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Objective@#To evaluate the effectiveness of AIDS intervention programs on men aged 50 or over and having had non-marital sexual behavior.@*Methods@#A community-based intervention/experimental and based on individual level study was adopted. Stratified sampling method was used. 12 townships/streets in Fuyang district of Hangzhou were identified as intervention or control group (six research sites each). All of the subjects in the township (street) were included. The inclusion criteria of study objects would include men aged 50 or older who reported having unmarried sex in the last year. Estimated sample size was 290, with each 145 in the intervention group and the control group. All the intervention group participants were provided with a total of 4 intervention-related items (knowledge and education on AIDS prevention, information radiation and behavioral change, broadcast expert lectures), every 3 months, for 12 month, the main evaluation indicators would include: incidence of non-marital sex and commercial sex in the last year, condom use when having non-marital sex in the last episode.@*Results@#A total of 312 subjects were recruited. 300 of them completed the baseline study while 284 of them completed the follow-up survey. Among the subjects who had undergone the baseline study, the average age was (65.58±7.89), 71.33% were married or cohabiting with someone, 52.00% having had primary school education. After the implementation of intervention programs, the incidence of non-marital sex dropped to 59.42% (82/138) and the incidence of commercial sex dropped from 79.73% (118/148) to 55.07% (76/138). Condom use rate in the last non-marital sexual contact increased from 19.59% (29/148) to 51.22% (42/82). In the control group, the incidence of non-marital sex in the year before dropped to 74.66% (109/146) and the incidence of commercial sex dropped from 91.45% (139/152) to 72.60% (106/146). Rates of condom use during the last non-marital sexual contact dropped from 32.89% (50/152) to 31.19% (34/109). Statistically, there were significant differences appeared between the two groups on the incidence of non-marital sex in the past year (χ2=7.48, P=0.008), the incidence of commercial sex in the last year (χ2=9.47, P=0.003) and the rate of condom use in the last sex experience (χ2=7.83, P=0.007).@*Conclusions@#Results from this intervention study showed that: in the intervention group, both the incidence rates of non-marital or commercial sex had reduced, together with the increase of condom use in non-marital sex in the last sexual experience. Intervention strategies that involving knowledge and education on AIDS prevention, information radiation and behavioral change, broadcasting lectures by experts etc. were all proved effective.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.
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Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.
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When facing the worldwide abuse of opioid substance,one of the effective responses is opioid substitution therapy (OST).However,different OST service patterns may affect the therapeutic outcome.Using the System Engineering Initiative for Patient Safety (SEIPS) model,we can analyze the factors that affecting the outcomes of patients from the perspective work system.In this paper,SEIPS model is used to describe the existing OST service model.According to the operation mechanism of the methadone maintenance treatment in China and the existing OST service model,some suggestions are put forward to carry out effective OST service in the country.
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Objective To explore the reasons and factors associated with new psychoactive substances abuse among patients with access to methadone maintenance treatment (MMT).Methods A well-developed questionnaire and urine tests were used to collect information about demographic characteristics,condition of MMT and drug abuse,family and social support of MMT clients.A 1 ∶ 1 matched case-control study was conducted,and conditional logistic regression model was used to identify factors associated with new psychoactive substances abuse.Results A total of 212 (106 pairs) clients receiving MMT were recruited,and most of them were males (78.3％,166/212),married or cohabitant (48.6％,103/212) and unemployed (63.2％,134/212).The average age of the clients was (45.1 ± 7.2) years.The main types of abused new psychoactive substances were benzodiazepine (62.3％,66/106) and methamphetamine (39.6％,42/106).The proportion of abusing multi new psychoactive substances was 8.5％ (9/106).Results from multivariate conditional logistic regression analysis indicated that using opioid drug during the past 6 months of MMT treatment might increase the risk of abusing new psychoactive substances (OR=3.25,95％CI:1.35-7.79),benzodiazepine (OR=3.25,95％CI:1.11-9.47) and methamphetamine (OR =13.31,95 ％ CI:1.12-158.01).Moreover,MMT for more than 9 years reduced the risk of abuse of new psychoactive substances (OR=0.03,95％ CI:0.01-0.21),benzodiazepine (OR=0.02,95％ CI:0.00-0.36) and methamphetamine (OR=0.02,95％ CI:0.00-0.69).Conclusion Less new psychoactive substances abuse might be associated with longer duration of MMT treatment.And inappropriate support from family and friends might increase the risk of abusing new psychoactive substances in MMT clients,especially in clients who used opioid.
