School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, China; State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Zaozhuang Center for Disease Control and Prevention, Zaozhuang, Shandong 277101, China.
Chin Med J (Engl). 2013;126(8):1517-21.
Following the increased human immunodeficiency virus (HIV) notification (infection) rates via sexual transmission and increased abuse of new synthetic drugs instead of heroin in China, a study on HIV infections and risk factors among synthetic drugs and heroin users in Beijing was conducted to provide a cue for further development of targets and strategies of HIV/AIDS control and prevention for different drug populations.
A total of 428 subjects including 224 heroin users and 204 new synthetic drug users was recruited from communities in Beijing by convenience sampling. A χ(2) test was used to compare HIV and syphilis infections between the two subpopulations. Logistic regression models were used to evaluate factors related to HIV, syphilis infections and abuse of synthetic drugs.
Unbalanced distributions of demographics were detected between the two subpopulations. Compared with heroin users, most users of synthetic drugs were migrants, single and of younger age (age ≤ 30 years). Ten HIV infections and twenty-four syphilis infections were confirmed among 428 subjects. No significant difference in HIV infection was found between the two subpopulations (crude odds ratio (OR) = 0.46, 95% confidence interval (CI): 0.07 - 15.80 and adjusted odds ratio (AOR) = 1.26, 95%CI: 0.09 - 18.28) while four times as many syphilis infections were identified among users of synthetics drugs (AOR = 3.92, 95%CI: 1.06 - 14.56). HIV and syphilis infections appeared to work synergistically. The migrants who were of Han ethnicity, single and who had stayed in Beijing for more than six months were more likely to abuse synthetics drugs.
The new synthetic drug users and heroin users are different subpopulations. We optimistically speculate that HIV has not yet been introduced into the former in Beijing, but considering higher syphilis infections in synthetic drug users and the role of syphilis in HIV infection, synthetic drug users, as a possible and important driver of the HIV/AIDS epidemic in Beijing, should be paid more attention in HIV prevention and control strategies.
在中国,经性途径传播的人类免疫缺陷病毒(HIV)通报(感染)率不断上升,滥用新型合成毒品的情况也日益增多,而非海洛因,因此在北京开展了一项关于新型合成毒品和海洛因使用者中 HIV 感染和相关危险因素的研究,为不同毒品人群的 HIV/AIDS 防控目标和策略的进一步制定提供线索。
采用方便抽样法,从北京市社区中招募了 428 名研究对象,包括 224 名海洛因使用者和 204 名新型合成毒品使用者。采用卡方检验比较两个亚组人群中的 HIV 和梅毒感染情况。采用 logistic 回归模型评估与 HIV、梅毒感染和滥用新型合成毒品相关的因素。
两个亚组人群的人口统计学特征分布不均衡。与海洛因使用者相比,新型合成毒品使用者大多为流动人口、单身且年龄较轻(≤30 岁)。在 428 名研究对象中,共确诊 10 例 HIV 感染和 24 例梅毒感染。两个亚组人群的 HIV 感染率无显著差异(粗比值比(OR)=0.46,95%置信区间(CI):0.07-15.80;调整比值比(AOR)=1.26,95%CI:0.09-18.28),而新型合成毒品使用者的梅毒感染率则高出四倍(AOR=3.92,95%CI:1.06-14.56)。HIV 和梅毒感染似乎具有协同作用。汉族、单身且在北京居住时间超过 6 个月的流动人口更有可能滥用新型合成毒品。
新型合成毒品使用者和海洛因使用者是不同的亚组人群。我们乐观地推测,HIV 尚未在北京市的前者中传播,但考虑到新型合成毒品使用者的梅毒感染率较高,以及梅毒在 HIV 感染中的作用,新型合成毒品使用者作为北京市 HIV/AIDS 流行的一个可能且重要的驱动因素,应在 HIV 预防和控制策略中得到更多关注。