Greenfield L, Bigelow G E, Brooner R K
Behavioral Pharmacology Research Unit, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
Drug Alcohol Depend. 1995 Aug;39(2):91-8. doi: 10.1016/0376-8716(95)01155-r.
The HIV-1 high-risk drug use behavior of intravenous drug abusers was assessed both retrospectively (for 6 months) and prospectively (for 6 months) via structured interview and urinalysis testing. Subjects were 281 intravenous drug abusers, 146 enrolled in outpatient methadone treatment (Treatment group) and 135 not in treatment (Community group). The Treatment group reported fewer drug injections and less needle sharing and had fewer positive urinalyses for opiates and cocaine than did the Community group. Reported drug injection and needle sharing declined over time, and an increasing proportion of subjects reported abstinence from these behaviors. In contrast to the behavioral reports of subjects, positive urinalyses indicating opiate and/or cocaine use did not decline over time. Almost half (45.8%) of the reported increase in injection abstinence from intake to month six was disconfirmed by urinalysis. In contrast to this large discrepancy regarding reported behavior change, there was good agreement between reported injection abstinence and urinalysis results at single points in time. These data indicate that the validity of the reported HIV-1 risk behavior change of drug abusers may be less than that of reported risk behavior occurrence. The data raise important questions about the validity of reported reductions in high-risk drug use behaviors, and indicate the importance of using biological indicators of HIV-1 risk behavior (such as urinalysis) whenever possible.
通过结构化访谈和尿液分析检测，对静脉注射吸毒者的HIV-1高风险吸毒行为进行了回顾性（为期6个月）和前瞻性（为期6个月）评估。研究对象为281名静脉注射吸毒者，其中146人参加了门诊美沙酮治疗（治疗组），135人未接受治疗（社区组）。与社区组相比，治疗组报告的吸毒注射次数和共用针头情况较少，鸦片类药物和可卡因尿检呈阳性的情况也较少。报告的吸毒注射和共用针头情况随时间推移而减少，报告戒除这些行为的受试者比例不断增加。与受试者的行为报告相反，表明使用鸦片类药物和/或可卡因的尿检呈阳性情况并未随时间推移而减少。从入组到第六个月报告的注射戒除增加情况中，几乎一半（45.8%）未得到尿检的证实。与报告的行为变化方面的巨大差异形成对比的是，在单个时间点上，报告的注射戒除情况与尿检结果之间存在良好的一致性。这些数据表明，吸毒者报告的HIV-1风险行为变化的有效性可能低于报告的风险行为发生情况的有效性。这些数据引发了关于报告的高风险吸毒行为减少有效性的重要问题，并表明尽可能使用HIV-1风险行为的生物学指标（如尿液分析）的重要性。
