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目的探讨在社区美沙酮维持治疗期间相关因素对受治者人类免疫缺陷病毒(HIV)及梅毒阳转的影响。方法对广东省13个社区美沙酮维持治疗门诊4 909名受治者进行3年随访,于入组时及随后每年进行HIV、梅毒检测,每6个月进行1次问卷调查随访,入组时及入组后每个月记录尿检情况。结果 4 909名受治者中,HIV、梅毒阳转率分别为0.41/100人年、1.30/100人年;已婚(RR=2.211)、过去1个月注射吸毒次数较多(RR=1.023)、过去3个月发生过性行为(RR=3.614)、基线时梅毒感染(RR=6.357)、阳性尿检次数比例较大(RR=3.235)是HIV阳转的危险因素,服用较高剂量美沙酮(RR=0.966)是HIV阳转的保护因素(P<0.05);女性(RR=4.148)、年龄较大(RR=1.098)、无工作(RR=1.866)、过去1个月注射吸毒(RR=4.515)以及过去3个月因吸毒发生性行为者(RR=17.910)梅毒阳转率较高(P<0.05)。结论注射吸毒及高危性行为是HIV及梅毒感染的高危因素,服用较高剂量美沙酮是HIV阳转的保护因素。
Objective To explore the influence of related factors on the positive conversion of human immunodeficiency virus (HIV) and syphilis during the community methadone maintenance treatment. Methods A total of 4 909 subjects from methadone maintenance treatment outpatient in 13 communities in Guangdong Province were followed up for 3 years. HIV and syphilis were detected at enrollment and every year thereafter. Questionnaires were followed up every 6 months. Record urinalysis every month after enrollment. Results Among 4 909 subjects, the positive rates of HIV and syphilis were 0.41 / 100 person-years and 1.30 / 100 person-years, respectively; they were married (RR = 2.211) (RR = 3.614), syphilis infection at baseline (RR = 6.357), and a large proportion of positive urine tests (RR = 3.235) were risk factors for positive HIV infection. Patients taking a higher dose of methadone (RR = 0.966) were the protective factors of HIV positive (P <0.05); women (RR = 4.148) = 4.515), and the incidence of syphilis was higher in the past 3 months (RR = 17.910) due to drug abusers (P <0.05). Conclusion Injecting drug use and high-risk behaviors are risk factors of HIV and syphilis infection. Taking higher doses of methadone is the protective factor of HIV positive.