Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China.
Syndemics of syphilis, HCV infection, and methamphetamine use along the east coast of China.
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DOI：
10.1186/1471-2458-14-172
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发表时间：
2014-02-17
影响因子：
4.5
通讯作者：
Jia Y
中科院分区：
文献类型：
--
作者：
Liao M;Kang D;Tao X;Cox C;Qian Y;Wang G;Yang C;Zhu X;Zhang N;Bi Z;Jia Y
近年来，中国的一些城市出现了俱乐部吸毒的热潮，特别是冰毒，它正迅速取代海洛因，成为全国使用最广泛的毒品。本文调查了中国东部沿海两个城市吸毒人群的吸毒类型、梅毒和丙型肝炎病毒感染情况及其与梅毒、丙型肝炎病毒感染和无保护商业性行为的关系。2010年进行的一项横断面调查提供了吸毒者的人口统计、性和吸毒行为、艾滋病毒知识和干预服务的利用情况。对血液样本进行艾滋病毒、梅毒和丙型肝炎病毒感染检测。在805名合格参与者中，0.2%的人感染了艾滋病毒，3.7%的人感染了丙型肝炎病毒，9.6%的人感染了梅毒。调查对象中，96.6%吸食冰毒，11.9%吸食过≥-2类毒品，11.4%吸食过毒品。多因素Logistic回归分析显示，梅毒感染者多为女性(调整优势比(AOR)=2.8，95%可信区间(CI)：1.2~6.5)，过去12个月内有过商业性行为(AOR=2.0，95%CI：1.0~3.9)，感染过丙型肝炎病毒(AOR=12.1，95%CI：4.1~20.3)，在过去12个月内与固定伴侣发生性关系的可能性较小(AOR=0.2，95%CI：0.1~0.6)。感染丙型肝炎病毒的人群更有可能注射毒品(AOR=2.7，95%CI：1.1~6.5)和感染梅毒(AOR=8.0，95%CI：3.5~18.0)。在最近一次性行为中与商业性伙伴发生无保护措施性行为的人群中，女性(AOR=2.9，95%CI：1.7~4.9)、初中及以下文化程度(AOR=3.4，95%CI：2.0~5.5)、最近一年从未接受过干预(AOR=2.1，95%CI：1.2~3.6)和感染梅毒(AOR=4.2，95%CI：2.4~7.4)的概率较大。吸毒者中以甲基苯丙胺为主，梅毒和丙型肝炎病毒感染率高得惊人，无保护的商业性行为在该人群中很常见。这些发现强调了有效的、多方面的干预措施的必要性，以解决这一群体中与性和药物使用相关的危险行为。需要进一步的研究才能更好地理解综合征的因果路径。
An upsurge in club drug use has been observed in recent years in some cities of China, especially methamphetamine, which is quickly replacing heroin to become the most widespread drug across the nation. This study investigated the type of drugs used, syphilis and hepatitis C virus (HCV) infection and the correlates for syphilis, HCV and unprotected commercial sex behavior among drug users in two cities along the east coast of China. A cross-sectional survey conducted in 2010 provided demographics, sexual and drug use behaviors, HIV knowledge and the utilization of intervention services among drug users. Blood samples were tested for HIV, syphilis, and HCV infection. Of 805 eligible participants, 0.2% were infected with HIV, 3.7% with HCV, and 9.6% with syphilis. Of the participants, 96.6% were methamphetamine users, 11.9% reported ever having used ≥2 types of these drugs, and 11.4% reported ever injecting drugs. In the multivariable logistic regression analysis, participants infected with syphilis were more likely to be female (adjusted odds ratio (AOR)=2.8, 95% confidence interval (CI): 1.2-6.5), have ever had commercial sex in the past 12 months (AOR=2.0, 95% CI: 1.0-3.9), be infected with HCV (AOR=12.1, 95% CI: 4.1-20.3) and less likely to have ever had sex with regular partners in the past 12 months (AOR=0.2, 95% CI: 0.1-0.6). Participants infected with HCV were more likely to have ever injected drugs (AOR=2.7, 95% CI: 1.1-6.5) and be infected with syphilis (AOR=8.0, 95% CI: 3.5-18.0). Participants who had unprotected sex with commercial sex partners in the last sexual encounter were more likely to be female (AOR=2.9, 95% CI:1.7-4.9), have middle school or lower level education (AOR=3.4, 95% CI:2.0-5.5), never have received intervention in the last year (AOR=2.1, 95%CI:1.2-3.6) and be infected with syphilis (AOR=4.2, 95% CI:2.4-7.4). Methamphetamine is the predominant drug used among the drug users, the prevalence of syphilis and HCV infection are alarmingly high, and unprotected commercial sex was common among this group. The findings highlight the need for effective, multifaceted interventions addressing sexual and drug use-related risky behaviors among this group. Further research is needed to better understand the causal pathway of the syndemics.
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