Tgp chi THONG TIN Y Dl/OC Sd 4 ndm 2010
THUC TRANG SD DUNG MA TUY TRONG NAM THANH NIEN 15-24 TUOI TAI
M O T
PHUDNG CUA
T H A N HPHO HA LONG, TJNH QDANG NINH, NAM 2 0 0 8
Nguyen Hong Sdn', Nguyen Tran Hien", Tran Viet Anh'"
TOM TAT
Mue tieu: md ti thdc trang sd dung ma tuy trong nam thanh nien 15-24 tudi tai mgt phddng eiia thinh pho Ha Long, tinh Quing Ninh, nam 2008. Ddi tddng va phddng phap:
nghien edu md ti cat ngang, phdng van toin bo 562 nam thanh nien td 15-24 tud'i tai mot phddng eiia thanh pho Ha Long bang dia CD qua tai nghe vi xet nghiem nddc tiiu tim heroin bang test nhanh cua hang Abbort. Kit qua: ty le nam thanh nien da tdng sd dung ma tuy la 10,5%o, da tdng tiem chfeh ma tuy (TCMT) li 0,18%o, hien dang sddung ma tuy li l,4%o, khdng ed ngddl hien dang TCMT; 45,8%o bio cio sddung can sa, bd di trong fan sddung ma tiiy dau tien. Trong so nam thanh nien dang sd dung ma tuy, cd 87,5%o sd dung amphetamin, 37,5%o sddtmg can sa, khdng cd ngddl dang sd dung heroin. Cd 1,1 %o nam thanh nien ed kit qui xet nghiem nddc tiiu dddng tfnh vdi cic loai ma tiiy dang thuoe phien. Kit luan: ty le nam thanh nien da tdng sd dung ma tiiy eao, hinh thdc sd dung ma tuy chu yiu li hut hit hoac nuot ma tiiy, loai ma tuy dang ddde sddtmg ehii yiu li can sa, bd di va amphetamin.
SUMMARY
Drug use situation among young men from 15 to 24 years-old a t the commune in Ha Long city, Quang Ninhi province, 2 0 0 8
Objectives: to describe drug use situation In young men from 15 to 24 years-old at the commune In Halong city, Quang Ninh province, 2008. Methods: a cross-seetional study with 562 young men from 15 to 24 years old in the one commune of Halong city were Interviewed by using CDs earphone and and tested urine for detecting heroin and morphine. Results: prevalence of lifetime drug use among young men was 10,5%o, prevalence of lifetime injecting drug use was 0.18%o, current drug use rate was 1.4%o, no person having Injecting drug use; 45.8%o reported they had used marijuana In the their ftrst use. Among young men using drug, 37.5%o reported they used marijuana, 87.5%o used amphetamine and no person used heroin. Urine test results showed that 1.1 %o young men were using drugs as narcotic drugs. Conclusions: prevalence of lifetime drug use among young men was high. Drug use pattern was mostly smoking, inhaling and swallowing. The mainly drugs were marijuana and amphetamine.
I . OAT VAN OE
HIV/AIDS da va dang trd thanh dai dich nguy hiem tai Viet Nam. Tinh den ngay 31/12/2008, sd cac tru'dng hdp nhiem HIV hien cdn sdng la 138.191 ngu'di (sd luy ti'ch nhiem HIV toan qudc la 179.735 tru'dng hdp).
Tiem chi'ch ma tijy vdi viec stf dung chung bdm kim tiem van la each lay truyen ma tuy ehu yeu nhat hien nay. Trong td'ng sd cac tru'dng hdp nhiem HIV du'dc phat hien, ddi tu'dng nghien ehich ma tuy chiem 44,3% va nam gidi chiem 82,0% [2,3].
Thanh nien la mdt trong cac ddi tu'dng chju hau qua nang ne cua dai dich HIV/AIDS vdi 58,6% sd ngu'di nhiem HIV du'dc phat hien la
du'di 30 tud'i [4]. Ty le nhiem HIV chung eho quan the thanh nien 15-24 tud'i trong toan qudc u'dc ti'nh la 0,3% vao nam 2008 [2]. Stf dung ma tuy ehfnh la yeu td nguy ed cao lam lay nhiem HIV trong thanh nien ttf 15-24 tud'i [3].
