【摘要】 目的了解艾滋病病毒(HIV)阳性服药人员在美沙酮维持治疗(MMT)门诊的保持状况及其影响因素。方法选取日均HIV阳性服药人员不少于10人的MMT门诊56个,基线调查6个月后,采用Kaplan-Meier和Cox比例风险模型分析队列保持率及其影响因素。结果共入组2 529人,随访6个月后保持率为74.4%(1 881/2 529);脱失率25.6%(648/2 529)。脱失的原因包括强制戒毒(26.4%)、疾病/怀孕(12.0%)、死亡(10.4%)和主动退出(10.4%)等。Cox比例风险模型多因素分析显示:采取干预措施、地区、年龄大于40岁、参加抗病毒治疗(ART)、基线调查前6个月未退出治疗、基线3次尿检全部阴性、平均剂量高、参加MMT时间长等,和较高的保持率相关(P<0.05)。结论干预措施有效提高了队列保持率,门诊工作中应积极推动HIV阳性服药人员参加抗病毒治疗,逐步提高美沙酮剂量,对40岁以下、参加MMT时间短、曾退出治疗和尿检阳性者加强干预。更多还原

【Abstract】 Objective To understand the retention and related factors among human immunodeficiency virus(HIV)-seropositive drug users receiving methadone maintenance treatment(MMT).Methods Fifty-six MMT clinics with no less than ten HIV-seropositive drug users per day were selected.Six months after the baseline survey,Kaplan-Meier and Cox model were used to analyze the retention and the related factors.Results A total of 2529 participants were enrolled,648persons dropped out in 6months(the retention was 74.4%),of whom 26.4% were due to compulsory detoxification,12.0% disease or pregnancy,10.4% death and 10.4% dropped out on their own accord.Cox regression model showed that area,age over 40years,intervention acceptance,participation in antiretroviral therapy(ART),insistance on treatment forsix monthsbeforebaseline,negativeurine test for three timesat baseline,high dosage and long termparticipation in MMT were contribution factors to the retention.Conclusion Intervention sare effective in increasing the retention rate.More patients should be encouraged to participate in ART,and to increase daily dose of methadone gradually,meanwhile,to strengthenthe intervention to the patients who are below 40years old,participate in MMT for a short time,and to the patients ever quit treatm ent and urine test positive.更多还原