Wang Changhe, Rou Keming, Pang Lin, Luo Wei, Cao Xiaobin, He Lin, Zhang Huan, Wu Zunyou
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prenvention, Beijing 102206, China.
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prenvention, Beijing 102206, China; School of Public Health, Anhui Medical University.
Zhonghua Liu Xing Bing Xue Za Zhi. 2014 Apr;35(4):417-20.
To explore the routes and factors associated with HIV new infection of heroin addicts who had been attending the methadone maintenance treatment (MMT) program.
A 1 : 1 nested case-control study was implemented with the cases (new HIV infections) and controls (HIV negative) selected from the treatment cohort of China MMT clients. Questionnaire was developed to collect information on demographic characters, behaviours on drug use, sexual behaviour, daily dosage of methadone intake, adherence to MMT, and psychological problems. Univariate analysis and multivariate condition logistic regression were used to identify factors associated with HIV infection.
108 (54 paired) clients on MMT were recruited, with 76 males and 32 females. Among them, 95 were Han Chinese and 13 were minorities, with average time of drug use as 12.1 ± 5.0 years. Among 54 new HIV infections, 33 were infected through sharing needles, 12 were through sexual contact and 9 unidentified. Results from multivariate condition logistic regression indicated that having longer duration of heroin use before on MMT (More than 10 years vs. less than 10 years,OR = 20.9, 95% CI:1.62-269.34, P = 0.02), shared needles in the last 6 months (OR = 276.7, 95%CI:5.65-> 999.99, P < 0.01) were risk factors while better adherence (More than 0.5 vs. less than 0.5,OR = 0.07, 95%CI:0.42-0.87, P = 0.04) and living with families (OR = 0.002, 95% CI:0.001-0.94, P < 0.01) were protective factors.
Sharing needles was the main route of HIV new infection among those clients that were on MMT. Factors as having received more support from both family and community, improvement of adherence to MMT, reducing the frequency of injection etc., could reduce the risk of HIV infection among those MMT clients.
探讨参加美沙酮维持治疗（MMT）项目的海洛因成瘾者感染新型艾滋病毒的途径及相关因素。
采用1:1巢式病例对照研究，病例（新发艾滋病毒感染）和对照（艾滋病毒阴性）选自中国MMT项目的治疗队列。设计问卷以收集有关人口统计学特征、吸毒行为、性行为、美沙酮每日摄入量、MMT依从性和心理问题的信息。采用单因素分析和多因素条件逻辑回归来确定与艾滋病毒感染相关的因素。
招募了108名接受MMT治疗的患者（54对），其中男性76名，女性32名。其中，汉族95名，少数民族13名，平均吸毒时间为12.1±5.0年。在54例新发艾滋病毒感染中，33例通过共用针头感染，12例通过性接触感染，9例感染途径不明。多因素条件逻辑回归结果表明，MMT治疗前使用海洛因时间较长（超过10年与少于10年，OR=20.9，95%CI：1.62-269.34，P=0.02）、在过去6个月内共用针头（OR=276.7，95%CI：5.65->999.99，P<0.01）是危险因素，而依从性较好（大于0.5与小于0.5，OR=0.07，95%CI：0.42-0.87，P=0.04）和与家人同住（OR=0.002，95%CI：0.001-0.94，P<0.01）是保护因素。
共用针头是接受MMT治疗的患者感染新型艾滋病毒的主要途径。家庭和社区给予更多支持、提高MMT依从性、减少注射频率等因素可降低MMT患者感染艾滋病毒的风险。