Quang Ninh la tinh vung bien gidi phia ddng bae eua Viet Nam, giap Trung Qudc. Tinh den ngay 30/11/2008, toan tinh da cd 14/14 huyen, thi, thanh phd, 155/186 xa, phu'dng cd ngu'di nhiem HIV. Nam 2008, sd tru'dng hdp nhiem HIV du'dc phat hien mdi la 402 tru'dng hdp, nang sd luy ti'ch lu'dt ngu'di du'dc xet nghiem ed HIV du'dng ti'nh la 17.414 tru'dng hdp. Td'ng sd ngu'di nhiem HIV du'dc xac dinh dia chi la 6.842 ngu'di. Ty le hien nhiem HIV so
ThS., Bo Y te; " PGS.TS., Vien Ve sinh Dich t l Trung u'dng; "'BS., Trifdng Dai hoc Y Ha Noi.
vdi dan sd cua tinh la 0,40%. Nam gidi chiem 85,9% sd ngu'di nhiem HIV du'pe bao cao trong toan tinh. Nhiem HIV tap trung chu yeu tai thanh phd Ha Long va thi xa Cam Pha. Vdi sd tru'dng hdp HIV la 2.534 ngu'di, chiem 40,5%
td'ng sd ngtfdi nhiem HIV xae dinh dtfdc dia chi eua tinh. Thanh phd Ha Long la huyen, thi ed sd lu'dng ngu'di nhiem HIV cao nhat tinh [1].
Ket qua giam sat trpng diem HIV tai Quang Ninh cho thay: nhiem HIV van tap trung chu yeu trong eae nhdm cd hanh vi nguy ed cao: ty le nhiem HIV d ngu'di nghien chfeh ma tuy tang ttf 0% nam 1996 den 65,9% nam 1998, 75,2% vao nam 2002 va hien nay la 33,2%.
Dae biet, ty le hien nhiem HIV trong thanh nien kham tuye'n nghTa vu quan stf tang eao, ttf 1,2% nam 1998 den 5,6% nam 2001 va giam la 0,37% vao nam 2007 [1,3]. Stf dung ma tuy la yeu td nguy cd cao lay nhiem HIV cua thanh nien 15-24 tud'i tai Quang Ninh. Muc tieu cua nghien ctfu nay la: md ta thtfc trang stf dung ma tuy trong nam thanh nien 15 -24 tud'i tai mdt phu'dng eua thanh phd Ha Long, tinh Quang Ninh, nam 2008.
I I . O O I TU'O'NG VA PHU'O'NG PHAP 1. Doi tddng nghiin ci/u
- Toan bd nam thanh nien ttf 15-24 tud'i (sinh trong khoang ttf ngay 01/01/1984 den 30/12/1993) hien dang sdng tren dia ban phu'dng Ha Tu tai thdi diem dieu tra va tinh nguyen tham gia nghien ctfu.
- Tieu chua'n loai trtf: cac nam thanh nien bi khuyet tat: diec, cam, mu.
- Thdi gian nghien ctfu: thang 12 nam 2008.
2. Phddng phap nghiin cdu 2.1. Thiit ki nghien edu. nghien ctfu md ta cat ngang.
2.2. Cach thdc tiin hanh:
* Cd mau:
M l - / ? ) n = Z
( l - a / 2 ){epf
- vdi: p la ty le nam thanh nien da ttfng stf dung ma tuy. (Theo eac nghien ctfu tru'dc day u'dc tinh ty le nay la 10%).
- a: la dd tin eay vdi a=5% thi Z (i.a/2)=l,96 - vdi d=Ep=0,25 X 0,10 (25 % eua p) ta cd n=553, lam trdn sd lay n=560.
* Chpn mau:
Chpn ngau nhien mdt phu'dng cua thanh phd Ha Long de tien hanh dieu tra. Phu'dng dPdc chpn la phtfdng Ha Tu, ed dan sd khoang 10.000 dan, Pdc tinh sd nam thanh nien cua phu'dng ttf 600-700 nam thanh nien.
