CAJ | 학술논문

目的评估美沙酮维持治疗对海洛因成瘾者与HIV传播有关的危险行为的影响.方法在贵州省8个美沙酮门诊内招募治疗时间不足2.5个月的海洛因成瘾者,通过面对面调查收集研究对象的基线信息和随访信息,基线信息包括人口学特征和与HIV传播有关的危险行为,随访调查只包括与HIV传播有关的危险行为.基线调查在2006年6月开始进行,随访调查在2007年6月结束.基线调查中共招募到1003例符合标准的研究对象,其中666例(66.4%)海洛因成瘾者在随访调查结束时仍在美沙酮门诊进行治疗.666例仍在接受治疗的海洛因成瘾者中,469例(70.4%)回答了随访调查问卷.使用Wilcoxon两样本非参数检验和McNemar检验对研究对象与HIV传播有关的危险行为的变化情况进行分析.结果 469例海洛因成瘾者平均每月使用海洛因的天数从26.4 d/月下降到0.9 d/月(Z=27.21,P＜0.05),饮酒天数基线为3.3 d/月,随访调查为3.7 d/月(Z=0.45,P=0.96).在过去30 d内共用针具行为的比例从基线的1.3%(6/469)下降到随访调查时的0.2%(1/469)(x2=5.00,P=0.02).基线调查时5.5%(26/469)的海洛因成瘾者报告在过去30 d内与多个性伴发生性行为,随访调查时这一比例达3.4%(16/469)(x2=3.18,P=0.08).基线调查显示6.4%(30/469)的海洛因成瘾者报告在过去30 d内和非固定性伴有过性关系,随访调查时达5.1%(24/469)(x2=0.95,P=0.33).基线调查时56.7%(17/30)的调查对象在与非固定性伴发生性关系时使用了安全套,随访时58.3%(14/24)使用了安全套(x2=1.96,P=0.16).结论美沙酮维持治疗能够降低海洛因成瘾者通过共用针具传播HIV的危险,但未见传播HIV的危险性行为的统计学意义上的改变.
목적 평고미사동유지치료대해락인성은자여HIV전파유관적위험행위적영향.방법 재귀주성8개미사동문진내초모치료시간불족2.5개월적해락인성은자,통과면대면조사수집연구대상적기선신식화수방신식,기선신식포괄인구학특정화여HIV전파유관적위험행위,수방조사지포괄여HIV전파유관적위험행위.기선조사재2006년6월개시진행,수방조사재2007년6월결속.기선조사중공초모도1003례부합표준적연구대상,기중666례(66.4%)해락인성은자재수방조사결속시잉재미사동문진진행치료.666례잉재접수치료적해락인성은자중,469례(70.4%)회답료수방조사문권.사용Wilcoxon량양본비삼수검험화McNemar검험대연구대상여HIV전파유관적위험행위적변화정황진행분석.결과 469례해락인성은자평균매월사용해락인적천수종26.4 d/월하강도0.9 d/월(Z=27.21,P＜0.05),음주천수기선위3.3 d/월,수방조사위3.7 d/월(Z=0.45,P=0.96).재과거30 d내공용침구행위적비례종기선적1.3%(6/469)하강도수방조사시적0.2%(1/469)(x2=5.00,P=0.02).기선조사시5.5%(26/469)적해락인성은자보고재과거30 d내여다개성반발생성행위,수방조사시저일비례체3.4%(16/469)(x2=3.18,P=0.08).기선조사현시6.4%(30/469)적해락인성은자보고재과거30 d내화비고정성반유과성관계,수방조사시체5.1%(24/469)(x2=0.95,P=0.33).기선조사시56.7%(17/30)적조사대상재여비고정성반발생성관계시사용료안전투,수방시58.3%(14/24)사용료안전투(x2=1.96,P=0.16).결론 미사동유지치료능구강저해락인성은자통과공용침구전파HIV적위험,단미견전파HIV적위험성행위적통계학의의상적개변.
Objective To evaluate HIV risk behaviors among heroin drug users who were treated in methadone maintenance treatment (MMT) clinics. Methods A prospective cohort study recruited and followed up clients of eight MMT clinics treated no more than two and half months in Guizhou province,China. Through face-to-face interviews,the baseline and following up informations were collected. And the baseline information included both demographic information and HIV risk behaviors, the following up informations included only HIV risk behaviors. The baseline investigation started in June, 2006 and the following up investigation finished in June,2007. A total of 1003 heroin drug users were recruited at baseline,among them 666 (66.4%) were still at treatment by the end of follow up and 469 (70.4%) clients participated in the follow up interview. Wilcoxon two sample test and McNemar test were used to test for changes in HIV risk behaviors between baseline and following up investigation. Results Among the 469 MMT clients who were followed up,the average days of reported heroin use decreased from 26.4 to 0.9 in the past 30 days(Z =27.21 ,P ＜0.05). Average days of alcohol use at baseline were 3.3 but 3.7 at follow up (Z= 0.45, P = 0.96 ). Needle-sharing behavior reported in the past 30 days decreased from 1.3% at baseline to 0.2% at follow up(x2 =5.00, P=0.025). At baseline,5.5% (26/469) subjects reported having multiple sex partners in the past 30 days compared to 3.4% ( 16/469 ) at following up( x2 = 3.18,P = 0.08 ). 6.4% ( 30/469 ) subjects reported casual sex with non-regular sex partners in the past 30 days at baseline compared to 5.1% (24/469) at following up( x2 =0.95,P =0.33). Of those who reported having casual sex relationship in the past 30 days 56.7% (17/30) reported using condoms at baseline but 58.3% (14/24) reported using condoms at follow up (x2 = 1.96, P = 0.16 ). Conclusion MMT was observed to decrease needle-sharing HIV risk behavior. However,decreased HIV sexual risk behaviors were not observed at statistical significant level.