Public Health Institute, Liverpool John Moores University, Liverpool, UK.
Department of Sociology, Manchester Metropolitan University, Manchester, UK.
Drug Alcohol Rev. 2021 May;40(4):586-596. doi: 10.1111/dar.13198. Epub 2020 Nov 8.
Historically, people who inject image and performance enhancing drugs (IPED) were not perceived as being at high risk of HIV or hepatitis C virus (HCV) infection. However, recent studies indicate HCV and HIV prevalences are elevated, with many HCV infections undiagnosed.
Men who inject IPEDs recruited from community settings and specialist services, including needle-syringe programs, across UK during 2016 self-completed a questionnaire. Multivariate analyses examined factors associated with HCV/HIV testing.
The participants' (n=562; 24% service recruited) median age was 31 years, 4% identified as gay or bisexual, 18% had ever been imprisoned and 6% had ever injected a psychoactive drug. Those community recruited more often reported sharing drugs vials (16% vs. 8%, P=0.021) and, among those with 2+ sexual partners, poor condom use (50% vs. 36%, P=0.063), than those service recruited. Overall, one-third had ever been tested for HCV (31%) and/or HIV (34%). Testing uptake was associated with other risk factors for HCV/HIV, being recruited through services and having received metabolic tests. Participants' motivations for using IPEDs were associated with recruitment setting and HIV/HCV testing uptake.
The majority were untested for HCV/HIV. HCV/HIV testing and risks were associated with recruitment through services. Previous needle and syringe program-based studies have potentially overestimated testing uptake and underestimated risk. Targeted interventions are needed, particularly for those not accessing services. The association between HCV/HIV testing uptake and receipt of metabolic tests suggests that developing a combined offer of these tests as part of health monitoring could improve uptake.
历史上，注射形象和性能增强药物（IPED）的人并未被认为处于感染艾滋病毒或丙型肝炎病毒（HCV）的高风险中。然而，最近的研究表明，HCV 和 HIV 的患病率有所上升，许多 HCV 感染未被诊断。
2016 年，在英国的社区环境和专科服务机构（包括针具交换计划）中招募了注射 IPED 的男性参与者，他们自行填写了一份问卷。多变量分析检查了与 HCV/HIV 检测相关的因素。
参与者（n=562；24%通过服务机构招募）的中位年龄为 31 岁，4%自认为是同性恋或双性恋，18%曾入狱，6%曾注射过精神活性药物。与通过服务机构招募的参与者相比，从社区招募的参与者更常报告共享药物小瓶（16%比 8%，P=0.021），并且在有 2+性伴侣的人中，避孕套使用不当的比例更高（50%比 36%，P=0.063）。总体而言，三分之一的人曾接受过 HCV（31%）和/或 HIV（34%）检测。检测率与 HCV/HIV 的其他风险因素、通过服务机构招募以及接受代谢检测有关。参与者使用 IPED 的动机与招募地点和 HIV/HCV 检测率有关。
大多数人都没有接受过 HCV/HIV 检测。HCV/HIV 检测和风险与通过服务机构招募有关。以前基于针具交换计划的研究可能高估了检测率，低估了风险。需要有针对性的干预措施，特别是针对那些不接受服务的人。HCV/HIV 检测率与代谢检测的接受率之间的关联表明，作为健康监测的一部分，提供这些检测的综合服务可能会提高检测率。
