Celentano D D, Muñoz A, Cohn S, Nelson K E, Vlahov D
Department of Health Policy and Management, Johns Hopkins School of Hygiene and Public Health, Baltimore, MD.
Addiction. 1994 Oct;89(10):1309-17. doi: 10.1111/j.1360-0443.1994.tb03310.x.
While high risk drug-related behaviors for human immunodeficiency virus (HIV) transmission among injection drug users (IDUs) are asserted to have declined over time in response to the AIDS epidemic, evidence from longitudinal cohorts has been sparse. In a cohort of 810 IDUs (442 seronegatives and 368 seropositives) in Baltimore, we identified drug-related risk behaviors at four consecutive semi-annual visits. Using robust methods for repeated measurements and multiple logistic regression, we estimated the probabilities of maintaining and reducing risk behaviors according to HIV serostatus and time in the study. Seropositive participants were more likely to maintain lower risk behaviors, and behavior maintenance increased with time in study for both seronegative and seropositive IDUs. Greater risk reduction (towards non-use and not sharing injection equipment) was seen among seropositive IDUs, with behavior change occurring soon after enrollment in the study. While behavior changes have been reported, many active IDUs, especially those still at risk for acquiring HIV infection, have not adequately reduced their risk. Continuing prevention programs and efforts in vaccine development are imperative to reduce the risk of HIV infection among IDUs.
虽然据断言，注射吸毒者（IDU）中与人类免疫缺陷病毒（HIV）传播相关的高风险行为随着时间推移因艾滋病流行而有所减少，但纵向队列研究的证据一直很少。在巴尔的摩的一个由810名注射吸毒者（442名血清阴性者和368名血清阳性者）组成的队列中，我们在连续四次半年期随访中确定了与毒品相关的风险行为。使用稳健的重复测量方法和多元逻辑回归，我们根据HIV血清状态和研究时间估计了维持和降低风险行为的概率。血清阳性参与者更有可能维持较低的风险行为，并且血清阴性和血清阳性的注射吸毒者的行为维持情况都随着研究时间的增加而增加。血清阳性的注射吸毒者中出现了更大程度的风险降低（趋向于不使用和不共用注射设备），行为改变在研究入组后不久就发生了。虽然已经报告了行为改变，但许多活跃的注射吸毒者，尤其是那些仍有感染HIV风险的人，并没有充分降低他们的风险。持续开展预防项目以及在疫苗研发方面做出努力对于降低注射吸毒者中HIV感染风险至关重要。
