RISK-FACTORS FOR THE TRANSITION FROM NONINJECTION TO INJECTION-DRUG USE AND ACCOMPANYING AIDS RISK BEHAVIOR IN A COHORT OF DRUG-USERS
RISK-FACTORS FOR THE TRANSITION FROM NONINJECTION TO INJECTION-DRUG USE AND ACCOMPANYING AIDS RISK BEHAVIOR IN A COHORT OF DRUG-USERS
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DOI：
10.1093/oxfordjournals.aje.a116962
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发表时间：
1994-06-15
影响因子：
5
通讯作者：
COUTINHO, RA
中科院分区：
文献类型：
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作者：
VANAMEIJDEN, EJC;VANDENHOEK, JAR;COUTINHO, RA
虽然注射吸毒者已被证明可以减少高危注射行为，以应对人类免疫缺陷病毒（HIV）感染和获得性免疫缺陷综合征（AIDS）的流行，但尚未实现完全消除危险行为。一个更基本的预防措施可能是阻止吸毒者开始注射。作者从1985年至1992年在荷兰阿姆斯特丹进行的一项队列研究中选择了184名吸毒者，这些人在进入研究时报告说，他们从未注射过毒品，或者在初次就诊前一年多注射过毒品。在5年的随访期内，在两组中发现了令人印象深刻的高累积率的过渡到注射药物使用。在从未注射过毒品的吸毒者中，30%的人开始注射;在参加研究前1-5年注射过毒品的人中，70%的人再次开始注射。这些比率随时间推移保持稳定。作者还证实，新注射者感染艾滋病毒的风险很高。使用生存和巢式病例对照分析，发现以下独立的风险因素，增加了开始注射的可能性：以前的注射史，种族以外的拉美/安的列斯群岛，经常长期使用可卡因，目前使用海洛因，目前稳定的性关系与合作伙伴谁注射毒品。鉴于队列研究中吸毒者开始注射的发生率高且稳定，预防这种行为似乎很困难。需要进行更多的研究，以确定有效的预防战略。
Although injection drug users have been shown to reduce high-risk injection behaviors in response to the epidemic of human immunodeficiency virus (HIV) infection and acquired immunodeficiency syndrome (AIDS), the total elimination of risk behaviors has not been achieved. A more fundamental preventive measure may be to keep drug users from starting to inject at all. The authors selected 184 drug users from a cohort study in Amsterdam, the Netherlands, from 1985 to 1992, who had reported at entry to the study that they either had never injected drugs or had injected for the last time more than 1 year before the initial visit. Over a 5-year follow-up period, impressively high cumulative rates of transition to injection drug use were found in both groups. Among drug users who had never injected drugs, 30% began injecting; among those who had injected drugs 1-5 years before their entry into the study, 70% started injecting again. These rates were stable over time. The authors also confirmed that new injectors are at high risk of acquisition of HIV infection. With the use of a survival and a nested case-control analysis, the following independent risk factors that increased the likelihood of starting to inject were found: previous injecting history, ethnicity other than Surinamese/Antillean, regular long-term use of cocaine, current use of heroin, and a current steady sexual relationship with a partner who injects drugs. Given the high and stable incidence of initiation of injection among drug users within tile cohort study, the prevention of this behavior appears to be difficult. Additional studies are needed to determine effective prevention strategies.