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Methadone maintenance treatment (MMT) greatly contributed to the successful outcomes of prevention and control on both AIDS and drug abuse in China.However,the features on drug abuse changed in the past decades,and the prevalence of new psychoactive substances abuse potentially somehow offset the achievement of MMT.This paper concised the information on research and surveys of this issue that targeting on the current situation,characteristics,related factors and relevant public health problem on new psychoactive substances abuse,among patients who have been on MMT,in China.
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Objective To analyze the problems in the network direct reporting of information about intervention service conducted in population at high risk for HIV infection in China during 2013-2014,and provide evidence for the improvement of the network direct reporting of the intervention information.Methods The wrong records of the intervention service in population at high-risk were collected from national AIDS prevention and treatment information system.The wrong records,including those found at county (district) level and those found at state level,were analyzed with descriptive statistical method.Results A total of 1 066 wrong records were found during 2013-2014,and average annual wrong record rate was ＜0.1％.Up to 71.3％ (760/1 066) of wrong records occurred in the first half year.The wrong records in eastern,central and western areas accounted for 14.9％ (159/1 066),22.6％ (241/1 066) and 62.5％ (666/1 066) of the total respectively.More wrong records were found in the intervention information for men who have sex with men and injecting drug users than in those for female sex workers.Among the total wrong records,86.4％ (921/ 1 066) were found at county level and 13.6％ (145/1 066) were found at state level.The wrong records were mainly "annual number of persons receiving the first HIV test" and "annual number of persons covered by intervention".Common causes of wrong records were underreporting and delay,staff fault,miscalculation and misunderstanding.Conclusion In general,the wrong record rate in intervention information for population at high risk for HIV infection reported directly through network was low in China.It is necessary to strengthen the recording of the intervention service,the quality control of statistics and network direct reporting and staff training to improve the quality of reported data of intervention service.
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Objective To analyze the problems in the network direct reporting of information about intervention service conducted in population at high risk for HIV infection in China during 2013-2014,and provide evidence for the improvement of the network direct reporting of the intervention information.Methods The wrong records of the intervention service in population at high-risk were collected from national AIDS prevention and treatment information system.The wrong records,including those found at county (district) level and those found at state level,were analyzed with descriptive statistical method.Results A total of 1 066 wrong records were found during 2013-2014,and average annual wrong record rate was ＜0.1％.Up to 71.3％ (760/1 066) of wrong records occurred in the first half year.The wrong records in eastern,central and western areas accounted for 14.9％ (159/1 066),22.6％ (241/1 066) and 62.5％ (666/1 066) of the total respectively.More wrong records were found in the intervention information for men who have sex with men and injecting drug users than in those for female sex workers.Among the total wrong records,86.4％ (921/ 1 066) were found at county level and 13.6％ (145/1 066) were found at state level.The wrong records were mainly "annual number of persons receiving the first HIV test" and "annual number of persons covered by intervention".Common causes of wrong records were underreporting and delay,staff fault,miscalculation and misunderstanding.Conclusion In general,the wrong record rate in intervention information for population at high risk for HIV infection reported directly through network was low in China.It is necessary to strengthen the recording of the intervention service,the quality control of statistics and network direct reporting and staff training to improve the quality of reported data of intervention service.
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Objective To understand the demographic characteristics of HIV infected injecting drug users (IDUs) with access to antiretroviral therapy (ART) and to identify the factors influencing their access to methadone maintenance treatment (MMT).Methods Outpatients infected with HIV through injecting drug use were selected from the ART clinics in 2 counties in Yunnan province.They were divided into 2 groups,MMT group and non MMT group.Descriptive epidemiologic analysis was conducted on their demographic characteristics,disease history and high risk behaviors and logistic regression analysis was done to identify the factors associated with the access to MMT.Results Among 635 IDUs (536 males,99 females) surveyed,247 received MMT (38.9％),388 received no MMT(61.1％).The median age was 40.33 years and the median diagnosed HIV infection time was 6.08 years.Multivariate logistic regression indicated that being female (OR=2.40,95％CI:1.00-5.74),educational level of junior high school (OR =3.28,95％CI:1.75-6.14),educational level of senior high school or above (OR =7.10,95 ％CI:1.90-26.62),more than 6 years of diagnosed HIV infection history (OR=3.84,95％CI:2.11-6.98) and HCV positive (OR=6.21,95％CI:3.06-12.58) were the positive factors influencing IDUs' access to MMT.However,being married (OR=0.38,95％CI:0.20-0.72) or being employed (OR=0.01,95％CI:0.00-0.02) were the negative factors influencing IDUs' access to MMT.Conclusion The proportion of HIV infected IDUs who received MMT in ART clinics was still very low in the two counties,targeted intervention measures should be taken to increase the MMT coverage,especially among those who are married or employed.
