美沙酮维持治疗人群高危性行为相关因素及交互作用分析

摘要

Objective To estimate the incidence of high-risk sexual behaviors and to explore the related factors among patients receiving methadone maintenance treatment.Methods Face to face interviews were conducted on 636 patients at 3 methadone maintenance treatment clinics in Guangxi Zhuang Autonomous Region,in China,from September to November,2014.General demographic characteristics and behavioral factors associated with high-risk sexual behavior of patients were collected through questionnaires.Both univariate and multivariate logistic regression analysis were used to analyze the related factors of high-risk sexual behaviors and the interactions between them.Results 636 participants were included in this study.Majority of the patients (80.2％) practiced high-risk sexual behaviors in the past three months.Data from the univariate analysis showed that factors as:gender,age,marital status,registered residence,history of hepatitis B (HepB) vaccination,age started drug use and HIV infection etc.might be associated with high-risk sexual behaviors (P＜0.05).Data from the multivariate logistic regression analysis showed that factors as:being male,histories with non-or unknown HepB vaccination and free of HIV infection etc.,were likely to have high-risk sexual behaviors,with OR (95％CI) as 1.668 (1.021-2.725),1.730 (1.068-2.801) and 2.880 (1.697-4.888),respectively.Additive interactions were observed between non-or unknown histories of HepB vaccination and free of HIV infection.Conclusion The incidence rates on high-risk sexual behaviors appeared high in patients under the methadone maintenance treatment.Patients with factors as:being male,histories with non-or unknown HepB vaccination and free of HIV infection were significantly associated with high-risk sexual behaviors.It is necessary to emphasize on behavioral intervention among patients under the methadone maintenance treatment,in order to reduce the occurrence of high-risk sexual behaviors.%目的 了解美沙酮维持治疗人群高危性行为的发生情况,并探讨相关因素.方法 对2014年9-11月在广西壮族自治区3所美沙酮维持治疗门诊的636名治疗者进行面对面问卷调查,收集其一般人口学特征、高危性行为及相关的行为因素等资料.通过x2检验和多因素回归分析探讨高危性行为的相关因素及其交互作用.结果 636名美沙酮维持治疗者中最近3个月发生过高危性行为的比例高达80.2％(510/636).单因素分析结果显示,性别、年龄、婚姻状况、户籍所在地、乙肝疫苗接种史、首次吸毒年龄和HIV感染可能与高危性行为的发生有关(P＜0.05);多因素回归分析表明,男性、未接种乙肝疫苗/接种史不详、未感染HIV的美沙酮维持治疗者发生高危性行为的风险较高,OR值(95％CI)分别为1.668(1.021～2.725)、1.730(1.068 ～ 2.801)和2.880(1.697～ 4.888).未接种乙肝疫苗/接种史不详与未感染HIV之间存在相加交互作用.结论美沙酮维持治疗人群高危性行为的发生率较高,其相关因素为男性、未接种乙肝疫苗/接种史不详以及未感染HIV.建议加强对美沙酮维持治疗者的干预,降低高危性行为的发生.