。