- Tien hanh dieu tra toan bd nam thanh nien 15-24 tud'i sdng tren dia ban phu'dng dPde chpn tai thdi diem dieu tra.
* Thu thap sd lieu:
- Tien hanh nghien ctfu khuyet danh va phdng van tinh trang stf dung ma tuy cua nam thanh nien 15-24 tud'i bang phu'dng phap stf dung dTa CD va tai nghe.
- Lay 10 ml nu'dc tieu de lam xet nghiem nhanh tim eae loai ma tuy dang thudc phien bang test nhanh heroin cua hang Abbort.
2.3. Xdly so lieu: banq phan mem STATA 10.
I I I . KET QUA
1. Dae trdng nhan Ichau hgc cua doi tddng nghiin cu'u
Td'ng sd ddi tu'dng nam thanh nien 15-24 tud'i tham gia phdng van la 562 ddi tu'dng, dp tud'i 15-19 tud'i chiem 53,9%, dp tud'i 20-24 tud'i chiem 46,1%. Oa sd cac ddi tu'dng la hpe sinh va sinh vien (53,7%), cdng nhan (19,7%), cd 11,6% that nghiep, 88,3% ddi tu'dng ed trinh dp tdt nghiep trung hpc cd sd trd len, 96,4% chu'a lay vd, 59,2% sdng ehu yeu dtfa vao thu nhap cua bd me, chf cd 22,6% cd viec lam va thu nhap d'n dinh.
2. Thdc trang sd dung ma tuy cua nam thanh niin 15-24 tuoi
2.1. Ty le sd dung ma tiiy ciia nam thanh nien 15-24 tud'i
Bang 1: Ty le sd dung ma tiiy eiia nam thanh nien 15-24 tudi (n=562)
Oa ttfng stf dung ma tuy Oa ttfng tiem chfeh ma tuy Hien dang stf dung ma tuy Hien dang tiem chfeh ma tuy Tudi trung vi fan stf dung ma tuy dau tien
SL 59 1 8 0
TL o/o 10,5 0,18 1,4
0 18 Ty le nam thanh nien 15-24 tud'i da ttfng stf dung ma tuy la 10,5% va da ttfng tiem chfeh ma tuy la 0,18%, ty le hien dang stf dung ma tuy la 1,4%, khdng cd nam thanh nien hien dang tiem chi'ch ma tuy.
Tgp chi THONG TIN Y Dl/OC Sd 4 ndm 2010
Bang 2: Ty le da tdng sd dung ma tiiy ciia nam thanh nien 15-24 tudi theo nhdm tudi, nhdm nghe nghiep va theo gia dinh
Theo Nhom tuoi Nhom 15-19 tuoi (n=303) Nhdm 20-24 tud'i (n=259) Theo Nghe nghiep Hoe sinh, sinh vien (n=302) Cd nghe on dinh (n=195) That nghiep (n=65) Theo Gia dinh Cd ngu'di nghien (n=66) Khdng nqUdi nqhien(n=418)
Da tdng sddung ma tiiy SL
29 30 27 21 11 12 47
TL %
9,6 11,6
8,9 10,8 16,9 18,2 9,6
ChUa tdng sdduna ma tiiv SL
274 229 275 174 54 54 442
TL %
90,4 88,4 91,1 89,3 83,1 81,8 90,4
P
>0,05
>0,05
<0,05
Stf khac biet ve ty le da ttfng stf dung ma tuy giiJa nhdm 15-19 tud'i (9,6%) vdi nhdm 20-24 tud'i (11,6%) va giiJa nhdm hpc sinh, sinh vien (8,9%) vdi nhdm cd nghe nghiep d'n djnh (10,8%) va nhdm that nghiep (16,9%) khdng cd y nghTa thdng ke (p>0,05).
