Gyarmathy V Anna, Neaigus Alan, Li Nan, Ujhelyi Eszter, Caplinskiene Irma, Caplinskas Saulius, Latkin Carl A
European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal.
Scand J Infect Dis. 2011 Jan;43(1):32-42. doi: 10.3109/00365548.2010.513064. Epub 2010 Sep 15.
The aim of this study was to assess the prevalence and correlates of disclosure to network members of being hepatitis C virus (HCV)- or human immunodeficiency virus (HIV)-infected among injecting dyads of infected injection drug users (IDUs) in Budapest, Hungary and Vilnius, Lithuania,. Multivariate generalized estimating equations (GEE) were used to assess associations. Very strong infection disclosure norms exist in Hungary, and HCV disclosure was associated with using drugs and having sex within the dyad. Non-ethnic Russian IDUs in Lithuania were more likely to disclose HCV infection to non-Roma, emotionally close and HCV-infected network members, and to those with whom they shared cookers, filters, drug solutions or rinse water or got used syringes from, and if they had fewer non-IDU or IDU network members. Ethnic Russian Lithuanian IDUs were more likely to disclose HCV if they had higher disclosure attitude and knowledge scores, 'trusted' network members, and had lower non-injecting network density and higher injecting network density. HIV-infected Lithuanian IDUs were more likely to disclose to 'trusted' network members. Disclosure norms matched disclosure behaviour in Hungary, while disclosure in Lithuania to 'trusted' network members suggests possible stigmatization. Ongoing free and confidential HCV/HIV testing services for IDUs are needed to emphasize and strengthen disclosure norms, and to decrease stigma.
本研究的目的是评估匈牙利布达佩斯和立陶宛维尔纽斯受感染注射吸毒者(IDU)注射二元组中,向网络成员披露丙型肝炎病毒(HCV)或人类免疫缺陷病毒(HIV)感染情况的患病率及其相关因素。采用多变量广义估计方程(GEE)来评估关联性。匈牙利存在非常强烈的感染披露规范,并且HCV披露与在二元组内吸毒和发生性行为有关。立陶宛非俄罗斯族IDU更有可能向非罗姆人、情感亲密且感染HCV的网络成员,以及与他们共用炊具、过滤器、毒品溶液或冲洗水或从其处获得用过的注射器的人披露HCV感染情况,并且如果他们的非IDU或IDU网络成员较少。立陶宛俄罗斯族IDU如果具有更高的披露态度和知识得分、“信任”网络成员,并且非注射网络密度较低且注射网络密度较高,则更有可能披露HCV感染情况。感染HIV的立陶宛IDU更有可能向“信任”的网络成员披露。在匈牙利,披露规范与披露行为相符,而立陶宛向“信任”网络成员的披露表明可能存在污名化现象。需要为IDU持续提供免费且保密的HCV/HIV检测服务,以强调和强化披露规范,并减少污名化。