在押女性吸毒者中 HIV 感染的病例对照研究：共用针具和有吸毒性伴侣的影响。

A case-control study of HIV infection among incarcerated female drug users: impact of sharing needles and having drug-using sexual partners.

机构信息

Department of Community Medicine, Taipei City Hospital, Taipei Medical University, Taiwan.

出版信息

J Formos Med Assoc. 2011 Jul;110(7):446-53. doi: 10.1016/S0929-6646(11)60066-1.

Abstract

BACKGROUND/PURPOSE: Taiwan experienced a rapid surge in human immunodeficiency virus (HIV) among injection drug users (IDUs) from 2003 to 2005. The male-to-female ratio of HIV cases decreased from 20:1 in 2003 to 6:1 in 2006. This change is primarily due to increasing numbers of female injection drug users in Taiwan. Our primary objective was to identify the risk factors associated with HIV infection among incarcerated female drug users.

METHODS

A case-control design involved recruitment of all eligible HIV-infected female inmates from all 24 prisons in Taiwan from November to December, 2007. Eligible HIV seronegative controls were chosen within the same prison and matched to the cases by age (within 3 years) and by history of illicit drug use. A subsample of these matches was randomly selected since there were many more eligible controls than HIV-infected cases. An anonymous self-administered questionnaire was completed with assistance from trained research assistants.

RESULTS

A total of 114 cases and 149 control participants were recruited, with a response rate of 82% and 54%. Injectable heroin use was significantly greater (p = 0.02) among HIV-infected cases (93.0%) than un-infected controls (84.6%). Compared to seronegative controls, HIV-infected cases were more likely to share drug paraphernalia and have drug-using sexual partners. Multiple logistic regression analysis revealed that the number of imprisonments (between 2-5 times; OR = 5.23), sharing mainly dilutes (OR= 63.47), and sharing dilutes concurrently with needles (OR= 127.33) significantly predicted HIV seroconversion, after controlling for age and years of education.

CONCLUSION

Sharing needles/dilutes and practicing unsafe intercourse with drug-using sexual partners places female drug users at considerable risk.

摘要

背景/目的：2003 年至 2005 年期间，台湾地区注射吸毒人群（IDUs）中的人类免疫缺陷病毒（HIV）感染迅速增加。HIV 病例的男女比例从 2003 年的 20:1 下降到 2006 年的 6:1。这种变化主要是由于台湾女性注射吸毒者人数的增加。我们的主要目标是确定与台湾女性监禁吸毒者中 HIV 感染相关的危险因素。

方法

采用病例对照设计，于 2007 年 11 月至 12 月期间从台湾地区所有 24 所监狱中招募所有符合条件的 HIV 感染女性囚犯。在同一所监狱内选择合适的 HIV 阴性对照，并根据年龄（3 年内）和非法药物使用史与病例相匹配。由于符合条件的对照者比 HIV 感染病例多得多，因此随机选择了这些匹配者的一个子样本。由经过培训的研究助理协助，完成了匿名的自我管理问卷。

结果

共招募了 114 例病例和 149 例对照者，应答率分别为 82%和 54%。注射海洛因的比例在 HIV 感染病例中明显更高（p = 0.02）（93.0%），而非感染对照者中则较低（84.6%）。与血清阴性对照者相比，HIV 感染病例更有可能共用毒品用具和与吸毒性伴侣发生无保护性行为。多变量逻辑回归分析显示，入狱次数（2-5 次；OR=5.23）、主要混合稀释物（OR=63.47）和同时共用稀释物和针头（OR=127.33）与 HIV 血清转换显著相关，校正年龄和受教育年限后仍有统计学意义。