Liao Meizhen, Kang Dianmin, Tao Xiaorun, Cox Catherine, Qian Yuesheng, Wang Guoyong, Yang Cui, Zhu XiaoYan, Zhang Na, Bi Zhenqiang, Jia Yujiang
Institution for AIDS/STD Control and Prevention & Shandong Key Laboratory for Epidemic Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province 250014, P R China.
BMC Public Health. 2014 Feb 17;14:172. doi: 10.1186/1471-2458-14-172.
An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China.
A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection.
Of 805 eligible participants, 0.2% were infected with HIV, 3.7% with HCV, and 9.6% with syphilis. Of the participants, 96.6% were methamphetamine users, 11.9% reported ever having used ≥2 types of these drugs, and 11.4% reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95% CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95% CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95% CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95% CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95% CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95% CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95% CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95%CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95% CI:2.4-7.4).
Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.
近年来，中国一些城市出现了俱乐部毒品使用量激增的现象，尤其是甲基苯丙胺，它正迅速取代海洛因，成为全国范围内分布最广的毒品。本研究调查了中国东部沿海两个城市吸毒者使用的毒品类型、梅毒和丙型肝炎病毒（HCV）感染情况，以及梅毒、HCV感染和无保护商业性行为的相关因素。
2010年进行的一项横断面调查提供了吸毒者的人口统计学信息、性和吸毒行为、艾滋病知识以及干预服务的利用情况。采集血样检测HIV、梅毒和HCV感染情况。
在805名符合条件的参与者中，0.2%感染了HIV，3.7%感染了HCV，9.6%感染了梅毒。参与者中，96.6%是甲基苯丙胺使用者，11.9%报告曾使用过≥2种此类毒品，11.4%报告曾注射过毒品。在多变量逻辑回归分析中，感染梅毒的参与者更可能为女性（调整后的优势比（AOR）=2.8，95%置信区间（CI）：1.2 - 6.5），在过去12个月内有过商业性行为（AOR = 2.0，95% CI：1.0 - 3.9），感染HCV（AOR = 12.1，95% CI：4.1 - 20.3），且在过去12个月内与固定性伴侣发生性行为的可能性较小（AOR = 0.2，95% CI：0.1 - 0.6）。感染HCV的参与者更可能曾注射过毒品（AOR = 2.7，95% CI：1.1 - 6.5）且感染梅毒（AOR = 8.0，95% CI：3.5 - 18.0）。在最近一次性接触中与商业性伴侣发生无保护性行为的参与者更可能为女性（AOR = 2.9，95% CI：1.7 - 4.9），接受过初中及以下教育（AOR = 3.4，95% CI：2.0 - 5.5），在过去一年中从未接受过干预（AOR = 2.1，95% CI：1.2 - 3.6），且感染梅毒（AOR = 4.2，95% CI：2.4 - 7.4）。
甲基苯丙胺是吸毒者使用的主要毒品，梅毒和HCV感染率高得惊人，无保护商业性行为在该群体中很常见。研究结果凸显了针对该群体中与性和吸毒相关的危险行为进行有效、多方面干预的必要性。需要进一步研究以更好地理解这些共病的因果途径。