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Objective To understand the quality of malaria blood examinations in township?level hospitals,so as to provide the evidence for continuing the malaria blood examinations in the stage of post?malaria elimination. Methods A total of 64 township hospitals were investigated and 640 negative malaria blood slides were scored individually according to 10 indicators inMalaria Elimination Technical Schemein 2013 and 2014. The single and multiple indicators were calculated,and the work of blood examinations and situation of technicians were investigated. The data of malaria blood examinations and patient discovery in township hospitals of Nantong City were collected and analyzedduring the period of 2011-2014. Results Forthe single indi?cator,29.5%of the thick blood films did not reach the standard,and 35.8%of thin blood films did not reach the standard. For the multiple indicators,blood slides with more than 4 indicators below the standard(poor quality)accounted for 32.5%. From ma?laria blood examinations and malaria situation,the number of slides was 194 635 during the period of 2011-2014,and there were no local vivax malaria casesin 4consecutive years from 2011 to 2014,andlocal malaria has been effectively controlled in Nantong City. For health facilities where malaria patients initially presented,the township and village level accounted for 16.3%,and county and higher level accounted for 83.7%. Conclusions The quality of malaria blood examinations in township level hospitals of Nantong City is not high and the microscopic examination has a relatively low efficiency in the discovery of ma?laria cases. A new model for malaria blood examinations needs to be further explored.
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Objective To assess the prevalence of overdose of heroin and risk factors in intravenous drug users (IDUs) in Yunnan Province.Methods During July-August of 2015,IDUs were recruited from four methadone maintenance treatment (MMT) clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures,Yunnan province.The information about IDUs' demographic characteristics and drug use history,overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey.The factors associated with overdose of heroin were evaluated with logistic regression models.Results Of the 340 IDUs surveyed,85.3％(290/340) were males,the mean age was 37.7± 8.7 years,65.6％ (223/340) were Han ethnicity,and 49.4％ (167/338) were HIV positive,22.6％ (77/340) reported having used club-related drugs (such as ephedrine,methamphetamine,benzodiazepines and ketamine) in the previous 12 months.Of the 340 IDUs,41.8％ (142/340) had at least one overdose of heroin in their lifetime (median:3 overdoses) and 15.6％ (53/340) had at least one overdose of heroin (median:1 overdose use) in previous 12 months.The mean age of the 53 IDUs was (36.7 ± 8.4) years,and 83.0％ (44/53) of them were males,the average drug use history was (16.5 ± 7.6) years.Dosage increase (26.4％,14/53) and multidrug use (28.3％,15/53) were the main causes for overdose of heroin.Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year (OR=0.534,95％CI:0.290-0.980) was independently associated with decreased risk of overdose of heroin,needle sharing in the past 6 months (OR=2.735,95％CI:1.383-5.407) and being forced to receive drug rehabilitation for less than one year (OR=2.881,95％CI:1.226-6.767) were independently associated with increased risk of overdose of heroin.Conclusion Overdose of heroin is common among IDUs in Yunnan.It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin,especially before they leave drug rehabilitation centers.And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.
