背景:非法药物使用导致相当大的全球发病率,但是在撒哈拉以南非洲,关于其趋势和相关因素的数据很少。我们使用2002-2017年南非的国家数据来考虑这些问题。
方法:我们分析了南非5次全国人口家庭调查(2002-2017年;n=89,113)中15岁或以上个体的数据。最近的药物使用被定义为最近三个月使用非法药物,即,任何使用大麻,可卡因,安非他明,吸入剂,镇静剂,致幻剂,阿片类药物,和/或其他非法药物。使用逻辑回归评估最近药物使用的时间趋势。多变量逻辑回归评估了近期药物使用与社会人口统计学因素之间以及药物使用与性风险行为之间的关联。艾滋病毒相关变量和其他福祉变量。
结果:由于大麻使用(1·5%至7·8%)和阿片类药物使用(0·01%至1·6%)的增加,从2002年到2017年,近期药物使用的患病率从1·5%增加到10·0%,可卡因(0·02%至1·8%),或苯丙胺(0·1%至1·5%)。在调整后的分析中,男性,年龄较小,生活在城市地区,混合血统或白人种族(与非洲黑人相比),失业率与近期药物使用呈正相关.最近的药物使用与:多个性伴侣(调整后的优势比[aOR]2·13,95%置信区间[CI]:1·80-2·51);15岁之前的性首次亮相(aOR1·70,95CI:1·29-2·23);危险/有害的酒精使用(aOR2·50,95CI:2·14-2·93)或酒精依赖(a801·95-最近的药物使用与艾滋病毒阳性无关,使用避孕套或正在接受抗逆转录病毒治疗。
结论:非法药物使用在南非大幅增加,并与许多社会人口特征有关,更高的性行为风险和其他幸福感变量。
BACKGROUND: Illicit drug use results in considerable global morbidity, but there is little data on its trends and factors associated with it in sub-Saharan Africa. We consider these questions using national data from South Africa for 2002-2017.
METHODS: We analysed data among individuals aged 15 years or older from five national population-based household surveys in South Africa (2002-2017; n = 89,113). Recent drug use was defined as the last three-months use of illicit drugs, i.e., any use of cannabis, cocaine, amphetamine, inhalants, sedatives, hallucinogens, opioids, and/or other illicit drugs. Time trends in recent drug use were assessed using logistic regression. Multivariable logistic regression assessed the association between recent drug use and socio-demographic factors and between drug use and sexual risk behaviours, HIV-related and other well-being variables.
RESULTS: The prevalence of recent drug use increased from 1·5% to 10·0% from 2002 to 2017, driven by increases in cannabis use (1·5% to 7·8%) and use of opioids (0·01% to 1·6%), cocaine (0·02% to 1·8%), or amphetamines (0·1% to 1·5%). In adjusted analyses, male gender, younger age, living in urban areas, mixed-ancestry or white ethnicity (compared to black-African), and unemployment were positively associated with recent drug use. Recent drug use was associated with: multiple sexual partners (adjusted odds ratio [aOR] 2·13, 95% confidence interval [CI]: 1·80-2·51); sexual debut before 15 years old (aOR 1·70, 95%CI: 1·29-2·23); hazardous/harmful alcohol use (aOR 2·50, 95%CI: 2·14-2·93) or alcohol dependence (aOR 3·33, 95%CI 2·92-3·80); ever experiencing intimate partner violence (aOR 1·56, 95%CI 1·12-2·17); psychological distress (aOR 1·53, 95%CI: 1·28-1·82); and lower chance of ever testing for HIV (aOR 0·89, 95%CI 0·80-1·00). Recent drug use was not associated with HIV positivity, condom use or being on antiretroviral therapy.
CONCLUSIONS: Illicit drug use has increased substantially in South Africa and is associated with numerous socio-demographic characteristics, higher sexual risk behaviours and other well-being variables.