Lifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia
Lifetime ATS use and increased HIV risk among not-in-treatment opiate injectors in Malaysia
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DOI：
10.1016/j.drugalcdep.2011.12.024
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发表时间：
2012-07-01
影响因子：
4.2
通讯作者：
Schottenfeld, Richard S.
中科院分区：
文献类型：
--
作者：
Chawarski, Marek C.;Vicknasingam, Balasingam;Schottenfeld, Richard S.
背景：自1970年代以来，马来西亚一直经历着严重的药物滥用问题，药物滥用是马来西亚艾滋病毒传播的主要驱动因素。我们调查了马来西亚未接受治疗的阿片注射者中与使用安非他明类兴奋剂（CATS）相关的艾滋病毒危险因素。方法：2006年10月至2008年5月，我们在马来西亚的三个主要城市地区进行了一系列调查。三次调查共纳入732名阿片注射吸毒者（男性679人，女性53人）。调查工具包括对人口统计学特征、药物使用史（包括首次使用年份和上月非法药物使用史；一生和上月欠条或共用针头或设备的历史）和艾滋病毒状况进行结构化访谈。结果：共194/704例（27.6%）HIV阳性。该样本中有两个因素与HIV感染显著相关：终生使用ATS史（OR [95%CI]: 2.3[1.5-3.6]）和终生共用注射器具史（OR [95%CI]: 4.2[1.8-9.8]）。艾滋病毒阳性和艾滋病毒阴性的参与者都报告了目前共用针头/设备的做法：分别为82%和75%。结论：1997年后，ATS的使用在研究样本中迅速传播，并与本已因阿片类IOU而处于高风险的人群中艾滋病毒感染风险增加有关。在马来西亚，未接受治疗的欠条从事高风险行为，无论其艾滋病毒状况如何。需要加强教育和公共卫生预防措施，以减少这一人群中艾滋病毒传播的风险。2012爱思唯尔爱尔兰有限公司版权所有。
Background: Malaysia has been experiencing significant drug abuse problems since the 1970s, and drug abuse is the major driver of HIV transmission in Malaysia. We investigated risk factors for HIV associated with use of amphetamine type stimulants CATS) among not-in-treatment opiate injectors in Malaysia.Methods: Between October of 2006 and May of 2008, we conducted a series of surveys in three major urban areas of Malaysia. A total of 732 opiate IDUs (679 males and 53 females) were enrolled in the three surveys. The survey instruments consisted of a structured interview on demographic characteristics, drug use history (including year of first use, and past month history of use of illicit drugs; lifetime and past month history of IOU or needle or equipment sharing), and HIV status.Results:There were 194/704(27.6%) HIV positive participants in the sample. Two factors were significantly associated with HIV infection in this sample: lifetime history of ATS use (OR [95%CI]: 2.3 [1.5-3.6]) and lifetime history of sharing of injection equipment (OR [95% CI]: 4.2 [1.8-9.8]). Both HIV-positive and HIV-negative participants reported high levels of current needle/equipment sharing practices: 82% vs. 75%, respectively.Conclusions: ATS use spread rapidly in the study sample after 1997 and is associated with an increased risk of HIV infection in this population already at high risk because of opiate IOU. Out-of-treatment IOUs in Malaysia engage in high risk behaviors regardless of their HIV status. Increased education and public health prevention measures are needed to reduce HIV transmission risks in this population. (C) 2012 Elsevier Ireland Ltd. All rights reserved.