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Objective To assess the prevalence of overdose of heroin and risk factors in intravenous drug users (IDUs) in Yunnan Province.Methods During July-August of 2015,IDUs were recruited from four methadone maintenance treatment (MMT) clinics and two compulsory drug rehabilitation centers in Honghe and Dehong prefectures,Yunnan province.The information about IDUs' demographic characteristics and drug use history,overdose of heroin in previous12 months and the latest overdose of heroin were collected through face to face questionnaire survey.The factors associated with overdose of heroin were evaluated with logistic regression models.Results Of the 340 IDUs surveyed,85.3％(290/340) were males,the mean age was 37.7± 8.7 years,65.6％ (223/340) were Han ethnicity,and 49.4％ (167/338) were HIV positive,22.6％ (77/340) reported having used club-related drugs (such as ephedrine,methamphetamine,benzodiazepines and ketamine) in the previous 12 months.Of the 340 IDUs,41.8％ (142/340) had at least one overdose of heroin in their lifetime (median:3 overdoses) and 15.6％ (53/340) had at least one overdose of heroin (median:1 overdose use) in previous 12 months.The mean age of the 53 IDUs was (36.7 ± 8.4) years,and 83.0％ (44/53) of them were males,the average drug use history was (16.5 ± 7.6) years.Dosage increase (26.4％,14/53) and multidrug use (28.3％,15/53) were the main causes for overdose of heroin.Multiple logistic regression analysis indicated that methadone maintenance treatment during the past year (OR=0.534,95％CI:0.290-0.980) was independently associated with decreased risk of overdose of heroin,needle sharing in the past 6 months (OR=2.735,95％CI:1.383-5.407) and being forced to receive drug rehabilitation for less than one year (OR=2.881,95％CI:1.226-6.767) were independently associated with increased risk of overdose of heroin.Conclusion Overdose of heroin is common among IDUs in Yunnan.It is necessary to encourage IDUs to receive MMT and strengthen the health education about the prevention of overdose of heroin,especially before they leave drug rehabilitation centers.And it is important to establish a referral mechanism from drug rehabilitation center to MMT clinic for drug users.
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<p><b>OBJECTIVE</b>To understand that whether initiation of antiretroviral therapy (ART) would impact on the change and its reasons regarding the HIV-related high risk behaviors among HIV-positive clients who attending the methadone maintenance treatment (MMT).</p><p><b>METHODS</b>In-depth interviews were conducted among 34 MMT clients in Yunnan province who were under ART. The related contents would include information on general demographic charicteristics, HIV infection,MMT, number of sexual partners before and after ART, sexual behavior and frequency of condom use, drug use, needle sharing, changes in risk behaviors before and after the ART, reasons for high-risk behavior, of the clients.</p><p><b>RESULTS</b>The average age of the interviewees was 38.5 years, and most of them were male (70.6%). The clients under this study all admitted that the frequencies of unsafe sex and needle sharing did not increase after the ART initiation, with the main reasons as increasing HIV related awareness, the use of methadone, high accessibility of free condoms and access to clean needles etc. However, 12 of 34 reported being relapsed and 3 reported inconsistent condom use. The interaction of ART and dosage of methadone were connected to the episodes of relapsing and the ART optimism would result in inconsistent condom use.</p><p><b>CONCLUSION</b>No evidence supported that the ART initiation would increase the risk behaviors among the HIV-infected MMT clients. However, attention needs to be paid to the new challenges caused by high expectation of ART.</p>
Subject(s)
Adult , Female , Humans , Male , China , Epidemiology , Condoms , HIV Infections , Epidemiology , Methadone , Therapeutic Uses , Needle Sharing , Opiate Substitution Treatment , Qualitative Research , Risk-Taking , Safe Sex , Sexual Behavior , Sexual Partners , Substance-Related Disorders , Drug Therapy , Unsafe SexABSTRACT
