摘要目的 分析山东省某女性强制戒毒所内吸毒者HIV和梅毒感染情况,以及梅毒感染的影响因素.方法 于2015年5月,以山东省某女性强制戒毒所为研究场所,采用整群抽样方法对戒毒人员进行问卷调查和血清学检测.调查对象纳入标准:自愿参加本项研究活动、有明确的毒品滥用史、无神经和精神病性症状或症状已经缓解者.共计451名.采用自行编制的《女性吸食毒品者健康知识问卷》,问卷内容包括社会人口学特征、艾滋病防治知识知晓情况、行为学信息、毒品使用情况、性病求医及治疗情况等.抽取每名调查对象3～5 ml静脉血,进行HIV抗体、梅毒螺旋体检测.采用x2检验对不同特征吸毒人群梅毒抗体阳性率差异进行比较;采用多因素非条件logistic回归模型分析调查对象梅毒抗体阳性的影响因素.结果 451名调查对象的年龄为(27.25±7.06)岁,梅毒螺旋体抗体阳性率为33.5％(151/451),HIV抗体阳性率为2.2％(10/451).入所前12个月是、否提供商业性服务者梅毒抗体阳性率分别为47.2％(25/53)和31.6％(125/396)(x2=5.12,P=0.024);入所前12个月是、否与临时性伴发生性行为者的梅毒抗体阳性率分别为47.4％(91/192)和23.6％ (60/254) (x2=27.6,P＜0.001);单纯疱疹阳性和阴性者梅毒抗体阳性率分别为39.4％(128/325)和18.3％(23/126)(x2=18.2,P＜0.001);吸毒频率≥3和＜3次/周者梅毒抗体阳性率分别为36.9％(106/287)和27.3％(42/154) (x2=4.20,P=0.041).与未婚腐异/丧偶吸毒者相比,同居的吸毒者梅毒抗体阳性的OR(95％CI)值为2.19(1.36～3.51);与入所前12个月未与临时性伴发生性行为的吸毒者相比,发生性行为的吸毒者梅毒抗体阳性的OR(95％CI)值为2.59(1.65～4.05);与单纯疱疹阴性吸毒者相比,阳性吸毒者梅毒抗体阳性的OR(95％CI)值为2.69(1.57～4.59).结论 山东省某强制戒毒所内戒毒人员的HIV抗体和梅毒螺旋体抗体阳性率较高;入所前12个月提供商业性服务、与临时性伴发生性关系、单纯疱疹阳性、吸毒频率≥3次/周、与他人同居会增加其感染梅毒的风险.

abstractsObjective To analyze the prevalence of HIV,syphilis and related factors among female drug users in Shandong women's compulsory drug rehabilitation center (SWCDRC).Methods During May 2015,we used a cluster sampling method for drug users in SWCDRC,with a questionnaire and serological testing.We included respondents who volunteered to take part in this study,had clear histories of drug abuse,and had no symptoms of psychosis or current drug use;451 women participated.The questionnaire addressed socio-demographic information and the participants' health knowledge,including AIDS knowledge,behavioral information,drug use,and STD treatment.We also drew 5 ml blood from each subject for serological tests of HIV and syphilis.Chi-square test was used to compare syphilis antibody positive rate among drug users who had different characteristics.Multi-factor unconditioned logistic regression model was used to explore related factors about syphilis infection of women drug users.Results Subjects' mean age was (27.25±7.06) years.Of the 451 women,33.5％ (151/451) tested positive for syphilis and 2.2％ (10/451) for HIV.The rate of syphilis antibody (SAb) positive whether providing commercial server,providing:47.2％ (25/53);no providing:31.6％ (125/396);x2=5.12,P=0.024.The SAb+ rate from whether having temporary sexual behavior,having:47.4％ (91/192);no having:23.6％ (60/254);x2=27.6,P＜0.001.The SAb+ rate of subjects who tested positive for herpes simplex virus-2 (HSV-2) was 39.4％ (128/325);for those who tested negative it was 18.3％ (23/126);x2=18.2,P＜0.001.The SAb+ rate by frequency of drug use was ≥3 times a week:36.9％ (106/287);＜3 times per week:27.3％ (42/154);x2=4.20,P=0.041.Compared with subjects who were unmarried,divorced,or widowed drug users,the OR(95％ CI) for SAb+ among subjects who cohabited with a partner was 2.19 (1.36-3.51).Compared with subjects who had not been having temporary sexual behavior,the OR (95％CI) for SAb+ among subjects who had been having temporary sexual behavior was 2.59 (1.65-4.05).Compared with HSV-2 subjects,the OR (95％CI) for SAb+ among subjects who were HSV-2+ was 2.69 (1.57-4.59).Conclusion HIV and syphilis infection rate among female drug users in SWCDRC were significantly higher than in the general population.Subjects who had provided commercial server in the previous 12 months,had temporary sexual behavior in the previous 12 months,were HSV-2+,used drugs ≥3 times per week or cohabitated with a partner had higher syphilis prevalence.