Sex differences in risk factors for HIV seroconversion among injection drug users -: A 10-year perspective
Sex differences in risk factors for HIV seroconversion among injection drug users -: A 10-year perspective
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DOI：
10.1001/archinte.161.10.1281
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发表时间：
2001-05-28
影响因子：
--
通讯作者：
Nelson, KE
中科院分区：
文献类型：
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作者：
Strathdee, SA;Galai, N;Nelson, KE
背景资料：在美国，注射毒品直接或间接占每年人类免疫缺陷病毒（艾滋病毒）感染的近一半。需要进行前瞻性研究，调查注射毒品使用者（IDUs）中的性和非肠道艾滋病毒风险。我们研究了男性和女性注射吸毒者之间的HIV血清转换的因素在巴尔的摩，马里兰州。方法：HIV阴性的注射吸毒者（1447名男性和427名女性）被招募到一个前瞻性研究，从1988年至1989年或1994年。参与者每半年接受一次艾滋病毒检测和调查，直至1998年12月。Poisson回归用于确定HIV血清转换的风险因素，按性别分层。行为被视为时间依赖性的协变量，在每半年period.Results变化：受试者主要是非洲裔美国人（91%），在登记的中位年龄为35岁。艾滋病毒的发病率为3.14/100人年（95%置信区间，2.78-3.53），性别之间没有显著差异。年轻的年龄独立预测艾滋病毒血清转换的男性和女性。在男性中，独立预测艾滋病毒血清转化的因素如下：高中以下学历，最近与多个合作伙伴共用针头，每天注射，以及射击场出席。最近从事同性恋活动和注射可卡因的男子的艾滋病毒感染率增加了一倍。在妇女中，艾滋病毒的发病率是那些最近报告的性传播疾病的两倍以上。结论：艾滋病毒的发病率仍然很高，在巴尔的摩注射吸毒者在过去的十年。艾滋病毒血清转换的风险因素因性别而异。男性的主要风险包括共用针头和同性恋活动;在女性中，与高风险异性恋活动相一致的因素比与毒品有关的风险更重要。针对注射吸毒者的人体免疫机能丧失病毒干预措施应针对性别，并包括性风险。
Background: Injection drug use directly or indirectly accounts for nearly half the annual human immunodeficiency virus (HIV) infections in the United States. Prospective studies that investigate both sexual and parenteral HIV risks among injection drug users (IDUs) are needed. We studied factors for HIV seroconversion among male and female IDUs in Baltimore, Md.Methods: The HIV-negative IDUs (1447 male and 427 female) were recruited into a prospective study from 1988 to 1989 or in 1994. Participants underwent semiannual HIV tests and surveys through December 1998. Poisson regression was used to identify risk factors for HIV seroconversion, stratified by sex. Behaviors were treated as time-dependent covariates that varied at each semiannual period.Results: Subjects were primarily African American (91%), and median age at enrollment was 35 years. Incidence of HIV was 3.14 per 100 person years (95% confidence interval, 2.78-3.53) and did not significantly differ by sex. Younger age independently predicted HIV seroconversion for both men and women. Among men, factors that independently predicted HIV seroconversion were the following: less than a high school education, recent needle sharing with multiple partners, daily injection, and shooting-gallery attendance. The incidence of HIV was double for men recently engaging in homosexual activity and cocaine injection. Among women, the incidence of HIV was more than double for those recently reporting sexually transmitted diseases.Conclusions: The incidence of HIV remained high among IDUs in Baltimore over the past decade. Risk factors for HIV seroconversion differed markedly by sex. Predominant risks among men included needle sharing and homosexual activity; among women, factors consistent with high-risk heterosexual activity were more significant than drug-related risks. Human immunodeficiency virus interventions aimed at IDUs should be sex-specific and incorporate sexual risks.