男男性行为者在马德里和巴塞罗那首次性注射毒品。
Sexualized drug injection among men who have sex with men in Madrid and Barcelona as the first episode of drug injecting.
机构信息
Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain.
CIBER Epidemiologia Y Salud Pública (CIBERESP), Madrid, Spain.
出版信息
Harm Reduct J. 2021 Aug 6;18(1):86. doi: 10.1186/s12954-021-00531-2.
BACKGROUND
We estimate the prevalence of drug injection, the variables associated with having ever injected and the proportion of ever injectors whose first drug injection was for having sex; we describe the first drug injection episode, analyze the drugs most frequently injected and estimate the prevalence of risky injecting behaviors.
METHODS
The participants were 3387 MSM without a previous HIV diagnosis attending four HIV/STI diagnosis services in Madrid and Barcelona. Lifetime prevalence and prevalence ratios (PRs) by different factors were calculated using Poisson regression models with robust variance. We compared the characteristics of first drug injection episode, lifetime injection and risky injecting behaviors of those whose first injection was for sex (FIS) with those whose was not (non-FIS).
RESULTS
Lifetime prevalence of injection was 2.1% (CI 1.7-2.7). In the multivariate analysis, it was strongly associated with having been penetrated by more than five men in the last 12 months (aPR = 10.4; CI 2.5-43.4) and having met most of their partners at private parties (aPR = 7.5; CI 4.5-12.3), and less strongly with other factors. Of those who had ever injected drugs, 81.9% injected for sex the first time they injected drugs (FIS). At first injection, FIS participants had a mean age of 31 years, 62.7% used mephedrone and 32.2% methamphetamine on that occasion. Of this FIS group 39.0% had ever shared drugs or equipment and 82.6% had always shared for sex. Some 30.8% of non-FIS reported having also injected drugs for sex later on.
CONCLUSIONS
Only two out of a hundred had ever injected, most to have sex and with frequent drug or injecting equipment sharing. Injecting for sex is the most common first episode of drug injection and is the most efficient risky behavior for the transmission of HIV, hepatitis B or C and other blood-borne infections. MSM participating in private parties should be considered a priority group for prevention policies.
背景
我们估计了药物注射的流行率、与曾经注射相关的变量以及首次注射用于性行为的注射者比例；我们描述了首次药物注射事件，分析了最常注射的药物，并估计了危险注射行为的流行率。
方法
参与者是 3387 名没有 HIV 既往诊断的男男性接触者，他们在马德里和巴塞罗那的四个 HIV/性传播感染诊断服务机构接受调查。使用泊松回归模型和稳健方差计算了不同因素的终生患病率和患病率比（PR）。我们比较了首次注射用于性行为（FIS）和非用于性行为（非 FIS）的首次药物注射事件、终生注射和危险注射行为的特征。
结果
终生注射的流行率为 2.1%（95%CI 1.7-2.7）。在多变量分析中，它与过去 12 个月内被 5 个以上男性插入（aPR=10.4；95%CI 2.5-43.4）和大多数性伴侣在私人聚会上认识（aPR=7.5；95%CI 4.5-12.3）高度相关，与其他因素的相关性较弱。在曾经注射过毒品的人群中，81.9%的人首次注射毒品是为了发生性行为（FIS）。在首次注射时，FIS 参与者的平均年龄为 31 岁，62.7%的人在那次使用了甲卡西酮，32.2%的人使用了甲基苯丙胺。在这个 FIS 组中，39.0%的人曾经共用过毒品或设备，82.6%的人一直为了发生性行为而共用。约 30.8%的非 FIS 报告后来也有过为了发生性行为而注射毒品。
结论
每一百个人中只有两个人曾经注射过，大多数人是为了发生性行为，并且经常共用毒品或注射设备。为了发生性行为而注射是药物注射的最常见的首次事件，也是 HIV、乙型肝炎或丙型肝炎和其他血源性感染传播的最有效危险行为。参加私人聚会的男男性接触者应被视为预防政策的优先群体。
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