Kermode Michelle, Armstrong Greg, Medhi Gajendra Kumar, Humtsoe Chumben, Langkham Biangtung, Mahanta Jagadish
Nossal Institute for Global Health, University of Melbourne, Level 4, 161 Barry St, Carlton, Victoria, 3010, Australia.
Regional Medical Research Centre, Indian Council for Medical Research, Post Box No.105, Dibrugarh, 786001, Assam, India.
Harm Reduct J. 2015 Mar 4;12:4. doi: 10.1186/s12954-015-0038-1.
Promoting safer sex behaviours among people who inject drugs is important as drug-using populations with high HIV prevalence can contribute to transition from a concentrated to a generalised epidemic. This study describes the sexual behaviours of men who inject drugs in two Northeast Indian states (Manipur and Nagaland) where HIV prevalence is high, with a focus on the HIV risks for their regular female sexual partners.
Data were obtained from two cross-sectional surveys combined (N = 3,362)-both conducted in 2009 using respondent-driven sampling to recruit men who injected drugs. Both surveys asked about demographics, drug use, sexual and injecting risk behaviours, and interventions. One survey tested participants for HIV and syphilis. Statistical analyses included logistic regression modelling to predict inconsistent condom use with regular sexual partners.
Two thirds of participants (68.2%) had a regular female sexual partner. Of these, 78.4% had sex with their regular partner in the last month, on average five times. Only 10.7% reported consistent condom use with regular partners. Unsafe injecting was common among men with regular partners, and 40.2% had more than one sexual partner in the last year. Half of those with regular partners (51.0%) had never had an HIV test, and 14.3% of those tested were HIV positive. After controlling for confounding, inconsistent condom use with regular partners was associated with being illiterate, married, sharing needle and syringe with others, never having had an HIV test and not receiving condoms from an NGO.
The findings from this study among men who inject drugs in Manipur and Nagaland highlight the risk of HIV infection for their regular female sexual partners. Promoting better uptake of HIV testing among men who inject drugs will potentially benefit both them and their regular partners. While effectively reaching regular partners is challenging, a number of strategies for improving their situation in relation to HIV prevention are available.
在注射吸毒人群中推广更安全的性行为很重要，因为艾滋病毒高流行率的吸毒人群可能会促使疫情从集中流行转变为广泛流行。本研究描述了印度东北部两个邦（曼尼普尔邦和那加兰邦）注射吸毒男性的性行为，这些地区艾滋病毒流行率很高，重点关注其固定女性性伴侣的艾滋病毒感染风险。
数据来自2009年进行的两项合并的横断面调查（N = 3362），均采用应答驱动抽样法招募注射吸毒男性。两项调查都询问了人口统计学、吸毒情况、性和注射风险行为以及干预措施。一项调查对参与者进行了艾滋病毒和梅毒检测。统计分析包括逻辑回归建模，以预测与固定性伴侣不一致使用避孕套的情况。
三分之二的参与者（68.2%）有固定的女性性伴侣。其中，78.4%的人在上个月与固定伴侣发生过性行为，平均五次。只有10.7%的人报告与固定伴侣始终坚持使用避孕套。在有固定伴侣的男性中，不安全注射很常见，40.2%的人在过去一年中有不止一个性伴侣。有固定伴侣的人中有一半（51.0%）从未接受过艾滋病毒检测，检测者中有14.3%艾滋病毒呈阳性。在控制混杂因素后，与固定伴侣不一致使用避孕套与文盲、已婚、与他人共用针头和注射器、从未接受过艾滋病毒检测以及未从非政府组织获得避孕套有关。
本研究在曼尼普尔邦和那加兰邦注射吸毒男性中的调查结果突出了其固定女性性伴侣感染艾滋病毒的风险。促进注射吸毒男性更好地接受艾滋病毒检测可能会使他们及其固定伴侣都受益。虽然有效接触到固定伴侣具有挑战性，但有一些改善他们在艾滋病毒预防方面状况的策略。
