Wiessing L G, Houweling H, Meulders W A, Cerdá E, Jansen M, Sprenger M J
Rijksinstituut voor Volksgezondheid en Milieu, Centrum voor Infectieziekten Epidemiologie, Bilthoven.
Ned Tijdschr Geneeskd. 1995 Sep 23;139(38):1936-40.
To assess the prevalence of HIV infection among intravenous (IDU) and non-intravenous drug users in Heerlen and Maastricht (Southern Netherlands), to detect subgroups of IDU with a higher risk of HIV infection, and to assess the risk of further spread of HIV.
Cross-sectional study.
Heerlen, Kerkrade, Brunssum and Maastricht, the Netherlands.
Between August 15 and November 25, 1994, a saliva specimen and a short questionnaire were obtained from 449 drug users (340 IDU) in Heerlen (and environs) and Maastricht. Participants were recruited through methadone care (54%), syringe exchange (16%), a street prostitution project (3%), street recruitment (23%) and other drug users (4%).
Of the 340 IDU 33 were infected (prevalence: 10% (95% confidence interval: 7-13)), among the 109 non-IDU no infections were found (0% (0-3)). IDU making use of the syringe exchange had a higher prevalence (odds ratio 3.13 (1.37-7.61)). In logistic regression analysis, this finding could not be explained by selection on more risky injecting. One in five currently injecting IDU reported having used someone else's used needle or syringe in the last 6 months. One in five IDU had a non-drug user as steady sexual partner. In sexual contacts between steady partners condom use was low. On the basis of self-reported serostatus it appeared that some infections have taken place in the last two years.
The prevalence of HIV infections among IDU in Heerlen and Maastricht is about 10%. IDU using the syringe exchange have a higher prevalence. This means this prevention reaches the high-risk group, but probably can not avoid all infections. The risk of further spread among IDU is high. The risk of spread to non-IDU and non-drug users is present.
评估荷兰南部海尔伦和马斯特里赫特地区静脉注射吸毒者(IDU)及非静脉注射吸毒者中HIV感染的流行情况,识别HIV感染风险较高的IDU亚组,并评估HIV进一步传播的风险。
横断面研究。
荷兰海尔伦、克尔克拉德、布伦瑟姆和马斯特里赫特。
1994年8月15日至11月25日期间,从海尔伦(及周边地区)和马斯特里赫特的449名吸毒者(340名IDU)中获取唾液样本和简短问卷。参与者通过美沙酮治疗(54%)、注射器交换(16%)、街头卖淫项目(3%)、街头招募(23%)以及其他吸毒者(4%)招募而来。
340名IDU中有33名感染(流行率:10%(95%置信区间:7 - 13)),109名非IDU中未发现感染(0%(0 - 3))。使用注射器交换的IDU流行率较高(优势比3.13(1.37 - 7.61))。在逻辑回归分析中,这一发现无法通过选择更具风险注射行为来解释。五分之一目前正在注射毒品的IDU报告在过去6个月内使用过他人用过的针头或注射器。五分之一的IDU有非吸毒者作为固定性伴侣。在固定伴侣之间的性接触中,避孕套使用率较低。根据自我报告的血清学状态,似乎在过去两年中发生了一些感染。
海尔伦和马斯特里赫特地区IDU中HIV感染的流行率约为10%。使用注射器交换的IDU流行率较高。这意味着这种预防措施针对了高危人群,但可能无法避免所有感染。IDU中进一步传播的风险很高。存在传播给非IDU和非吸毒者的风险。