中国内地静脉注射吸毒人群中 HIV 感染的流行：系列、横断面研究。
Epidemic of HIV infection among persons who inject drugs in mainland China: a series, cross-sectional study.
机构信息
School of Basic Medical Sciences, Peking University, Beijing, 100191, China.
School of Public Health, Peking University, Beijing, 100191, China.
出版信息
Harm Reduct J. 2021 Jun 12;18(1):63. doi: 10.1186/s12954-021-00511-6.
BACKGROUND
Studies have suggested that the injection drug use (IDU) was no longer the main transmission route of HIV/AIDS in China. However, there has never been a study to assess the national HIV epidemic among persons who inject drugs (PWIDs) based on a nationwide database.
METHODS
PWIDs among new entrants in detoxification centers with HIV test results were extracted from the 2008-2016 National Dynamic Management and Control Database for Persons Who Use Drugs (NDMCD). Logistic regressions were used to analyze factors associated with HIV infection, and joinpoint regression were used to examine trends in the HIV prevalence.
RESULTS
A total of 103,619 PWIDs among new entrants tested for HIV in detoxification centers between 2008 and 2016 were included in the analysis. The HIV prevalence was 5.0% (n = 5167) among PWIDs. A U-shaped curve of the HIV prevalence decreased from 4.9% in 2008 to 3.3% in 2010 (Annual Percent Change [APC] - 20.6, 95% CI - 32.5 to - 6.7, p < 0.05) and subsequently increased from 3.3% in 2010 to 8.6% in 2016 (APC 17.9, 95% CI 14.5-21.4, p < 0.05) was observed. The HIV prevalence in west regions in China all presented decreased trends, while central and eastern regions presented increased trends.
CONCLUSIONS
Although the HIV prevalence has been declining in general population, the HIV prevalence among PWIDs has shown an increasing trend since 2010. Current policies on HIV control in PWIDs should be reassessed.
背景
研究表明，注射吸毒（IDU）在中国已不再是 HIV/AIDS 的主要传播途径。然而，从未有研究基于全国性数据库评估中国注射吸毒者（PWIDs）中的 HIV 流行情况。
方法
从 2008-2016 年全国药物滥用动态管理数据库中提取有 HIV 检测结果的戒毒中心新入组的 PWIDs。采用 logistic 回归分析 HIV 感染的相关因素，采用 joinpoint 回归分析 HIV 流行率的趋势。
结果
共纳入 103619 名 2008-2016 年在戒毒中心检测 HIV 的新入组 PWIDs。PWIDs 的 HIV 流行率为 5.0%（n=5167）。HIV 流行率呈 U 型曲线，从 2008 年的 4.9%下降至 2010 年的 3.3%（APC -20.6，95%CI-32.5 至-6.7，p<0.05），随后从 2010 年的 3.3%上升至 2016 年的 8.6%（APC 17.9，95%CI 14.5-21.4，p<0.05）。中国西部地区的 HIV 流行率均呈下降趋势，而中部和东部地区呈上升趋势。
结论
尽管普通人群的 HIV 流行率呈下降趋势，但自 2010 年以来，PWIDs 中的 HIV 流行率呈上升趋势。应重新评估当前针对 PWIDs 的 HIV 控制政策。
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