サンフランシスコの静脈注入薬物使用者におけるコカイン使用とHIV感染
R E Chaisson1, P Bacchetti, D Osmond
1Medical Service, San Francisco General Hospital.
JAMA
|January 27, 1989
まとめ
黒人の異性愛者の静脈注射薬物使用者は,特にコカイン使用と共有の注射器具に関連したヒト免疫不全ウイルス (HIV) のリスクが高くなります. メタドン療法では,リスクの高い行動の軽減に様々な結果が出ています.
科学分野:
- 公衆衛生は公衆衛生である.
- 感染症 感染症は感染症です.
- エピデミオロジー エピデミオロジー
背景:
- ヘテロセクシュアルな静脈注射薬物使用者は,ヒト免疫不全ウイルス (HIV) 感染の鍵となる集団です.
- この集団内の特定の危険因子を理解することは,標的を絞った予防戦略にとって極めて重要です.
研究 の 目的:
- ヘテロセクシュアル・静脈注射薬物使用者におけるHIV感染に関連する危険因子を特定し,分析する.
- 特定の薬物使用パターン,特にコカイン,および社会人口学的要因がHIVの血清流行に与える影響を評価する.
主な方法:
- ヘテロセクシュアル・静脈注射薬物使用者633人を対象とした横断的な研究.
- 人種/民族 (黒人,ヒスパニック,白人) のHIVの血清発生率の評価.
- 薬物使用行動 (コカイン,ヘロイン),注射慣行,メタドン治療の状態を含むHIV感染の独立した予測要因を決定するための多変量分析.
主要な成果:
- 黒人 (26%) とヒスパニック (10%) のHIVの血清流行率は,白人 (6%) と比較して,黒人 (26%) とヒスパニック (10%) の個人に著しく高かった.
- 日常の静脈注射コカイン使用は主要なリスク因子 (OR,6.4) であり,コカインを定期的に使用する可能性が高い黒人被験者の方がより高い.
- 射撃ギャラリーでの薬物使用と注射器具の共有はHIV感染と関連しており,コカイン使用者の間でより一般的です. メタドン療法はヘロインの使用を減少させましたが,コカインの注射行動には24%のユーザーのコカイン注射行動に限られた影響がありました.
結論:
- 黒人人種,コカインの定期注射,銃撃ギャラリーでの薬物使用,注射器具の共有は,異性愛者の静脈注射薬物使用者におけるHIV感染の重要な独立した予測要因です.
- メタドン療法はヘロインの使用を減らすのに役立ちますが,コカイン注射を抑制する効果にはさらなる調査と強化された介入戦略が必要です.
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