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目的探讨广东省静脉吸毒人员共用针具的影响因素,以及针具交换项目对预防吸毒人员共用针具的效果。方法采用社区干预研究的方法,选择各方面因素比较类似的两个镇,一个作为干预社区,一个为对照社区。干预区采用针具交换干预措施,对照区不采取任何干预措施,为期10个月。于干预前后分别采用滚雪球的方式抽取注射吸毒者进行断面调查,以评估共用针具的影响因素。影响因素的确定采用Logistic单因素分析,对有显著意义的变量进行多因素Logistic逐步回归分析。结果干预前后分别调查了428和429名静脉吸毒者。干预后干预组和对照组最近30天内共用针具率分别为20.4%和35.3%,差异有显著性(χ2=11.83,P=0.001)。多因素Logistic逐步回归分析结果显示:知晓艾滋病知识(OR=0.62,95%CI:0.45~0.85)、20~30岁年龄组(OR=1.41,95%CI:1.04~1.91)、使用多种毒品(OR=2.21,95%CI:1.53~3.19)、注射吸毒的年限(OR=2.38,95%CI:1.43~3.99)、重复使用注射器(OR=2.94,95%CI:2.06~4.19)、一次买4支针以上(OR=0.53,95%CI:0.33~0.86)、买针不方便(OR=2.08,95%CI:1.38~3.12)及是否看过艾滋病宣传折页或宣传画(OR=0.59,95%CI:0.42~0.83),是影响吸毒者共用针具的主要原因。结论针具交换项目有效地降低了静脉吸毒人员共用针具率,知晓艾滋病知识、针具交换项目的宣传及针具的可及性,是针具共用的预防因素;而青年人群、使用多种毒品及注射吸毒时间较长等,是共用针具的危险因素。因此今后的针具交换项目应该针对这些危险因素才能达到控制艾滋病在静脉吸毒人群中的传播。
Objective To explore the influencing factors of sharing needles among intravenous drug addicts in Guangdong Province and the effects of needle exchange programs on sharing needles among drug addicts. Methods Using the methods of community intervention study, two towns with similar factors in all aspects were selected, one as intervention community and one as control community. Interventions with needle exchange interventions, the control area without any intervention for a period of 10 months. Before and after the intervention, snowballs were used to extract injection drug users for cross-sectional survey to assess the impact of sharing needles. The influencing factors were determined by Logistic univariate analysis and multivariate Logistic stepwise regression analysis of significant variables. Results Before and after the intervention, 428 and 429 intravenous drug users were investigated. After the intervention, the rate of common needles in the intervention group and control group in the last 30 days was 20.4% and 35.3%, respectively, with significant difference (χ2 = 11.83, P = 0.001). The multivariate Logistic stepwise regression analysis showed that knowledge of AIDS (OR = 0.62, 95% CI: 0.45-0.85), 20-30 age group (OR = 1.41, 95% CI: 1.04-1.91) (OR = 2.21, 95% CI: 1.53-3.19), the number of years of drug abuse (OR = 2.38,95% CI: 1.43-3.9), repeated use of syringes (OR = 2.94, 95% CI: 2.06-4.19) (OR = 0.53, 95% CI: 0.33-0.86), inconvenient to buy the needle (OR = 2.08, 95% CI: 1.38-3.12), and whether or not the AIDS awareness leaflet or posters were seen (OR = 0.59, 95% CI: 0.42 ~ 0.83), which is the main reason that affects the sharing needles of drug addicts. Conclusion The needle exchange program has effectively reduced the share of needle-sharing rate among drug users, knowledge of HIV / AIDS, promotion of needle exchange programs, accessibility of needles, and prevention of needle sharing. In young people, Drugs and injecting drug abuse longer, is a risk factor for sharing needles. Therefore, future needle exchange programs should address these risk factors in order to achieve control of HIV transmission in intravenous drug users.