<p><b>OBJECTIVE</b>To explore the impacts of antiretroviral treatment on drug use and high risk sexual behaviors among HIV-positive MMT clients.</p><p><b>METHODS</b>A cross-sectional study was conducted in patients undergoing ART (ART-experienced) and patients not undergoing ART (ART-naive) attending MMT in 5 clinics in Yunnan Honghe and Dehong prefectures in 2014. A questionnaire was designed to collect socio-demographic characteristics, ART and MMT information and sexual and drug use behaviors within 3 months before the investigation was conducted. Logistic regression analysis was conducted to identify the predictors for drug use and risky sexual behaviors.</p><p><b>RESULTS</b>A total of 328 cases were included in the analysis, among which 202 were ART-experienced and 126 were ART-naÏve. Among 152 respondents who were sexually active, 61 (40.1%) reported having unprotected sex (UPS) with their regular partners in the prior 3 months. A total of 57.6% (189/328) of the respondents used drugs in the prior 3 months. Multiple logistic regression analysis revealed that younger than 35 years old (OR = 3.57, 95% CI: 1.23-10.37), fertility desire (OR = 4.47, 95% CI: 1.49-13.41), partner being HIV-positive (OR = 4.62, 95% CI: 1.80-11.86), length of MMT attendance less than 5 years (OR = 2.92, 95% CI: 1.14-7.53), agreed that it was necessary to use condom no matter the viral load is high or low (OR = 0.14, 95% CI: 0.04-0.51) were protective factors of UPS in the prior 3 months. Multiple logistic regression analysis revealed that being Han (OR = 0.46, 95% CI: 0.24-0.89), feeling having good health status (OR = 0.39, 95% CI: 0.18-0.85), being enrolled in ART (OR = 0.32, 95% CI: 0.17-0.60) were protective factors for drug use in the prior three months, having contact with drug using friends (OR = 4.41, 95% CI: 2.31-8.29), having experience of missing an MMT dose (OR = 3.47, 95% CI: 1.92-6.29), and not satisfied with current MMT dose (OR = 13.92, 95% CI: 3.24-59.93) were risk factors for drug use during the prior three months.</p><p><b>CONCLUSION</b>ART was not associated with risky sexual behavior and drug use in the prior 3 months in this population. Future interventions should promote ART among this population, and provide education at the same time to prevent the emergence of cross infections and drug-resistant strains.</p>
Subject(s)
Humans , Anti-HIV Agents , China , Condoms , Cross-Sectional Studies , HIV Infections , HIV Seropositivity , Organometallic Compounds , Protective Factors , Risk Factors , Risk-Taking , Sexual Behavior , Sexual Partners , Substance-Related Disorders , Unsafe SexABSTRACT
<p><b>OBJECTIVE</b>To describe club-based drug use and to explore the determinants on those HIV-positive methadone maintenance treatment (MMT) clients.</p><p><b>METHODS</b>This study was conducted in 5 MMT clinics in Yunnan province and 612 MMT clients who met the survey criteria were recruited for the study. Urine sample was tested as a biological marker to identify if heroin, methamphetamine, methylene-dioxy-methyl-amphetamine, buprenorphine or benzodiazepine had been used.</p><p><b>RESULTS</b>The average age among the 612 clients was 38.9 ± 6.3 years. Among these, 78.9% were males, with the average years of education as 8.0 ± 3.4 years. There were 60.5% clients who had good relationship with their families. 153 (25.0%) clients reported having used club-related drugs in the last 12 months. Results from the urine test showed that the positive rate on morphine was 14.4%, while the positive rate for club-related drugs was 26.6%. Factors as residential area, casual sexual partners, retention on MMT and occasionally use of heroin were associated with urine results on club-related drugs and the prevalence of self-reported club drug use (P < 0.05).</p><p><b>CONCLUSION</b>Club-related drug use was common among HIV-positive MMT clients. Inspection and supervision for club-related drugs and the education and intervention programs on related high risk behaviors should be strengthened.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , China , Epidemiology , HIV Seropositivity , Drug Therapy , Methadone , Therapeutic Uses , Opiate Substitution Treatment , Risk Factors , Substance-Related Disorders , EpidemiologyABSTRACT
<p><b>OBJECTIVE</b>To describe the adherence and related determinants among HIV-positive methadone maintenance treatment(MMT)clients in Dali,Yunnan province from 2005 to 2013.</p><p><b>METHODS</b>Cases were selected from the "National MMT Information Management System". The main information included demographic, drug abuse behaviors prior to enrollment, MMT treatment and highly active antiretroviral therapy (HAART). Detailed medication records were collected to calculate the adherence to MMT. Multivariate unconditional logistic regression was conducted to analyze the impact factors of adherence.</p><p><b>RESULTS</b>The MMT adherence rate of 480 subjects is 58.11%. Data from the multivariate unconditional logistic regression indicated that among those HIV-positive MMT clients that on HAART program (OR = 1.52, 95% CI:1.03-2.24), related factors as:having stable job(OR = 1.69, 95% CI:1.11-2.56), having compulsory history prior to enrollment in MMT (OR = 1.78, 95% CI:1.04-3.04) were likely to have higher rate on MMT adherence, whereas clients who showed positive result in the last urine morphine test (OR = 0.38, 95% CI:0.24-0.59) were associated with lower rate on MMT adherence.</p><p><b>CONCLUSION</b>In order to improve the rate of adherence to MMT among those HIV-positive MMT clients, the coverage of HAART needed to be expanded and new approaches in combining MMT and HAART developed. Education and intervention efforts should be focused on clients who currently were jobless, those with last urine morphine testing as positive or had never received compulsory treatment.</p>
