中缅边境城市缅甸妙瓦底地区冰毒使用者高危性行为的性别差异：谁有风险？
Gender-specific differences in high-risk sexual behaviors among methamphetamine users in Myanmar-China border city, Muse, Myanmar: who is at risk?
机构信息
Department of Healthcare Administration, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan.
Nagoya University Asian Satellite Campuses Institute, Nagoya, Japan.
出版信息
BMC Public Health. 2018 Feb 1;18(1):209. doi: 10.1186/s12889-018-5113-6.
BACKGROUND
Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar.
METHODS
A community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors.
RESULTS
A large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30-2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08-1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86-3.93) and being employed (AOR = 1.57; 95% CI = 1.13-2.18) were risk factors for engaging in high-risk sexual behaviors as well.
CONCLUSIONS
High-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
背景
甲基苯丙胺（MA）的使用对健康造成负面影响，因此成为一个重大的公共卫生问题。然而，迄今为止，尚无针对 MA 使用者的高危性行为（ condom 使用不当、多个性伴侣和性传播感染史）的流行病学研究。在缅甸，这一话题尤为重要，缅甸被认为是东南亚地区 MA 主要生产国之一。因此，本研究旨在调查缅甸妙乌镇 MA 使用者的高危性行为相关因素。
方法
2013 年 1 月至 3 月，在缅甸掸邦北部妙乌镇，采用基于社区的横断面研究方法，利用 respondent-driven sampling 和计算机辅助自访谈方法招募了 1183 名 MA 使用者（772 名男性；411 名女性）。使用广义估计方程模型来检验与高危性行为相关的因素。
结果
大量 MA 使用者存在高危性行为（ condom 使用不当：男性，90.7%；女性，85.2%；多个性伴侣：男性，94.2%；女性，47.2%；性传播感染史：男性，55.7%；女性，56.0%）。在男性中，同时使用多种兴奋剂（调整后的优势比 [AOR] =1.77；95%置信区间 [CI] =1.30-2.41）和性工作者的顾客（AOR=1.41；95%CI=1.08-1.83）是发生高危性行为的危险因素。在女性中，移民工人（AOR=2.70；95%CI=1.86-3.93）和受雇（AOR=1.57；95%CI=1.13-2.18）也是发生高危性行为的危险因素。
结论
男性和女性 MA 使用者均存在高危性行为。应制定考虑到性别的 MA 预防计划，以更多关注移民、性工作者顾客和受教育程度较低的女性 MA 使用者等弱势群体。
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