德国前苏移民中注射吸毒者的风险行为和病毒感染：DRUCK 研究结果。

Risk behaviours and viral infections among drug injecting migrants from the former Soviet Union in Germany: Results from the DRUCK-study.

机构信息

Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.

Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany; Charité University Medicine, Berlin, Germany.

出版信息

Int J Drug Policy. 2018 Sep;59:54-62. doi: 10.1016/j.drugpo.2018.06.011. Epub 2018 Jul 11.

DOI:10.1016/j.drugpo.2018.06.011

PMID:30005420

Abstract

BACKGROUND

High prevalence of drug use and injection-related risk behaviours have been reported among former Soviet Union (FSU)-migrants. To investigate hepatitis C (HCV) and HIV seroprevalence and related risk behaviours in this subgroup in Germany, we compared first generation FSU-migrants and native Germans using data from a sero-behavioural survey of people who inject drugs (PWID).

METHODS

Current injectors were recruited using respondent-driven sampling in eight German cities in 2011-2014. Questionnaire-based interviews were conducted and dried blood spots collected and tested for anti-HCV, HCV-RNA, and anti-HIV1/2. Descriptive and multivariable analyses (MVA) were performed.

RESULTS

A total of 208 FSU-born and 1318 native German PWID were included in the analysis. FSU-migrants were younger than Germans (median age: 33 vs. 39 years), and more often male (83.1% vs. 75.9%, p = 0.022). HCV seroprevalence was 74.5% in FSU-migrants vs. 64.6% in Germans (p = 0.006), HIV seroprevalence was 5.8% and 4.6%, respectively (p = 0.443). The proportion of FSU-migrants reporting injecting-related risk behaviours was higher than among Germans: injecting daily (39.4% vs. 30.2%, p = 0.015), with friends (39.2% vs. 31.2%, p = 0.038), cocaine (32.7% vs. 23.8%, p = 0.044), more than one drug (18.2% vs. 9.6%, p = 0.006), and sharing filters/cookers (35.5% vs. 28.0%, p = 0.045). No statistically significant differences were observed in HIV/HCV testing rates (range: 50.7%-65.6%), opioid substitution treatment (43.9% vs. 50.5%), and access to clean needles/syringes (89.8% vs. 90.3%). In MVA, risk for HCV-infection was increased in male FSU-migrants compared to German males (OR 3.32, p = 0.006), no difference was identified between female FSU-migrants and German females (OR: 0.83, p = 0.633).

CONCLUSION

Male FSU-migrants were at highest risk of being HCV infected. Therefore, targeted actions are needed to ensure access and acceptance of harm reduction measures, including HCV-testing and -treatment for this subpopulation of PWID.

摘要

背景

在前苏联（FSU）移民中，药物使用和与注射相关的风险行为的高发率已被报道。为了研究德国这一亚群中丙型肝炎（HCV）和艾滋病毒（HIV）的血清流行率和相关风险行为，我们使用了一项对注射吸毒者（PWID）的血清行为调查的数据，将第一代 FSU 移民与当地德国人进行了比较。

方法

2011 年至 2014 年，在德国八个城市采用受访者驱动抽样法招募当前的注射者。进行了基于问卷的访谈，并采集了干血斑样本，用于检测抗 HCV、HCV-RNA 和抗 HIV1/2。进行了描述性和多变量分析（MVA）。

结果

共纳入 208 名 FSU 出生和 1318 名德国本土 PWID 进行分析。FSU 移民比德国人年轻（中位数年龄：33 岁与 39 岁），且男性比例更高（83.1%与 75.9%，p=0.022）。FSU 移民的 HCV 血清流行率为 74.5%，德国人为 64.6%（p=0.006），HIV 血清流行率分别为 5.8%和 4.6%（p=0.443）。FSU 移民报告与注射相关的风险行为的比例高于德国人：每天注射（39.4%与 30.2%，p=0.015），与朋友一起注射（39.2%与 31.2%，p=0.038），使用可卡因（32.7%与 23.8%，p=0.044），使用多于一种药物（18.2%与 9.6%，p=0.006）和共享过滤器/炊具（35.5%与 28.0%，p=0.045）。HIV/HCV 检测率（范围：50.7%-65.6%）、阿片类药物替代治疗（43.9%与 50.5%）和获得清洁针头/注射器（89.8%与 90.3%）无统计学显著差异。在 MVA 中，与德国男性相比，男性 FSU 移民感染 HCV 的风险增加（OR 3.32，p=0.006），而女性 FSU 移民与德国女性之间无差异（OR：0.83，p=0.633）。