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中国西部地区艾滋病高危群体中吸毒人群对暴露前药物预防措施的接受意愿分析
钟珣1,钟晓妮1*,彭斌1,张燕1,梁浩2,邹云锋3,戴江红4,刘倩萍5,宋本莉5,黄爱龙6
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(1. 重庆医科大学公共卫生学院流行病与卫生统计学教研室,重庆400016
2. 广西医科大学公共卫生学院流行病与卫生统计学教研室,南宁530021
3. 广西医科大学公共卫生学院毒理学教研室,南宁530021
4. 新疆医科大学公共卫生学院流行病与卫生统计学教研室,乌鲁木齐 830000
5. 四川省西昌市皮肤病性病防治站,西昌 615000
6. 重庆医科大学感染性疾病分子生物学教育部重点实验室,重庆 400016
*通信作者)
摘要:
目的 探讨中国西部地区艾滋病高危群体中吸毒人群对暴露前药物预防(PrEP)措施用于降低HIV感染风险的接受意愿及其影响因素。 方法 采用滚雪球抽样法招募来自重庆、四川、新疆、广西4个中国西部省市、自治区中的男男性行为者(MSM)、女性性工作者(FSW)和HIV感染者的阴性配偶或固定性伴(PAR)三类艾滋病高危人群中的190名吸毒人员,利用调查员协助下的自填问卷方式对他们进行问卷调查,采用单因素和多因素logistic回归分析。 结果 调查艾滋病高危群体中吸毒人员共190例,MSM、FSW、PAR分别占34.74%(66/190)、48.42%(92/190)、16.84%(32/190)。PrEP在保证药物安全有效的前提下,整体吸毒人群的接受意愿可以达70%左右,并且有随条件的优越性升高而增加的趋势。多因素logistic回归分析结果 显示,与吸毒人群接受PrEP的意愿呈显著关联的有:认为艾滋病严重(OR:2.66,95%CI:1.14~6.25, P=0.024 2)和对艾滋病患者的态度(OR:4.41,95%CI:1.68~11.58, P=0.002 6;OR: 2.99,95%CI:1.05~8.54, P=0.040 3)以及HIV检测(OR:1.94,95%CI:0.98~3.87, P=0.058 1)。结论 艾滋病高危群体中吸毒人群对PrEP的接受意愿主要与其艾滋病相关的知识行为及对待艾滋病的态度有关,提示应加强预防艾滋病的宣传教育,提高特定人群乃至全社会对艾滋病的正确认识,对多种预防措施进行联合使用,以增加艾滋病高危群体对PrEP的接受意愿。
关键词:  吸毒人群  获得性免疫缺陷综合征  暴露前药物预防  接受意愿
DOI:10.3724/SP.J.1008.2012.00374
投稿时间:2011-12-27修订日期:2012-03-13
基金项目:国家科技重大专项 (2008ZX10001-016).
Attitude on pre-exposure prophylaxis (PrEP) among drug users from high-risk population of AIDS in western China
ZHONG Xun1,ZHONG Xiao-ni1*,PENG Bin1,ZHANG Yan1,LIANG Hao2,ZOU Yun-feng3,DAI Jiang-hong4,LIU Qian-ping5,SONG Ben-li5,HUANG Ai-long6
(1. Department of Epidemiology and Health Statistics, School of Public Health, Chongqing Medical University, Chongqing400016, China
2. Department of Epidemiology and Health Statistics, School of Public Health, Guangxi Medical University, Nanning530021, Guangxi, China
3. Department of Toxicology, School of Public Health, Guangxi Medical University, Nanning530021, Guangxi, China
4. Department of Epidemiology and Health Statistics, School of Public Health, Xinjiang Medical University, Urumchi 830000, Xinjiang, China
5. Xichang Institute for Prevention and Control of Dermatosis and STD, Xichang 615000, Sichuan, China
6. The Key Laboratory of Molecular Biology About Infectious Diseases, Ministry of Education, Chongqing Medical University, Chongqing400016, China
*Corresponding author.)
Abstract:
Objective To investigate the attitude on pre-exposure prophylaxis (PrEP) among drug users from high-risk population of AIDS in western China and its influencing factors. Methods A total of 190 drug users were recruited by snowball sampling from high-risk population of AIDS including those involved in mem having sex with men (MSM), female sex workers (FSW) and the spouse or sex partner (PAR) of HIV carrier in Chongqing, Sichuan, Guangxi and Xinjiang. Self-administered questionnaire survey was conducted with the assistance of investigators. Univariate and multivariate logistic regression was employed for statistical analysis. Results MSM, FSW and PAR accounted for 34.74%(66/190), 48.42%(92/190) and 16.84% (32/190) among the 190 drug users, respectively. The positive attitude rate for PrEP among drug users reached 70% in the premise of drug safety and effectiveness, which increased with favorable condition provided. The Results of multivariate logistic regression analysis indicated that the factors significantly associated with the positive attitude for PrEP included awareness of AIDS seriousness (OR: 2.66, 95% CI: 1.14-6.25, P=0.024 2), attitudes towards HIV patients(OR: 4.41, 95% CI: 1.68-11.58, P=0.002 6; OR: 2.99, 95% CI: 1.05-8.54, P=0.040 3) and virus detection of AIDS (OR: 1.94, 95% CI: 0.98-3.87, P=0.058 1). Conclusion The attitude for PrEP among drug users from AIDS high-risk population is mainly related to the attitude for AIDS, AIDS-related knowledge and behavior, and preventive measures for AIDS, indicating that PrEP should be implemented and promoted with a sound social background, and education on HIV/AIDS prevention should be reinforced. Positive attitude towards AIDS prevention need to be developed among drug users by various behavioral therapies, so as to improve the attitude for PrEP among drug users with high HIV risks.
Key words:  drug users  acquired immunodeficiency syndrome  pre-exposure prophylaxis  acceptability