Cd 12/59=20,3% nam thanh nien da ttfng stf dung ma tuy sdng trong gia dinh cd ngtfdi nghien ma tuy. Nam thanh nien sdng trong gia dinh cd ngu'di nghien ma tuy ed ty le da ttfng stf dung ma tuy (18,2%) eao hdn nhdm gia dinh khdng cd ngu'di nghien ma tuy (9,6%) cd y nghTa thdng ke (p<0,05).
2.2. Dae diem hanh vl sddung ma tiiy Bang 3: Loai ma tiiy ddde sddung
Can sa, bo da Thudc phien Heroin Amphetamin Thiuoc an than Khac
Tong
Sddung trong fan dau tien
SL 27
0 4 20
1 7 59
TL % 45,8
0,0 6,8 33,9
1,7 11,9
100
Hien nay dang sddung SL
3 0 0 7 1 1 8
TL % 37,5
0.0 0,0 87,5 12,5 12,5 100 Can sa, bd da va amphetamin la nhij'ng loai ma tuy du'dc stf dung chu yeu, vdi 45,8% stf dung can sa, bd da trong lan stf dung dau tien va 87,5% hien dang stf dung ma tuy stf dung amphetamin.
Tyle 100
80 60-•
40 20 0
3,4
rf?m?t-
0 0 Z 7 Chi tiem chich Chi hiit hit Phoi hap
0 Lan (3lu tien • Hien nay
Bleu do 3: Cach sd dung ma tiiy ciia cac doi tddng sddung sddung ma tuy
Hut, hi't ma tuy la each stf dung ma tuy ehu yeu eua nam thanh nien, vdi 96,6% hut hft ngay trong lan stf dung ma tuy dau tien. Hien nay, 100% nhiJng nam thanh nien dang stf dung ma tuy la hut, hit, hoac nudt ma tuy.
Ty le % 100
80 60 40 20
54,2 59,8-
11,9
I 1
22 6,"1" 3,4
Ban ru Chan Muon Tang Bi ep Khac ddi thLT tinh buoc
due
Bleu do 2: Ly do sddting ma tiiy trong lan dau tien (n=59)
Oa sd cac ddi tu'dng nam thanh nien stf dung ma tuy trong lan dau tien la do ehfnh ban than cua ddi tPpng mudn thtf cam giac cua ngPdi stf dung ma tuy (54,2%) va ly do chu yeu khac la bi ban be ru re, ldi keo (50,8%).
Bang 4: Kit qua xet nghiem ma tiiy dang thuoe phien trong nddc tieu
^^-^^Sd(-h)
Bien sd ^~~~~——..^
Sd nam thanh nien du'dc XN(n=562) Sd thanh nien bao eao ed stf dung eae ma tuy dang thudc phien (n=562)
SL 6 0
TL o/o
1,1 0
P
<0,05
Ty le nam thanh nien ttf 15-24 tud'i cd ket qua xet nghiem cac chat dang thudc phien trong nu'dc tieu du'dng tfnh la 1,1%, trong khi phdng van khdng cd nam thanh nien nao bao cao hien dang stf dung cac loai ma tuy nay. Stf khac biet nay ed y nghTa thdng ke vdi p<0,05.
IV. BAN LUAN
Vdi stf phat trien cua nen kinh te thj tru'dng va md rdng giao lull, budn ban vdi nu'dc lang gieng Trung Qudc, nen ttf nhijpg nam cudi thap ky 90, ma tuy da xam nhap vao mdt bd phan thanh thieu nien va hpc sinh, sinh vien cua Quang Ninh, gay anh htfdng xau den stfc khde, dao dtfc, ldi sdng cua thanh thieu nien, dae biet tai thanh phd Ha Long va thi xa Cam Pha [1,3].
Ket qua nghien ctfu cho thay, ty le nam thanh nien 15-24 tud'i tai phtfdng Ha Tu, Ha Long da ttiTig stf dung ma tuy la 10,5%, eao hdn nhieu so vdi ket qua dieu tra Itfdng gia nguy cd nhiem HIV nam 2002 tai Long An la 3,5%. Tai Nghe An, mdt tinh nam tren dtfdng van chuyen thudc phien ttf Lao, nhtfng ty le nay cung chi la 1,5%, cac tinh khac nhu'Thanh Hda, Ha TTnh, ty le nay rat thap, chi cd 0,6% [4].
