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[云南省两县接受抗逆转录病毒治疗门诊的注射吸毒者中影响美沙酮维持治疗可及性的因素]

[Factors influencing access to methadone maintenance treatment among injecting drug users attending antiretroviral treatment clinics in two counties, Yunnan province].

作者信息

Chen Jun, Cao Xiaobin, Zhang Bo, Wu Ling, Yan Guanming, Wu Zunyou

机构信息

School of Public Health, Anhui Medical University, Hefei 230032, China; Division of Health Education and Behavior Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206.

Division of Health Education and Behavior Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2016 Jan;37(1):68-71. doi: 10.3760/cma.j.issn.0254-6450.2016.01.014.

DOI:10.3760/cma.j.issn.0254-6450.2016.01.014
PMID:26822646
Abstract

OBJECTIVE

To understand the demographic characteristics of HIV infected injecting drug users (IDUs) with access to antiretroviral therapy (ART) and to identify the factors influencing their access to methadone maintenance treatment (MMT).

METHODS

Outpatients infected with HIV through injecting drug use were selected from the ART clinics in 2 counties in Yunnan province. They were divided into 2 groups, MMT group and non MMT group. Descriptive epidemiologic analysis was conducted on their demographic characteristics, disease history and high risk behaviors and logistic regression analysis was done to identify the factors associated with the access to MMT.

RESULTS

Among 635 IDUs (536 males, 99 females) surveyed, 247 received MMT (38.9%), 388 received no MMT(61.1%). The median age was 40.33 years and the median diagnosed HIV infection time was 6.08 years. Multivariate logistic regression indicated that being female (OR=2.40, 95%CI:1.00-5.74), educational level of junior high school (OR=3.28, 95%CI:1.75-6.14), educational level of senior high school or above (OR=7.10, 95%CI:1.90-26.62), more than 6 years of diagnosed HIV infection history (OR=3.84, 95% CI:2.11-6.98) and HCV positive (OR=6.21, 95% CI:3.06-12.58) were the positive factors influencing IDUs' access to MMT. However, being married (OR=0.38, 95%CI:0.20-0.72) or being employed (OR=0.01, 95%CI:0.00-0.02) were the negative factors influencing IDUs' access to MMT.

CONCLUSION

The proportion of HIV infected IDUs who received MMT in ART clinics was still very low in the two counties, targeted intervention measures should be taken to increase the MMT coverage, especially among those who are married or employed.

摘要

目的

了解接受抗逆转录病毒治疗(ART)的注射吸毒感染艾滋病毒者(IDU)的人口统计学特征,并确定影响其获得美沙酮维持治疗(MMT)的因素。

方法

从云南省2个县的ART诊所选取经注射吸毒感染艾滋病毒的门诊患者。将他们分为两组,MMT组和非MMT组。对其人口统计学特征、病史和高危行为进行描述性流行病学分析,并进行逻辑回归分析以确定与获得MMT相关的因素。

结果

在接受调查的635名IDU(536名男性,99名女性)中,247名接受了MMT(38.9%),388名未接受MMT(61.1%)。中位年龄为40.33岁,艾滋病毒感染诊断中位时间为6.08年。多变量逻辑回归表明,女性(OR = 2.40,95%CI:1.00 - 5.74)、初中文化程度(OR = 3.28,95%CI:1.75 - 6.14)、高中及以上文化程度(OR = 7.10,95%CI:1.90 - 26.62)、艾滋病毒感染诊断病史超过6年(OR = 3.84,95%CI:2.11 - 6.98)和丙型肝炎病毒阳性(OR = 6.21,95%CI:3.06 - 12.58)是影响IDU获得MMT的积极因素。然而,已婚(OR = 0.38,95%CI:0.20 - 0.72)或就业(OR = 0.01,95%CI:0.00 - 0.02)是影响IDU获得MMT的消极因素。

结论

在这两个县的ART诊所中,接受MMT的注射吸毒感染艾滋病毒者的比例仍然很低,应采取针对性干预措施以提高MMT覆盖率,特别是在已婚或就业者中。

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