许骏, 罗莉, 胡荣, 曹琳, 张敏, 王夏. 2009-2016年湖北省武汉市吸毒人群艾滋病病毒、梅毒和丙型肝炎感染状况及其影响因素分析[J]. 疾病监测, 2019, 34(3): 254-259. DOI: 10.3784/j.issn.1003-9961.2019.03.016
引用本文: 许骏, 罗莉, 胡荣, 曹琳, 张敏, 王夏. 2009-2016年湖北省武汉市吸毒人群艾滋病病毒、梅毒和丙型肝炎感染状况及其影响因素分析[J]. 疾病监测, 2019, 34(3): 254-259. DOI: 10.3784/j.issn.1003-9961.2019.03.016
Jun Xu, Li Luo, Rong Hu, Lin Cao, Min Zhang, Xia Wang. Prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users in Wuhan, 2009–2016[J]. Disease Surveillance, 2019, 34(3): 254-259. DOI: 10.3784/j.issn.1003-9961.2019.03.016
Citation: Jun Xu, Li Luo, Rong Hu, Lin Cao, Min Zhang, Xia Wang. Prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users in Wuhan, 2009–2016[J]. Disease Surveillance, 2019, 34(3): 254-259. DOI: 10.3784/j.issn.1003-9961.2019.03.016

2009-2016年湖北省武汉市吸毒人群艾滋病病毒、梅毒和丙型肝炎感染状况及其影响因素分析

Prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users in Wuhan, 2009–2016

  • 摘要:
    目的分析2009 — 2016年湖北省武汉市艾滋病监测哨点吸毒人群艾滋病病毒(HIV)、梅毒、丙型肝炎(丙肝)感染状况和变化趋势。
    方法2009 — 2016年每年4 — 6月,采用国家统一制定的问卷对武汉市哨点中监管场所和社区吸毒者、美沙酮门诊最近1个月吗啡尿检阳性者开展连续横断面调查,并采集调查对象血液标本进行HIV、梅毒和丙肝病毒(HCV)抗体检测。
    结果2009 — 2016年共监测6 408名毒品使用者。 HIV抗体阳性率平均为0.73%,维持在较低水平;梅毒为5.07%;HCV为54.35%,维持在较高水平。 不同来源及特征的吸毒人群感染情况不同。 多元logistic回归分析显示,外省户籍(OR=4.183,95%CI:1.670 ~ 10.476,P=0.002)、其他民族(OR=7.754,95%CI:2.537 ~ 23.703,P=0.000)、曾共用针具(OR=5.908,95%CI:2.906 ~ 12.009,P=0.000)、监管场所来源吸毒人员(OR=2.468,95%CI:1.054 ~ 5.783,P=0.038)是感染HIV的危险因素。 女性(OR=2.705,95%CI:2.116 ~ 3.457,P=0.000)、有注射毒品史(OR=1.567,95%CI:1.133 ~ 2.165,P=0.007)、社区来源吸毒人员(OR=3.000,95%CI:2.265 ~ 3.973,P=0.000)是感染梅毒的危险因素。 而女性(OR=1.135,95%CI:1.151 ~ 1.583,P=0.000)、本省(OR=1.439,95%CI:1.208 ~ 1.713,P=0.000)、传统毒品和混合毒品使用者(OR=3.643,95%CI:2.975 ~ 4.462,P=0.000;OR=3.454,95%CI:2.616 ~ 4.561,P=0.000)、有注射毒品史(OR=4.381,95%CI:3.777 ~ 5.082,P=0.000)、监管场所来源吸毒人员(OR=2.075,95%CI:1.809 ~ 2.381,P=0.000)是感染HCV的危险因素。
    结论武汉市吸毒人群整体HCV抗体阳性率较高,新型毒品使用者比例呈上升趋势。 在继续做好美沙酮维持治疗的同时需进一步调查当前吸毒人群HIV、梅毒和丙肝感染现况并分析影响因素。

     

    Abstract:
    ObjectiveTo understand the prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users under sentinel surveillance in Wuhan during 2009–2016 and provide evidence for the improvement of HIV infection, syphilis and hepatitis C surveillance and behavior intervention in this population.
    MethodsA consecutive cross-sectional survey with uniformed questionnaire was conducted in drug uses selected in custody facilities and communities as well as urine morphine positive persons who visiting methadone maintenance treatment clinics in last month during the annual sentinel surveillance between April and June, and basic demographic information and blood samples were collected from them.
    ResultsA total of 6 408 drug users were included in the analysis. The prevalence rates of HIV infection, syphilis and hepatitis were 0.73% (low), 5.07% and 54.35% (high), respectively. The prevalence differed in drug users with different demographic characteristics. Multivariate analysis indicated that HIV infection related risk factors included living in other provinces originally (OR=4.183, 95%CI: 1.670–10.476, P=0.002), other ethnic group (OR=7.754, 95%CI: 2.537–23.703, P=0.000), syringe sharing (OR=5.908, 95%CI: 2.906–12.009, P=0.000) and being drug user in custody facility (OR=2.468, 95%CI: 1.054–5.783, P=0.038). Syphilis infection related risk factors included being female (OR=2.705, 95%CI: 2.116–3.457, P=0.000), injecting drug use (OR=1.567, 95%CI: 1.133–2.165, P=0.007) and being drug user in community (OR=3.000, 95%CI: 2.265–3.973, P=0.000). Hepatitis C virus infection related risk factors included being female (OR=1.135, 95%CI: 1.151–1.583, P=0.000), living in Hubei province (OR=1.439, 95%CI: 1.208–1.713, P=0.000), being traditional drug user or mixed drug user (OR=3.643, 95%CI: 2.975–4.462, P=0.000; OR=3.454, 95%CI: 2.616–4.561, P=0.000), injecting drug use (OR=4.381, 95%CI: 3.777–5.082, P=0.000) and being drug user in custody facility (OR=2.075, 95%CI: 1.809–2.381, P=0.000).
    ConclusionThe hepatitis C virus infection rate in drug users was high in Wuhan, and the proportion of new type drug users was in increase. It is necessary to continue the improvement of methadone maintenance treatment and further investigate the prevalence of HIV infection, syphilis and hepatitis C and influencing factors in drug users.

     

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