HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
Lancet. 2010 Aug 7;376(9739):458-74. doi: 10.1016/S0140-6736(10)60753-2.
Amphetamine-group substances are used worldwide and are more prevalent than either cocaine or opioids. We reviewed published reports about amphetamine-group substances and did a meta-analysis of randomised controlled trials of behavioural interventions for their use. Most research was done in developed countries. Many, but not all, studies show an association between amphetamine-group substance use and risk of HIV infection. Much use of amphetamine-group substances is non-injection and is associated with increased HIV risk, particularly in men who have sex with men. The structural, social, interpersonal, and personal factors that link to amphetamine-group substance use and HIV risk are poorly understood. 13 studies, with a cumulative sample size of 1997 individuals, qualified for the meta-analysis. Overall, high-intensity behavioural interventions were moderately effective in reducing use of amphetamine-group substances (effect size 0.28, 95% CI 0.13-0.44). We did not find conclusive evidence that behavioural interventions as a group are more effective than are passive or minium treatment for reduction of amphetamine-group substance use or sexual risk behaviours. The search for effective, scalable, and sustainable interventions for amphetamine-group substance use, including pharmacotherapies, should be supported and encouraged.
苯丙胺类物质在全球范围内被使用，且其流行程度超过可卡因或阿片类药物。我们对已发表的关于苯丙胺类物质的报告进行了综述，并对其使用的行为干预措施的随机对照试验进行了荟萃分析。大多数研究是在发达国家进行的。许多（但不是全部）研究表明，苯丙胺类物质的使用与艾滋病毒感染的风险之间存在关联。许多苯丙胺类物质的使用是非注射性的，与艾滋病毒风险增加有关，尤其是与男性发生性关系的男性。将苯丙胺类物质的使用与艾滋病毒风险联系起来的结构、社会、人际和个人因素还了解甚少。有 13 项研究，累计样本量为 1997 人，符合荟萃分析的条件。总体而言，高强度的行为干预措施在减少苯丙胺类物质使用方面是中等有效的（效果大小 0.28，95%CI 0.13-0.44）。我们没有发现确凿的证据表明，作为一个群体的行为干预措施比被动或最低限度的治疗更能有效减少苯丙胺类物质的使用或性风险行为。应该支持和鼓励寻找有效的、可扩展的和可持续的苯丙胺类物质使用干预措施，包括药物治疗。
