Wiebel W W, Jimenez A, Johnson W, Ouellet L, Jovanovic B, Lampinen T, Murray J, O'Brien M U
Division of Epidemiology-Biostatistics, School of Public Health, University of Illinois at Chicago, USA.
J Acquir Immune Defic Syndr Hum Retrovirol. 1996 Jul;12(3):282-9. doi: 10.1097/00042560-199607000-00008.
We monitored trends in HIV risk behaviors and seroconversion among out-of-treatment injection drug users (IDUs) receiving street-based outreach intervention. Beginning in 1988, 641 HIV-seronegative IDUs were recruited by targeted sampling methods to reflect broader IDU populations and were followed for 4 years (1988-1992). All were active injectors not in treatment when recruited. Cohort members were targets of HIV-prevention outreach. The intervention was guided by the Indigenous Leader Outreach Model: Exaddicts deliver HIV-prevention services targeting IDU social networks in community settings. Primary outcome measures were HIV seroconversion and HIV risk behaviors. Observed incidence of HIV infection decreased, from 8.4 to 2.4 per 100 person-years. Prevalence of drug risk behaviors also decreased, from 100 to 14%. Seroconversion was associated with injection risk behavior [risk ratio (RR) = 9.8]. Sex risk behavior also decreased, but less dramatically, from 71 to 45%. Out-of-treatment IDUs in Chicago have reduced their rates of new HIV infection by reducing their injection risk behavior. New infections were strongly associated with injection risk behavior but not with sex risk behavior.
我们监测了接受街头外展干预的未接受治疗的注射吸毒者（IDU）中HIV风险行为和血清转化的趋势。从1988年开始，通过目标抽样方法招募了641名HIV血清阴性的注射吸毒者，以反映更广泛的注射吸毒者群体，并对其进行了4年（1988 - 1992年）的跟踪。所有招募对象在招募时均为活跃的注射吸毒者且未接受治疗。队列成员是HIV预防外展的目标对象。该干预以本土领袖外展模式为指导：戒毒者在社区环境中针对注射吸毒者的社交网络提供HIV预防服务。主要结局指标为HIV血清转化和HIV风险行为。观察到的HIV感染发病率从每100人年8.4例降至2.4例。毒品风险行为的患病率也从100%降至14%。血清转化与注射风险行为相关[风险比（RR）= 9.8]。性风险行为也有所下降，但降幅较小，从71%降至45%。芝加哥未接受治疗的注射吸毒者通过降低注射风险行为降低了新的HIV感染率。新感染与注射风险行为密切相关，但与性风险行为无关。
