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[与药物依赖患者中艾滋病毒传播的冒险行为相关的变量]

[Variables related to risk taking behavior for HIV transmission among drug-dependent patients].

作者信息

Cervera G, Valderrama J C, Bolinches F, Salazar A, Martínez J

机构信息

Unidad de Toxicomanías, Hospital Clínico Universitario, Valencia.

出版信息

Actas Luso Esp Neurol Psiquiatr Cienc Afines. 1998 May-Jun;26(3):155-64.

PMID:9717340
Abstract

AIMS

To determine the factors associated with the maintenance of HIV-related risk behaviours in opiate patients dependent and establish whether psychopathology and more specifically personality disorders are part of them.

DESIGN

Cross-sectional study with descriptive and analytical elements.

SETTING

The inpatient Drug-Dependence Unit of the Psychiatry Department at the Hospital Clínico Universitario in Valencia, Spain.

STUDY SAMPLE

Study subjects (n = 110) were consecutive first admissions to the Drug-Dependence Unit.

INSTRUMENTS

The following instruments were used a structured clinical history, a Questionnaire on HIV-related risk behaviours, the Symptom Checklist-90 (SCL-90), the Beck Depression Inventory (BDI), and the Structured Clinical Interview for DSM-III-R personality disorders (SCID-II).

RESULTS

Patients who had HIV-related risk behaviours were younger (CI95% = 0.43-3.99) and showed a younger age of first heroin and cocaine use. An association was found between a maintenance of risk behaviours and a current cocaine dependence (OR = 2.39; CI95% = 1.04-5.48), a current benzodiazepine dependence (OR = 6.81; CI95% = 2.67-17.38) and being HIV positive (OR = 2.5; CI95% = 1.10-5.67). An association was also found between HIV-related risk behaviours and the number of prior drug-related hospital admissions. The maintenance of risk behaviours was associated with the presence of personality disorders (OR = 2.63; CI95% = 1.18-5.84) and particularly with the antisocial personality disorder (OR = 3.75; CI95% = 1.61-8.75). The logistic regression analysis showed that the existence of benzodiazepine dependence, cocaine dependence, antisocial personality disorder and the number of drug-related admissions classified correctly 81.08% of patients.

CONCLUSIONS

The higher severity of patients that maintained HIV-related risk behaviours and the association found with personality disorders suggests the need of designing more efficient therapeutic strategies for a subpopulation of drug misuser that showing HIV-related risk behaviours.

摘要

目的

确定与阿片类药物依赖患者维持艾滋病相关危险行为有关的因素,并确定精神病理学尤其是人格障碍是否属于这些因素。

设计

包含描述性和分析性要素的横断面研究。

地点

西班牙巴伦西亚大学临床医院精神科住院药物依赖单元。

研究样本

研究对象(n = 110)为连续首次入住药物依赖单元的患者。

工具

使用了以下工具:结构化临床病史、艾滋病相关危险行为问卷、症状自评量表90(SCL - 90)、贝克抑郁量表(BDI)以及DSM - III - R人格障碍结构化临床访谈(SCID - II)。

结果

有艾滋病相关危险行为的患者更年轻(95%置信区间 = 0.43 - 3.99),首次使用海洛因和可卡因的年龄也更小。发现危险行为的维持与当前可卡因依赖(比值比 = 2.39;95%置信区间 = 1.04 - 5.48)、当前苯二氮䓬类药物依赖(比值比 = 6.81;95%置信区间 = 2.67 - 17.38)以及艾滋病病毒阳性(比值比 = 2.5;95%置信区间 = 1.10 - 5.67)之间存在关联。还发现艾滋病相关危险行为与既往与药物相关的住院次数之间存在关联。危险行为的维持与人格障碍的存在有关(比值比 = 2.63;95%置信区间 = 1.18 - 5.84),尤其与反社会人格障碍有关(比值比 = 3.75;95%置信区间 = 1.61 - 8.75)。逻辑回归分析表明,苯二氮䓬类药物依赖、可卡因依赖、反社会人格障碍的存在以及与药物相关的住院次数能正确分类81.08%的患者。

结论

维持艾滋病相关危险行为的患者病情更严重,且与人格障碍存在关联,这表明需要为表现出艾滋病相关危险行为的药物滥用亚群体设计更有效的治疗策略。

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