Shahesmaeili Armita, Haghdoost Ali Akbar, Soori Hamid
PhD Candidate, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran AND Regional Knowledge Hub AND WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Professor, Department of Epidemiology, School of Public Health, Regional Knowledge Hub AND WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.
Addict Health. 2015 Winter-Spring;7(1-2):1-13.
Despite the implementation of harm reduction program, some injecting drug users (IDU) continue to engage in high-risk behaviors. It seems that there are some social factors that contribute to risk of human immunodeficiency virus (HIV) transmission in IDUs. The aim of this study was to analysis the social network of IDUs and examines the effect of network location on HIV transmission risk using the multiple membership multilevel models.
From October 2013 to March 2014 we conducted face-to-face interviews on 147 IDUs. We asked participants to nominate up to 20 people whom they had more than causal contact with them during the last month and specify if each nominee is drug injector or not. We defined four Network locations as Core and Peripheries of main components. The risk of HIV transmission for each individual was measured based on 7 items scale. We applied Multiple Membership Multilevel Linear Regression analysis to examine the relationship between network location and HIV transmission risk. We used Stata and UCINET software's for the analysis of data.
The mean age of participants was 37 ± 9.32. Most of the individuals were male, single and educated up to guidance school. Being a core member of the main component as like as being a member of other small components in comparison with Isolates/unlinked significantly increased the HIV Transmission risk. Engagement in methadone maintenance therapies (MMT) was associated with a decrease in HIV transmission score.
Network analysis is a useful guide to find the most influential members of IDUs network and may have a complementary role for harm reduction program. The efficacy of interventions programs can be reinforced by addressing them to core individuals within the network. Furthermore, it provides the harm reduction staff to find the broader number of IDUs who are usually hard to reach by routine outreach case-finding tasks.
尽管实施了减少伤害计划，但一些注射吸毒者（IDU）仍继续从事高风险行为。似乎存在一些社会因素导致IDU感染人类免疫缺陷病毒（HIV）的风险。本研究的目的是分析IDU的社会网络，并使用多重成员多级模型检验网络位置对HIV传播风险的影响。
2013年10月至2014年3月，我们对147名IDU进行了面对面访谈。我们要求参与者提名最多20名他们在上个月与其有超过偶然接触的人，并指明每个被提名者是否为吸毒者。我们将四个网络位置定义为主要成分的核心和边缘。根据7项量表测量每个个体的HIV传播风险。我们应用多重成员多级线性回归分析来检验网络位置与HIV传播风险之间的关系。我们使用Stata和UCINET软件进行数据分析。
参与者的平均年龄为37±9.32岁。大多数个体为男性，单身，学历为指导学校。与孤立者/无关联者相比，作为主要成分的核心成员以及作为其他小成分的成员，显著增加了HIV传播风险。参与美沙酮维持治疗（MMT）与HIV传播得分降低相关。
网络分析是找到IDU网络中最具影响力成员的有用指南，可能对减少伤害计划具有补充作用。通过针对网络中的核心个体实施干预计划，可以增强其效果。此外，它使减少伤害工作人员能够找到更多通常难以通过常规外展病例发现任务接触到的IDU。
