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目的了解广西灵山县2007-2011年间海洛因成瘾者美沙酮维持治疗(methadone maintenancetreatment,MMT)保持率的情况,并探讨其影响因素。方法数据来自全国艾滋病综合防治信息系统中的社区MMT数据库,以入组治疗时间作为进入队列时间进行历史性队列研究,计算不同年份MMT保持率,运用COX比例风险回归模型分析其影响因素。结果广西灵山县2007-2011年间共996人入组治疗,男性为主,占92.17%;平均年龄为(33.7±6.6)岁;待业/无业者居多,占38.25%;初中及以下文化程度者占93.98%。最近1次尿检阳性者占70.98%;HIV阳性者401人,感染率为40.26%;MMT保持时间最短者不足1个月,最长60个月。截止观察期末,第1年到第5年的保持率分别为51.8%、50.8%、65.4%、76.6%和72.0%。累计退出治疗1 256人次,主要原因为无故7 d不治疗,占40.76%。多因素分析结果显示:研究对象的性别、职业、文化程度、开始吸毒年龄最后1次尿检结果以及HIV抗体检测结果与维持治疗保持时间长短关联有统计学意义。结论自2006年以来灵山县MMT保持率总体呈上升趋势,但反复进入和退出的人次较多,脱失率较高。因此,应加强对MMT者的咨询、宣传和关怀等社会工作,并解决好偷吸毒品问题。
Objective To understand the maintenance rate of methadone maintenance treatment (MMT) in heroin addicts between 2007 and 2011 in Lingshan County, Guangxi Province, and to explore the influencing factors. Methods Data were collected from the community MMT database in the national AIDS prevention and control information system. The treatment time was used as the historical cohort study to calculate the retention rate of MMT in different years. COX proportional hazards regression model was used to analyze the influencing factors. Results A total of 996 people were enrolled from 2007 to 2011 in Lingshan County, Guangxi Province. The majority of men were male, accounting for 92.17% of the total. The average age was (33.7 ± 6.6) years old. Most unemployed / unemployed persons accounted for 38.25% 93.98%. The most recent positive urine test accounted for 70.98%; HIV-positive 401 people, the infection rate was 40.26%; MMT to maintain the shortest of less than 1 month, up to 60 months. As of the end of the observation period, the retention rates from the first year to the fifth year were 51.8%, 50.8%, 65.4%, 76.6% and 72.0% respectively. The total number of withdrawals and treatments was 1 256, mainly due to no treatment for 7 days for no reason, accounting for 40.76%. The results of multivariate analysis showed that the gender, occupation, educational level, the last urinalysis at the beginning of drug addiction and the results of HIV antibody test were correlated with the duration of maintenance treatment. Conclusion The overall MMT retention rate in Lingshan County has been on an upward trend since 2006, but there are more repeat entry and exit and higher loss rates. Therefore, social work such as counseling, publicity and caring for the MMT should be strengthened and the drug smuggling problem solved.