High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan.
High risk behaviors of injection drug users registered with harm reduction programme in Karachi, Pakistan.
复制标题
在巴基斯坦卡拉奇注册的注射吸毒者的高风险行为。
DOI：
10.1186/1477-7517-4-7
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发表时间：
2007-02-10
影响因子：
4.4
通讯作者：
Wray, Norman
中科院分区：
文献类型：
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作者：
Altaf, Arshad;Shah, Sharaf Ali;Zaidi, Najam A;Memon, Ashraf;Nadeem-ur-Rehman;Wray, Norman
巴基斯坦信德省艾滋病控制方案的监测数据表明，卡拉奇注射吸毒者中的艾滋病毒感染率正在迅速上升，2004 - 2005年已达到9%，表明该国已从艾滋病毒流行的初期阶段发展到集中阶段。2004 - 2005年第二代监测结果显示，全市395名注射吸毒者中有104人（26.3%）呈HIV阳性。我们在巴基斯坦卡拉奇针头交换和减少危害规划的登记注射吸毒者中进行了横断面研究。在2003年10月至11月期间，共有161名注射吸毒者参与了这项研究。实施了详细的问卷调查，并收集了艾滋病毒、乙型肝炎和丙型肝炎和梅毒的血样。采用酶联免疫吸附试验（ELISA）进行HIV、乙肝和丙肝抗体检测。在Randox试剂盒上进行梅毒试验（RPR和TPHA）。除了计算频率外，还对连续变量（如年龄、初次性行为年龄和开始成瘾的平均年龄）进行了单变量分析，并对分类变量（如是否有偿性行为）进行了卡方检验，以确定乙型肝炎、丙型肝炎和梅毒的危险因素。IDU的平均年龄为35.9岁，开始用药的平均年龄为15.9岁。每天药物注射次数为2.3次。共有128名注射吸毒者（79.5%）报告使用集体共用注射器注射毒品。超过一半（58.3%）的人表示曾为性行为付费，64%的人表示从未使用安全套。有44个国家（28%）报告进行了血液商业销售。161人中HIV阳性1人（0.6%）。乙型肝炎12例（7.5%），丙型肝炎151例（94.3%），梅毒21例（13.1%）。丙型肝炎呈阳性的注射吸毒者更有可能在更早的年龄开始性行为，而且从未使用过避孕套。同样，乙型肝炎阳性的注射吸毒者更有可能属于较年轻的年龄组。梅毒阳性注射吸毒者更有可能为性行为买单，而且从未使用安全套。巴基斯坦需要采取谨慎措施，例如提供无菌注射器、康复和阿片替代疗法，以减少注射吸毒者的高风险行为。
Surveillance data of Sindh AIDS Control Programme, Pakistan suggest that HIV infection is rapidly increasing among IDUs in Karachi and has reached 9% in 2004–5 indicating that the country has progressed from nascent to concentrated level of HIV epidemic. Findings of 2nd generation surveillance in 2004–5 also indicate 104/395 (26.3%) IDUs HIV positive in the city. We conducted a cross sectional study among registered IDUs of a needle exchange and harm reduction programme in Karachi, Pakistan. A total of 161 IDUs were included in the study between October–November 2003. A detailed questionnaire was implemented and blood samples were collected for HIV, hepatitis B & C and syphilis. HIV, hepatitis B and C antibody tests were performed using Enzyme Linked Immunosorbent Assay (ELISA) method. Syphilis tests (RPR & TPHA) were performed on Randox kit. Besides calculating frequencies univariate analysis was performed using t tests for continuous variables as age, age at first intercourse and average age of initiation of addiction and chi square for categorical variables like paid for sex or not to identify risk factors for hepatitis B and C and syphilis. Average age of IDU was 35.9 years and average age of initiation of drugs was 15.9 years. Number of drug injections per day was 2.3. Shooting drugs in group sharing syringes was reported by 128 (79.5%) IDUs. Over half 94 (58.3%) reported paying for sex and 64% reported never using a condom. Commercial selling of blood was reported by 44 (28%). 1 of 161 was HIV positive (0.6%). The prevalence of hepatitis B was 12 (7.5%), hepatitis C 151 (94.3%) and syphilis 21 (13.1%). IDUs who were hepatitis C positive were more likely to start sexual activity at an earlier age and had never used condoms. Similarly IDUs who were hepatitis B positive were more likely to belong to a younger age group. Syphilis positive IDUs were more likely to have paid for sex and had never used a condom. Prudent measures such as access to sterile syringes, rehabilitation and opiate substitution therapies are required to reduce high risk behaviors of IDUs in Pakistan.