Xia Ying-Hua, Chen Wen, Tucker Joseph D, Wang Charles, Ling Li
Faculty of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, No, 74, Zhongshan Road II, Yuexiu District, Guangzhou 510080, P,R, China.
BMC Public Health. 2013 Sep 30;13:899. doi: 10.1186/1471-2458-13-899.
HIV and hepatitis C (HCV) co-infection is highly common among Chinese injection drug users but it is difficult to reach IDUs at traditional VCT (Voluntary HIV counseling treatment) clinics. A new national model integrating HIV/HCV testing with methadone maintenance treatment was started in 2006. The purpose of this study was to investigate HIV and HCV test uptake and associated factors at methadone clinics in Guangdong Province, China.
A cross-sectional design using routine surveillance data and laboratory testing confirmation was applied to determine rates of HIV and HCV test uptake. Multi-level modeling was used to examine individual-level and clinic-level correlates of increased test uptake.
45 out of 49 methadone clinics in Guangdong Province agreed to participate in the study. Among all 13,270 individuals, 10,046 (75.7%) had HIV test uptake and 10,404 (78.4%) had HCV uptake. At the individual level, methadone clients 30 years or older were more likely to have HIV and HCV test uptake (p <0.001 for both). At the clinic level, methadone clinics with greater health care personnel were more likely to have HIV (p = 0.01) and HCV (p = 0.044) test uptake. HIV test uptake significantly correlated with HCV test uptake (correlation coefficient = 0.64).
Methadone clinics provide an opportunity for routine integrated HIV and HCV screening among drug users in China. Increased test uptake in young drug users and increased health care personnel at clinics may further improve screening.
在中国，艾滋病毒（HIV）与丙型肝炎病毒（HCV）合并感染在注射吸毒者中极为常见，但在传统的自愿咨询检测（VCT）诊所难以接触到这些注射吸毒者。2006年启动了一项将HIV/HCV检测与美沙酮维持治疗相结合的新的全国性模式。本研究旨在调查中国广东省美沙酮诊所的HIV和HCV检测接受情况及相关因素。
采用横断面设计，利用常规监测数据和实验室检测确认来确定HIV和HCV检测接受率。采用多层次模型来检验检测接受率增加的个体层面和诊所层面的相关因素。
广东省49家美沙酮诊所中有45家同意参与本研究。在所有13270名个体中，10046人（75.7%）接受了HIV检测，10404人（78.4%）接受了HCV检测。在个体层面，30岁及以上的美沙酮治疗患者更有可能接受HIV和HCV检测（两者p均<0.001）。在诊所层面，医护人员更多的美沙酮诊所更有可能接受HIV检测（p = 0.01）和HCV检测（p = 0.044）。HIV检测接受率与HCV检测接受率显著相关（相关系数 = 0.64）。
美沙酮诊所为中国吸毒者进行常规的HIV和HCV联合筛查提供了机会。提高年轻吸毒者的检测接受率以及增加诊所的医护人员可能会进一步改善筛查情况。
