云南省两地抗病毒治疗门诊注射吸毒HIV感染者入组美沙酮维持治疗的影响因素分析

陈军; 曹晓斌; 张波; 吴玲; 严关明; 吴尊友

Abstract

陈军,曹晓斌,张波,吴玲,严关明,吴尊友.云南省两地抗病毒治疗门诊注射吸毒HIV感染者入组美沙酮维持治疗的影响因素分析[J].Chinese journal of Epidemiology,2016,37(1):68-71

云南省两地抗病毒治疗门诊注射吸毒HIV感染者入组美沙酮维持治疗的影响因素分析

Factors influencing access to methadone maintenance treatment among injecting drug users attending antiretroviral treatment clinics in two counties, Yunnan province

Received:June 03, 2015

DOI：10.3760/cma.j.issn.0254-6450.2016.01.014

KeyWord: 艾滋病美沙酮维持治疗抗病毒治疗注射吸毒者

English Key Word: AIDS Methadone maintenance treatment Antiretroviral therapy Injecting drug users

FundProject:国家科技重大专项(2012ZX10001007-002); 中国艾滋病/结核病多学科研究培训项目(5U2RTW006918)

Author Name	Affiliation	E-mail
Chen Jun	School of Public Health, Anhui Medical University, Hefei 230032, China Division of Health Education and Behavior Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206
Cao Xiaobin	Division of Health Education and Behavior Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206
Zhang Bo	Social Service Section, Yunnan Institute for Drug Abuse, Kunming 650000
Wu Ling	Methadone Maintenance Treatment Clinic, Gejiu County Center for Disease Control and Prevention, Gejiu 661000
Yan Guanming	Methadone Maintenance Treatment Clinic, Jianshui County Center for Disease Control and Prevention, Jianshui 654300
Wu Zunyou	School of Public Health, Anhui Medical University, Hefei 230032, China Division of Health Education and Behavior Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206	wuzy@263.net

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Abstract:

目的了解云南省两地抗病毒治疗(ART)门诊注射吸毒HIV感染者的基本特征并分析其入组美沙酮维持治疗(MMT)的影响因素。方法将云南省两地艾滋病疫情数据库进行关联,在ART门诊筛选出由注射吸毒感染HIV的人群作为研究对象,分成两组,一组是正在参加MMT,另一组是从未入组MMT。提取这些研究对象的一般人口学特征、相关疾病史、高危行为等信息。对研究对象的基本信息进行描述,运用单因素和多因素非条件logistic回归模型分析其影响因素。结果 635例研究对象中,247例(38.9%)正在参加MMT,388例(61.1%)从未入组MMT;男性536例(84.4%),女性99例(15.6%);年龄M=40.33岁;确证感染HIV时间的M=6.08年。多因素分析结果显示,女性(OR=2.40,95%CI:1.00～5.74)、初中文化程度(OR=3.28,95%CI:1.75～6.14)和高中及以上文化程度(OR=7.10,95%CI:1.90～26.62)、确证感染时间≥6年(OR=3.84,95%CI:2.11～6.98)、患有丙型肝炎(OR=6.21,95%CI:3.06～12.58)是入组MMT的促进因素;已婚(OR=0.38,95%CI:0.20～0.72)、有职业(OR=0.01,95%CI:0.00～0.02)是入组MMT的限制因素。结论两地ART门诊的注射吸毒人群入组MMT的比例不高,为加强这类人群转介入组MMT,需要对具有不同特征的患者采取有针对性干预措施。

English Abstract:

Objective To understand the demographic characteristics of HIV infected injecting drug users (IDUs) with access to antiretroviral therapy (ART) and to identify the factors influencing their access to methadone maintenance treatment (MMT). Methods Outpatients infected with HIV through injecting drug use were selected from the ART clinics in 2 counties in Yunnan province. They were divided into 2 groups, MMT group and non MMT group. Descriptive epidemiologic analysis was conducted on their demographic characteristics, disease history and high risk behaviors and logistic regression analysis was done to identify the factors associated with the access to MMT. Results Among 635 IDUs (536 males, 99 females) surveyed, 247 received MMT (38.9%), 388 received no MMT(61.1%). The median age was 40.33 years and the median diagnosed HIV infection time was 6.08 years. Multivariate logistic regression indicated that being female (OR=2.40, 95%CI:1.00-5.74), educational level of junior high school (OR=3.28, 95%CI:1.75-6.14), educational level of senior high school or above (OR=7.10, 95%CI:1.90-26.62), more than 6 years of diagnosed HIV infection history (OR=3.84, 95%CI:2.11-6.98) and HCV positive (OR=6.21, 95%CI:3.06-12.58) were the positive factors influencing IDUs' access to MMT. However, being married (OR=0.38, 95%CI:0.20-0.72) or being employed (OR= 0.01, 95%CI:0.00-0.02) were the negative factors influencing IDUs' access to MMT. Conclusion The proportion of HIV infected IDUs who received MMT in ART clinics was still very low in the two counties, targeted intervention measures should be taken to increase the MMT coverage, especially among those who are married or employed.

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