Pines Heather A, Rusch Melanie L, Vera Alicia, Rangel Gudelia, Magis-Rodriguez Carlos, Strathdee Steffanie A
Division of Global Public Health, Department of Medicine, University of California, San Diego, CA, USA
University of Victoria, School of Public Health and Social Policy, Victoria, BC, Canada Vancouver Island Health Authority, Victoria, BC, Canada.
Int J STD AIDS. 2015 Dec;26(14):1022-7. doi: 10.1177/0956462414568394. Epub 2015 Jan 22.
Given that syphilis is associated with HIV infection among people who inject drugs (PWID), we examined syphilis incidence among PWID in Tijuana, Mexico. From 2006 to 2007, 940 PWID (142 women and 798 men) were recruited via respondent-driven sampling and followed for 18 months. At semi-annual visits, participants were tested for syphilis and completed surveys, which collected information on socio-demographics, sexual behaviours, substance use and injection behaviours. Poisson regression was used to estimate syphilis incidence rates (IRs), incidence rate ratios (IRRs) and 95% confidence intervals (CIs). Twenty-one participants acquired syphilis during follow-up (IR = 1.57 per 100 person-years, 95% CI: 1.02-2.41). In a multivariate analysis, syphilis incidence was higher among women (IRR = 3.90, 95% CI: 1.37-11.09), HIV-positive participants (IRR = 4.60, 95% CI: 1.58-13.39) and those who reported ever exchanging sex for drugs, money, or other goods (IRR = 2.74, 95% CI: 0.97-7.76), while syphilis incidence was lower among those living in Tijuana for a longer duration (IRR = 0.95 per year, 95% CI: 0.91-1.00) and those reporting at least daily injection drug use (past 6 months) (IRR = 0.22, 95% CI: 0.09-0.54). Our findings suggest interventions that address the destabilising conditions associated with migration and integrate sexual and drug-related risk reduction strategies may help reduce syphilis incidence among PWID along the Mexico-US border.
鉴于梅毒与注射毒品者（PWID）中的艾滋病毒感染有关，我们调查了墨西哥蒂华纳市注射毒品者中的梅毒发病率。2006年至2007年，通过应答者驱动抽样招募了940名注射毒品者（142名女性和798名男性），并对其进行了18个月的随访。在半年一次的访视中，对参与者进行梅毒检测并完成调查问卷，收集有关社会人口统计学、性行为、物质使用和注射行为的信息。采用泊松回归估计梅毒发病率（IR）、发病率比（IRR）和95%置信区间（CI）。21名参与者在随访期间感染了梅毒（IR = 每100人年1.57例，95% CI：1.02 - 2.41）。在多变量分析中，梅毒发病率在女性中较高（IRR = 3.90，95% CI：1.37 - 11.09）、艾滋病毒阳性参与者中较高（IRR = 4.60，95% CI：1.58 - 13.39）以及那些报告曾以性交易换取毒品、金钱或其他物品的人中较高（IRR = 2.74，95% CI：0.97 - 7.76），而梅毒发病率在居住在蒂华纳时间较长的人中较低（IRR = 每年0.95例，95% CI：0.91 - 1.00）以及那些报告至少每天注射毒品（过去6个月）的人中较低（IRR = 0.22，95% CI：0.09 - 0.54）。我们的研究结果表明，针对与移民相关的不稳定状况并整合性和毒品相关风险降低策略的干预措施，可能有助于降低墨西哥 - 美国边境沿线注射毒品者中的梅毒发病率。
