Razlike u rizičnim ponašanjima u odnosu na HIV infekciju između muških i ženskih pripadnika populacije injektirajućih korisnika droga u Podgorici

Dragan Laušević; Boban Mugoša; Nataša Terzić; Zoran Vratnica; Itana Labović; Senad Begic

doi:10.5937/cma2-6869

Dragan Laušević Institut za javno zdravlje Crne Gore, Centar za kontrolu i prevenciju bolesti
Boban Mugoša Institut za javno zdravlje Crne Gore
Nataša Terzić Institut za javno zdravlje Crne Gore
Zoran Vratnica Institut za javno zdravlje Crne Gore
Itana Labović HIV/AIDS Office, United Nations Development Programme, Podgorica
Senad Begic Institut za javno zdravlje Crne Gore

DOI: https://doi.org/10.5937/cma2-6869

Sažetak

Uvod Injektirajući korisnici droga (IKD) predstavljaju populaciju koja je u povećanom riziku od infekcije sa krvlju i polno prenosivim bolestima. Zbog mogućih različitosti u stepenu rizičnih ponašanja između muških i ženskih pripadnika populacije IKD, neophodno je utvrditi da li razlike postoje i u kojim oblastima, što može pomoći adekvatnijem definisanju programa prevencije krvlju i polno prenosivih infekcija.

Metod Sprovedena je bio-bihejvioralna studija presjeka uz upotrebu metoda uzorkovanja vođenog ispitanicima (respondent-driven sampling). Pored anektnih podataka o socio-demografskim karakteristikama i ponašanjima koja povećavaju rizik za krvne i polno prenosive infekcije, od ispitanika su dobijeni uzorci krvi za testiranje na prisustvo antitijela na HIV, HCV i HBsAg.

Rezultati Ukupno su regrutovana 402 ispitanika/ce od čega 362 (90%) muških i 40 (10%) ženskih pripadnika IKD populacije. Značajne razlike između ispitanika i ispitanica su se u najvećoj mjeri odnosile na rizična ponašanja u sferi seksualnog ponašanja i seroprevalenciji HCV infekcije.

Zaključak Neophodno je dalje unaprjeđivati zdravstveno prosvetni rad među pripadnicima IKD, kako bi što je moguće veći broj IKD bio informisan o zdravstvenim rizicima koje nosi injektiranje droge, i bio redovno snabdjevan dovoljnom količinom sterilnog pribora za injektiranje i kondomima čime bi se smanjila mogućnost prenosa infekcije HIV-om i drugim krvlju i polno prenosivim infekcijama kako među njima samima tako i na njihove seksualne partnere koji nijesu pripadnici IKD (slučajni i komercijalni seksualni partneri). Prilikom primjene preventivnih programa na terenu, neophodno je voditi računa o određenim ponašajnim obrascima koji su specifični za pol IKD.

Ključne riječi: injektiranje droga, HIV, AIDS, pol, seksualno ponašanje

Reference

Hamers FF, Downs AM. HIV in central and eastern Europe. The Lancet 2003; 361:1035-1044.

Aceijas C, Rhodes T. Global estimates of prevalence of HCV infection among injecting drug users. International Journal of Drug policy 2007; 18:352-358.

Degenhardt L, Hall L, Warner-Smith M. Illicit drug use. In: Ezzati M, Lopez AD, Rodgers A, Murray CJL, eds. Comparative quantification of health risks: global and regional burden of diseases attributable to selected major risk factors.2nd ed. Geneva. World Health Organization, 2004.

Solomon S, Srikrishnan A, Mehta S, et al. high prevalence of HIv, HIV/hepatitis C virus coinfection, and risk behaviors among injecting drug users in Chennai, India: a couse for concern. J Acquir Immune Defic Syndr 2008; 49:327-32.

Panda KM, Lokabiraman S, Jayashree K, et al. risk factors for HIV infection in injection drug users and evidence for onward transmission of HIV to their sexual partners in Chennai, India. J Acquir Immune Defic Syndr 2005; 39:9-15.

Abdala N, Krasnoselskikh T, Durante A, Timofeeva M, Verevochkin S, Kozlov A, sexually transmitted infections, sexual risk behaviors and the risk of heterosexual spread of HIV among and beyond IDUs in St. Petersburg, Russia. Eur. Addict Res 2008; 14:19-25.

Yao Y, Wang n, Chu J, et al. Sexual behavior and risk for HIV infection and transmission among male injecting drug users in Yunnan, China. Int j infect dis 2009; 13:154-61.

