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目的探索同伴推动抽样法(respondent-driven sampling,RDS)在社区吸毒人群HIV/STI流行病学调查中应用的可行性。方法2008年选择佛山市南海区和东莞市,借助当地的美沙酮维持治疗(methadone maitenance treatment,MMT)门诊选择初级种子,采用限额招募和双向激励机制招募社区吸毒人群进行HIV/STI相关行为学调查和生物学检测。其中南海调查地点为美沙酮门诊,招募限额为3,激励机制早期为超市购物券,3个月后增加部分现金;东莞调查地点为健康体检门诊,招募限额为5,激励机制为现金。对所得数据利用RDSAT进行统计学校正。结果佛山市南海区17名种子经过26周共招募127名社区吸毒人员,招募人数达到预期样本量的63.5%,每周招募人数为0~16人,中位数为4,招募链最长为8轮,其中3条招募链超过3轮,所招募人数占总招募数的70.1%;东莞市13名种子经过15周共招募290名社区吸毒人员,达到预期样本量的145%,每周招募人数为5~41人,中位数为17,最长招募链为11轮,2条招募链超过3轮,所招募人数占总招募数的88.6%。南海和东莞的招募样本分别在第6轮、第8轮达到平衡;经RDSAT校正后,估计南海区及东莞市吸毒人群参加MMT的比例分别为15.7%、8.4%。结论RDS用于社区吸毒人群的HIV/STI流行病学调查是可行的,使调查对象感到安全的地点和适当水平的激励机制是促使目标人群参与的关键因素。
Objective To explore the feasibility of respondent-driven sampling (RDS) in the HIV / STI epidemiological survey among drug addicts in the community. Methods Nanhai district of Foshan City and Dongguan city were selected in 2008, local primary methadone maitenance treatment (MMT) outpatient selection of primary seed, quota recruitment and two-way incentive mechanism to recruit community drug users for HIV / STI-related behavioral investigation and Biological testing. Among them, the survey site in the South China Sea was methadone clinics, with a recruitment quota of 3, early incentives for supermarket shopping vouchers and an increase of some cash after 3 months. The place of investigation in Dongguan was a health examination, with a recruitment quota of 5 and cash incentive. The data obtained were statistically corrected using RDSAT. Results A total of 127 community drug addicts were recruited from 17 seeds in Nanhai District of Foshan City in 26 weeks. The number of recruits reached 63.5% of the expected sample size. The number of recruits per week was 0-16, with a median of 4 and the longest Eight rounds, of which three more than 3 rounds of recruitment chain, the number of recruits accounted for 70.1% of the total number of recruits; Dongguan City, 13 seeds after 15 weeks recruited 290 community drug addicts, 145% of expected sample size, recruit weekly The number of people was 5 to 41, with a median of 17, the longest recruitment chain of 11 rounds, two recruitment chain more than three rounds, the number of people recruited accounted for 88.6% of the total number of recruits. Samples from the South China Sea and Dongguan were balanced at the 6th and 8th rounds, respectively. After RDSAT correction, the proportion of drug addicts participating in the MMT in the South China Sea and Dongguan was estimated to be 15.7% and 8.4% respectively. Conclusion It is feasible to use RDS for HIV / STI epidemiological survey among drug addicts in community and to find the safe place and the appropriate level of motivation for the respondents are the key factors to get the target population to participate.