Correlation of codeine abuse with HIV infection and related high-risk behavior among men who have sex with men
PENG Er-lei, MAO Xiang, LI Jia-ming, JIANG Yong-jun, GENG Wen-qing, XU Jun-jie
Key Laboratory of AIDS Immunology of the National Health Commission, the First Affiliated Hospitalof China Medical University, Shenyang, Liaoning 110001, China
摘要目的 了解男男性行为(men who have sex with men,MSM)人群磷酸可待因的滥用情况,分析滥用磷酸可待因与(human immunodeficiency virus,HIV)感染及相关高危行为的关系。 方法 采用访谈式问卷收集2012年6月-2013年6月,中国7城市MSM人群的社会人口学、性行为、磷酸可待因及其他药物滥用行为等信息。采集静脉血检测HIV抗体。 结果 4 492名MSM调查对象中,84名(1.87%)自报近半年内有磷酸可待因滥用经历。滥用者近半年内发生同性商业性行为(AOR=3.431,95%CI:2.104~5.593)、肛门出血(AOR=2.052,95%CI:1.243~3.387)、安全套破裂(AOR=2.735,95%CI:1.578~4.741)、群体性行为(AOR=4.573,95%CI:2.454~8.521)、吸食rush(AOR=2.759,95%CI:1.763~3.387)和存在部分特定性病症状(AOR=4.926,95%CI:2.880~8.426)的风险均显著更高。吸食过rush(AOR=1.509,95%CI:1.219~1.869)、肛门出血(AOR=1.595,95%CI:1.246~2.041)和存在部分特定性病症状(AOR=1.689,95%CI:1.192~2.392)与HIV感染呈正相关。未发现滥用磷酸可待因与HIV感染之间的显著关联性(OR=1.289,95%CI:0.588~2.825)。 结论 尽管MSM群体中磷酸可待因滥用还不普遍,但相关滥用者容易发生与HIV感染相关的各类高危行为,间接增加其HIV感染风险。卫生部门需进一步加强关注和监测MSM群体的磷酸可待因滥用情况,控制该人群HIV的流行和扩散。
Abstract:Objective To investigate the prevalence of codeine abuse and its relationship with HIV infection and related high-risk behavior among men who have sex with men (MSM). Methods An interview-based questionnaire survey was conducted among MSM in seven Chinese cities from June 2012 to June 2013. The information about socio-demographics, sexual behavior, codeine and other substance use was assembled, and venous blood samples were collected for HIV antibody testing. Results Among 4,492 surveyed MSM, 84 (1.87%) self-reported OTC codeine use in the past 6 months. Homosexual commercial sex (AOR=3.431,95%CI:2.104-5.593), anal bleeding (AOR=2.052, 95%CI:1.243-3.387), condom breakage (AOR=2.735, 95%CI:1.578-4.741), group sexual encounters (AOR=4.573, 95%CI:2.454-8.521), rush poppers use (AOR=2.759, 95%CI:1.763-3.387) andhaving some specificsymptoms of sexually transmitted infections (AOR=4.926, 95%CI:2.880-8.426) were independent predictors of codeine abuse in the past six months. Rush poppers use (AOR=1.509, 95%CI:1.219-1.869), anal bleeding (AOR=1.595, 95%CI:1.246-2.041),having some specificsymptoms of sexually transmitted infections (AOR=1.689, 95%CI:1.192-2.392) were positively correlated with HIV infection. No significant correlation was found between codeine abuse and HIV infection (OR=1.289, 95%CI=0.588-2.825). Conclusions Although codeine abuse is not popular in MSM, codeine abusers are prone to engaging in HIV-related high-risk behavior, which indirectly increases the risk of HIV infection. Public health departments need to further strengthen surveillance of codeine abuse so as to curb the fast spread of HIV among MSM.
彭二磊, 毛翔, 李佳明, 姜拥军, 耿文清, 徐俊杰. 磷酸可待因滥用与MSM人群HIV感染及相关高危行为的关联性[J]. 实用预防医学, 2019, 26(1): 1-4.
PENG Er-lei, MAO Xiang, LI Jia-ming, JIANG Yong-jun, GENG Wen-qing, XU Jun-jie. Correlation of codeine abuse with HIV infection and related high-risk behavior among men who have sex with men. , 2019, 26(1): 1-4.
[1] 殷炜珍, 唐记华. 可待因止咳水依赖及防治[J]. 中国药物滥用防治杂志, 2017, 23(1):59-62. [2]周小兰. 广东省中学生含磷酸可待因“止咳水”的滥用状况调查[D]. 广州:中山大学, 2010. [3] 胡志辉, 孙涛涛, 聂秋容. 可待因类止咳水成瘾治疗前后骨矿密度研究[J]. 中国骨质疏松杂志, 2016, 22(8):1004-1007. [4] 刘志民, 吕宪祥, 连智,等. 我国部分地区吸毒人群中止咳药滥用流行病学调查[J]. 药物流行病学杂志, 2002, 11(3):129-131. [5] Zhang H, Teng T, Lu H, et al. Poppers use and risky sexual behaviors among men who have sex with men in Beijing, China[J].Drug Alcohol Depen, 2015(160):42-48. [6] Xu JJ, Chu ZX, Min Z, et al. A cross-sectional study of HIV and syphilis infections among male students who have sex with men (MSM) in northeast China: implications for implementing HIV screening and intervention programs[J]. BMC Public Health, 2011, 11(1):287. [7] Mayer KH, Colfax G, Guzman R. Club drugs and HIV infection: a review[J]. Clin Infect Dis, 2006, 42(10):1463-1469. [8] Zheng C, Xu J, Hu Q, et al. Commercial sex and risk of HIV, syphilis, and herpes simplex virus-2 among men who have sex with men in six Chinese cities[J]. BMC Infect Dis, 2016, 16(1):765. [9] Xu JJ, Zhang C, Hu QH, et al. Recreational drug use and risks of HIV and sexually transmitted infections among Chinese men who have sex with men: mediation through multiple sexual partnerships[J]. BMC Infect Dis, 2014, 14(1):1-7. [10] Xu JJ, Qian HZ, Chu ZX, et al. Recreational drug use among Chinese men who have sex with men: a risky combination with unprotected sex for acquiring HIV infection[J]. Biomed Res Int, 2016, 2014(2):725361. [11] 邱兴庆, 张静, 孟丽丽,等. 襄阳市MSM人群艾滋病新发感染影响因素探讨[J]. 实用预防医学, 2016, 23(9):1066-1069. [12] 赵俊仕, 陈曦, 贺健梅,等. 湖南省新型毒品吸食者行为特征分析[J]. 实用预防医学, 2016, 23(5):526-528. [13] Hirshfield S, Schrimshaw EW, Stall RD, et al. Drug use, sexual risk, and syndemic production among men who have sex with men who engage in group sexual encounters[J]. Am J Public Health, 2015, 105(9):1849-1858. [14] Hidaka Y, Ichikawa S, Koyano J, et al. Substance use and sexual behaviours of Japanese men who have sex with men: a nationwide internet survey conducted in Japan[J]. BMC Public Health, 2006, 6(1):239.