Solomon S, Mehta S, Latimore A, Srikrishnan A, Celentano D. the impact of HIV and high-risk behaviours on the wives of married men who have sex with men and injecting drug users: implications for HIV prevention. J Int AIDS Soc 2010; 13(suppl 2): S7.

Institute of Public Health, Center for Disease Control and Prevention. Annual Report on HIV/AIDS in Montenegro. Podgorica, Montenegro; april 2014.

Government of Montenegro. HIV/AIDS Strategy for the Republic of Montenegro 2005-2009. Podgorica, Montenegro; May 2005.

Government of Montenegro. National strategic response to HIV/AIDS in Montenegro 2010-2014. Podgorica, Montenegro; May 2010.

Heckathorn D. Respondent driven sampling: a new approach to the study of hidden populations. Social Problems 1997; 44(2):174-99.

Heckathorn D, Semaan S, Broadhead RS, and Hughes JJ. Extensions of respondent-driven sampling: a new approach to the study of injection drug users aged 18-25. AIDS and Behavior 2002; 6(1):55-67.

Magnani R, Sabin K, Saidel T, Heckathorn D. Review of sampling hard-to-reach and hidden populations for HIV surveillance. AIDS 2005; 19 (suppl 2): S67-S72

UNAIDS. Monitoring the declaration of commitment on HIV/AIDS: guidelines on construction of core indicators – 2008 reporting. Geneva. UNAIDS; 2007.

Prevalence of HIV and other parenterally and sexually transmitted infections and risk behaviours among injecting drug users in Sarajevo, Banja Luka and Zenica. UNICEF Bosnia and Hercegovina. 2007.

Vilibić Čavlek T, Marić J, Katičić Lj, Kolarić B. Hepatitis C virus antibody status, sociodemographic characteristics and risk behavior among injecting drug users in Croatia. Cent Eur J Public Health 2011; 19(1); 26-29.

Ministry of Health and Institute of Public Health of Serbia Survey among high risk groups for HIV and PLWHA. Institute of Public Health. Belgrade, Serbia; September 2010.

Institute of Public Health. Albania behavioural and biological surveillance study report, third round, 2011. Institute of Public Health. Tirana, Albania; 2012.

Mikik V, Kuzmanovska G, Memeti S. Report from the bio behavioural survey among injecting drug users and assessment of population size of injecting drug users in Macedonia, 2010. Institute for Public Health of Republic of Macedonia. Skopje, FYR of Macedonia; 2011.

Evans JL, Hahn JA, Page-Shafer K, Lum PJ, Stein ES, Davidson PJ, Moss AR. Gender differences in sexual and injecting risk behavior among active injection drug users in San Francisco (the UFO Study). J Urban Health. 2003; Mar;80(1):137-46.

Doherty MC, Garfein RS, Monterroso E, Latkin C. Geneder difference in the initiation of injecting drug use among young adults. Journal of Urban Health 2000; 77(3):396-414. Doi:10.1007/BF02386749.

Folch C, Casabona J, Espelt A, Majo X, Merono M, Gonzales V, Brugal MT, REDAN Study Group. Geneder differences in HIV risk behaviours among intravenous drug users in Catalonia, Spain. Gac Sanit 2013; 27(4):338-343.

Cintra AMdeO, Caiaffa WT, Mingoti SA. Characteristics of male and female injecting drug users of the Ajude-Brasil II Project. Cad. Saude Publica. 2006; 22(4):791-802.

Plitt SS, Gratrix J, Hewitt S, Conroy P, Parnell T, Lucki B, Pilling V, Anderson B, Choudri Y, Archibald CP, Singh AE. Seroprevalence and Correlates of HIV and HCV among Injecting Drug Users in Edmonton, Alberta. Can J Public Health 2010;101(1):50-55.

Tyndall MW, Patrick D, Spittal P, et al. Risky sexual behaviours among injecting drug users with high HIV prevalence: implications for STD control. Sex Transm Infect. 2002; 78: i170-i175 doi:10.1136/sti.78.suppl_1.i170

Tracy D, Hanh JA, Lewis CF, Evans J, Briceno A, Morris MD, Lum PJ, Page K. Higher risk of incident hepatitis C virus among young women who inject drugs compared with young men in association with sexual relationships: a prospective analysis from the UFO Study cohort. BMJ Open 2014; 4:e004988. doi:10.1136/bmjopen-2014-004988.