Prevalence and correlates of syphilis and condom use among male injection drug users in four Afghan cities.
Prevalence and correlates of syphilis and condom use among male injection drug users in four Afghan cities.
复制标题
DOI：
10.1097/olq.0b013e3181e2c76a
复制
发表时间：
2010-11
影响因子：
3.1
通讯作者：
Tjaden J
中科院分区：
文献类型：
--
作者：
Todd CS;Nasir A;Raza Stanekzai M;Abed AM;Strathdee SA;Bautista CT;Scott PT;Botros BA;Tjaden J
在阿富汗，注射毒品的使用正在增加，但对注射毒品使用者中的危险性行为和性传播感染的流行情况知之甚少。本研究的目的是评估阿富汗赫拉特、贾拉拉巴德、喀布尔和马扎里沙里夫男性注射吸毒者中梅毒和女性性工作者（FSW）安全套使用的流行率及其相关性。这项横断面研究的参与者在2005年6月至2008年1月期间完成了一项由访谈者管理的问卷调查和梅毒血清学检测。采用现场对照Logistic回归分析方法，评估与FSW使用梅毒安全套相关的因素。在1 078名男性注射吸毒者中，大多数（90.3%）报告有过性经历，其中27.6%报告使用过避孕套。与FSW（58.1%）和男性或男孩（25.7%）的性经验是常见的，虽然以前与FSW（32.6%）或男性伴侣（10.8%）使用安全套相对罕见。很少有人报告在过去6个月内有终生性传播感染诊断（6.3%，n=68）或症状（10.4%，n=110）。梅毒患病率为3.72%（95%CI：2.66 - 5.06%），不同地点之间差异显著，从0%（贾拉拉巴德）到13.9%（马扎里沙里夫）（p<0.001）。梅毒与STI诊断（AOR=3.84）或最近6个月内与FSW的性别（AOR=3.82）以及较低（≤6年）的教育水平（AOR=2.20）显著相关。在过去十年中，FSW使用安全套与阿富汗境外的生活独立相关（AOR=5.52，95% CI：1.83 - 16.71），收入较高（AOR=2.03，95% CI：1.17 - 3.51），终身伴侣数量更多（AOR=1.80，95%CI：1.32 - 2.45）和更年轻的年龄（AOR=0.985，95%CI：0.973 - 0.998）。虽然梅毒的流行率和安全套的使用因地点而异，但高风险性行为很常见，阿富汗注射吸毒者中很少有持续使用安全套的情况。减少伤害方案应包括减少性风险和在阿富汗城市推广和分发避孕套。对阿富汗四个城市的注射毒品使用者进行的一项横断面研究发现，梅毒流行率较低，安全套使用率相当低，危险性行为水平较高。
Injecting drug use is increasing in Afghanistan but little is known about sexual risk behaviors and sexually transmitted infection (STI) prevalence among injection drug users (IDU). The purpose of this study is to assess prevalence and correlates of syphilis and condom use with female sex workers (FSWs) among male IDUs in Hirat, Jalalabad, Kabul, and Mazar-i-Sharif, Afghanistan. Participants in this cross-sectional study completed an interviewer-administered questionnaire and serologic testing for syphilis between June 2005 and January 2008. Factors associated with syphilis condom use with FSWs were assessed with site-controlled logistic regression analysis. Of 1,078 male IDUs, most (90.3%) reported prior sexual experience, of whom 27.6% reported any condom use. Sexual experiences with FSWs (58.1%) and men or boys (25.7%) were common, though prior condom use with FSWs (32.6%) or male partners (10.8%) was relatively rare. Few reported having a lifetime STI diagnosis (6.3%, n=68) or symptoms (10.4%, n=110) in the last 6 months. Prevalence of syphilis was 3.72% (95% CI: 2.66 – 5.06%) and varied significantly between sites ranging from 0% (Jalalabad) to 13.9% (Mazar-i-Sharif) (p<0.001)). Syphilis was significantly associated with STI diagnosis (AOR=3.84) or sex with FSWs (AOR=3.82) in the last 6 months, and with lower (≤6 years) educational level (AOR=2.20). Prior condom use with FSWs was independently associated with living outside Afghanistan in the last decade (AOR=5.52, 95% CI: 1.83 – 16.71), higher income (AOR=2.03, 95% CI: 1.17 – 3.51), greater number of lifetime partners (AOR=1.80, 95% CI: 1.32 – 2.45), and younger age (AOR=0.985, 95% CI: 0.973 – 0.998). Though prevalence of syphilis and condom use varied significantly by site, high levels of risky sexual behavior were common and consistent condom use was rare among IDUs in Afghanistan. Harm reduction programming should incorporate sexual risk reduction and condom promotion and distribution in Afghan cities. A cross-sectional study of injecting drug users in four Afghan cities found low syphilis prevalence, fairly low rates of condom use, and high levels of risky sexual behaviors.