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目的了解昆明市2010年吸毒人员艾滋病病毒(HIV)感染及相关因素。方法采用固定场所连续抽样,对昆明市强制戒毒所新入所的人员进行问卷调查,收集人口学和吸毒行为、性行为信息,采集血样检测HIV抗体。结果共调查吸毒人员872人,98.9%使用海洛因,10.2%使用2种及以上毒品,74.1%注射毒品,其中27.3%曾共用针具。所调查吸毒人员入所前一年与固定性伴、商业性伴坚持使用安全套的比例分别为10.5%和43.7%,HIV阳性者为13.9%和45.5%。所调查吸毒人员HIV感染率为14.3%,注射毒品者为18.1%。单因素分析显示:25-39岁年龄组、昆明市户籍、注射吸毒和共用针具与HIV感染相关。多因素分析仅发现,共用针具吸毒(OR=4.9,95%CI:2.2-11.1)为HIV感染的独立影响因素。结论有效减少注射和共用针具行为,依然是控制昆明市吸毒人员中HIV传播的关键。同时,吸毒人员经性途径传播HIV的危险广泛存在,尽快扩大美沙酮维持治疗、针具交换与安全套推广使用等综合干预措施的覆盖面,是下一步干预工作的重点。
Objective To understand the HIV infection and related factors of drug addicts in Kunming in 2010. Methods Continuous sampling was conducted in fixed sites. Questionnaires were made on the new premises of compulsory drug rehabilitation centers in Kunming. Population demographics, drug abuse behaviors and sexual behaviors were collected. Blood samples were collected to detect HIV antibodies. Results A total of 872 drug addicts were investigated, 98.9% used heroin, 10.2% used two or more drugs, and 74.1% used drugs. Of these, 27.3% had shared needles. The proportion of drug abusers who insisted on using condoms with fixed partners and commercial partners in the year prior to their enrollment was 10.5% and 43.7% respectively, and that of HIV-positive persons was 13.9% and 45.5% respectively. HIV prevalence rates among drug abusers surveyed were 14.3% and for injecting drug users 18.1%. Univariate analysis showed that in the 25-39 age group, household registration, drug abuse and sharing needles in Kunming were associated with HIV infection. Multivariate analysis found that sharing needles (OR = 4.9, 95% CI: 2.2-11.1) were independent predictors of HIV infection. Conclusions Effectively reducing the injection and sharing of needles remains the key to controlling the spread of HIV in drug abusers in Kunming. At the same time, the dangers of HIV transmission through drug users are widespread. Comprehensive coverage of methadone maintenance treatment, exchange of needles and promotion of condoms as soon as possible is the focus of further intervention.