Subject(s)
Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Antiretroviral Therapy, Highly Active , China , Epidemiology , HIV Infections , Drug Therapy , Epidemiology , Psychology , HIV Seropositivity , Medication Adherence , Methadone , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To explore the routes and factors associated with HIV new infection of heroin addicts who had been attending the methadone maintenance treatment (MMT) program.</p><p><b>METHODS</b>A 1 : 1 nested case-control study was implemented with the cases (new HIV infections) and controls (HIV negative) selected from the treatment cohort of China MMT clients. Questionnaire was developed to collect information on demographic characters, behaviours on drug use, sexual behaviour, daily dosage of methadone intake, adherence to MMT, and psychological problems. Univariate analysis and multivariate condition logistic regression were used to identify factors associated with HIV infection.</p><p><b>RESULTS</b>108 (54 paired) clients on MMT were recruited, with 76 males and 32 females. Among them, 95 were Han Chinese and 13 were minorities, with average time of drug use as 12.1 ± 5.0 years. Among 54 new HIV infections, 33 were infected through sharing needles, 12 were through sexual contact and 9 unidentified. Results from multivariate condition logistic regression indicated that having longer duration of heroin use before on MMT (More than 10 years vs. less than 10 years,OR = 20.9, 95% CI:1.62-269.34, P = 0.02), shared needles in the last 6 months (OR = 276.7, 95%CI:5.65-> 999.99, P < 0.01) were risk factors while better adherence (More than 0.5 vs. less than 0.5,OR = 0.07, 95%CI:0.42-0.87, P = 0.04) and living with families (OR = 0.002, 95% CI:0.001-0.94, P < 0.01) were protective factors.</p><p><b>CONCLUSION</b>Sharing needles was the main route of HIV new infection among those clients that were on MMT. Factors as having received more support from both family and community, improvement of adherence to MMT, reducing the frequency of injection etc., could reduce the risk of HIV infection among those MMT clients.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Case-Control Studies , Follow-Up Studies , HIV Infections , Epidemiology , Heroin Dependence , Drug Therapy , Matched-Pair Analysis , Methadone , Therapeutic UsesABSTRACT
Objective To explore the best cut-point of waist-to-heisht ratio (WHtR) for identifying metabolic syndrome(MS)in adolescents.Methods A cross-sectional study was conducted in 4 507 adolescents aged 13-18 years in Qinhuangdao.Receiver operating characteristic (ROC) curve analysis was employed to determine the optimal WHtR cut-point for detecting MS.Results The prevalences of MS were higher among higher WHtR in both boys and girls.Odds ratios for MS significantly increased from the WHtR≥0.45 in boys(OR =13.85,95%CI 4.08-46.97)and in girls (OR=12.42,95%CI 2.62-58.96,P<0.01).The ROC curve analysis showed that the optimal WHtR cut-point was 0.45 in boys with the sensitivity of 89.4%and specificity of 81.4%.and in girls with sensitivity of 90.3%and specificity of 86.5%.Conclusion There is a significant correlation between WHtR and MS.Optimal WHtR cut-point for predicting MS is 0.45.
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Objective To understand the prevalence and the factors associated with depression and anxiety among patients attending the community-based methadone maintenance treatment(MMT) program.Methods 9 MMT clinics in 3 provinces were randomly selected,in which 1 301 MMT patients who met the criteria of recruitment were all interviewed.A cross-sectional study by administrative questionnaire was employed to investigate the demographics,drug abuse and MMT treatment status of the respondents.The 1301 respondents were also evaluated for depression and anxiety by SDS(Self-Rating Depression Scale) and SAS(Self-Rating Anxiety Scale) respectively.ANOVA and multivariate linear regressions analysis was used to verify the factors associated with depression and anxiety respectively.Results The prevalence of depression and anxiety among the MMT patients were 38.3%(498/1 301) and 18.4%(239/1 301).The multivariates linear regression analysis indicated that at the level of ?=0.05,gender,employment status were associated with depression,while gender,employnment status,educational level,drug abuse and methadone daily dosage were associated with anxiety.Conclusions There are certain proportions of MMT clients who suffer from depression and anxiety.The MMT clinic staff should put more emphasis on the efforts to reduce psychological disorders and its potential risks by enhancing psychological councelling,intervention and social support towards the MMT patients.