*Center for Global Health, Centers for Disease Control and Prevention, Nairobi, Kenya; †National AIDS and Sexually Transmitted Infection (STI) Programme, Ministry of Health, Nairobi, Kenya; and ‡National Public Health Laboratory Services, Ministry of Health, Nairobi, Kenya.
J Acquir Immune Defic Syndr. 2014 May 1;66 Suppl 1(Suppl 1):S57-65. doi: 10.1097/QAI.0000000000000106.
Unsafe medical injections remain a potential route of HIV transmission in Kenya. We used data from a national survey in Kenya to study the magnitude of medical injection use, medication preference, and disposal of medical waste in the community.
The Kenya AIDS Indicator Survey 2012 was a nationally representative population-based survey. Among participants aged 15-64 years, data were collected regarding medical injections received in the year preceding the interview; blood samples were collected from participants for HIV testing.
Of the 13,673 participants who answered questions on medical injections, 35.9% [95% confidence interval (CI): 34.5 to 37.3] reported receiving ≥1 injection in the past 12 months and 51.2% (95% CI: 49.7 to 52.8) preferred receiving an injection over a pill. Among those who received an injection from a health care provider, 95.9% (95% CI: 95.2 to 96.7) observed him/her open a new injection pack, and 7.4% (95% CI: 6.4 to 8.4) had seen a used syringe or needle near their home or community in the past 12 months. Men who had received ≥1 injection in the past 12 months (adjusted odds ratio, 3.2; 95% CI: 1.2 to 8.9) and women who had received an injection in the past 12 months, not for family planning purposes (adjusted odds ratio, 2.6; 95% CI: 1.2 to 5.5), were significantly more likely to be HIV infected compared with those who had not received medical injection in the past 12 months.
Injection preference may contribute to high rates of injections in Kenya. Exposure to unsafe medical waste in the community poses risks for injury and infection. We recommend that community- and facility-based injection safety strategies be integrated in disease prevention programs.
不安全的医疗注射仍然是肯尼亚艾滋病毒传播的一个潜在途径。我们利用肯尼亚全国调查的数据，研究了社区中医疗注射的使用程度、药物偏好和医疗废物的处理情况。
2012 年肯尼亚艾滋病指标调查是一项具有全国代表性的基于人群的调查。在 15-64 岁的参与者中，收集了在接受采访前一年接受的医疗注射数据；从参与者中采集血液样本进行艾滋病毒检测。
在回答医疗注射问题的 13673 名参与者中，35.9%（95%置信区间：34.5 至 37.3）报告在过去 12 个月内接受了≥1 次注射，51.2%（95%置信区间：49.7 至 52.8）更喜欢接受注射而不是药丸。在那些从医疗保健提供者那里接受注射的人中，95.9%（95%置信区间：95.2 至 96.7）观察到他/她打开了一个新的注射包，7.4%（95%置信区间：6.4 至 8.4）在过去 12 个月内看到过他们家或社区附近使用过的注射器或针头。在过去 12 个月内接受过≥1 次注射的男性（调整后的优势比，3.2；95%置信区间：1.2 至 8.9）和过去 12 个月内接受过注射但不是为了计划生育目的的女性（调整后的优势比，2.6；95%置信区间：1.2 至 5.5）与过去 12 个月内未接受过医疗注射的人相比，感染艾滋病毒的风险显著更高。
注射偏好可能导致肯尼亚注射率较高。社区中不安全的医疗废物暴露会造成受伤和感染的风险。我们建议将社区和医疗机构为基础的注射安全策略纳入疾病预防计划中。