Tud'i trung vj cua lan stf dung ma tuy dau tien la 18 tud'i. Tuy vay, da cd 9,6% nam thanh nien Itfa tud'i 15-19 tud'i da ttfng stf dung ma tuy, cd nam thanh nien stf dung ma tuy khi mdi 14 tud'i. Ket qua nay dung nhu" nhan dinh cua cac chuyen gia ve xu the tre hda eua nhCfng ngPdi stf dung ma tuy [3,7,8]. Oay la thach thtfc Idn, ddi hdi stf quan tam eham sdc giao due eua gia dinh, edng ddng ddi vdi eon em minh, ngay ttf khi ho bat dau budc vao tud'i vi thanh nien (10-19 tuoi).
Loai ma tuy du'dc nam thanh nien Ha Tu dang stf dung chu yeu hien nay la can sa, bd da (37,5%) va ma tuy td'ng hdp amphetamin (87,5%). Ket qua nay eho thay cd stf khac biet so vdi ket qua dieu tra trtfdc day, khi dd heroin la loai ma tuy du'dc stf dung chu yeu vdi 77,8% sd ngu'di dang stf dung ma tuy tai Ha Long nam 2003 [1] va 99,2% tai Nghe An, nam 2002 [4]. Stf khac biet ve loai ma tuy stf dung nay mdt phan do trao lu'u xu the cua thanh nien hien nay thich stf dung cae loai ma tuy td'ng hdp nhU amphetamin, hoac dung cac loai ma tuy ddn gian de kiem, de stf dung nhU can sa, bd da, "thudc ed",... [7,8].
Ly do chu yeu khien nam thanh nien lao vao con du'dng stf dung ma tuy van la do tfnh hieu ky cua tud'i tre, mudn kham pha nhij'ng dieu mdi me, mudn thtf cam giac la. Viec dung thtf ma tuy la kha pho bien trong thanh thieu nien d nhieu qudc gia [5,6,7]. Tai Ha Tu, da sd nam thanh nien stf dung ma tuy lan dau la do mudn thtf khoai cam cua chat ma tuy (54,2%), ben canh dd stf ru re, ldi keo cua ban be (50,8%) da lam cho nam thanh nien khdng lam chu du'dc ban than minh, sa nga tru'dc stf quyen ru cua ma tuy. Mdt sd nam thanh nien khac do tac ddng cua mdi tru'dng gia dinh, xa hdi nhtf sdng trong gia dinh cd ngu'di nghien ma tuy (20,3%) hoac do that tinh, chan ddi (11,8%) ma cung di tim ngudn vui ttf ma tuy. Chfnh vi vay, viec giao due ttf tu'dng, trang bj cac kien thtfc, ky nang sdng can thiet eho thanh nien, giup cho thanh nien kien quyet ehu ddng khtfde ttf ma tuy la cdng viec quan trpng hang dau, ddng thdi viee tao ra mdi tru'dng sdng lanh manh, xay dutig gia dinh van hda hanh phue va tao san chdi, viec lam eho thanh nien se giup cho thanh nien tranh xa te nan ma tuy.
Tiem chfeh ma tuy la con du'dng ngan nhat dan den nhiem HIV. Tuy vay, ty le da ttfng TCMT trong nam thanh nien tai Ha Tu thap, chi ed 0,18%. Ket qua nay thap hdn so vdi ket qua dieu tra tai Ha Long nam 2003 (3,9%) [1]
va cung thap hdn so vdi ket qua dieu tra nam 2002 tai Binh Du'dng la 1,5% [6] va tai Nghe An la 1,0% [4]. Ket qua dieu tra cho thay, cd stf thay dd'i each thtfc stf dung ma tuy ttf tiem chfeh sang hut, hft, hoac nudt ma tuy vdi
Tgp chi THONG TIN YDl/OC Sd 4 ndm 2010
96,6% stf dung each khdng tiem chfeh trong lan stf dung ma tuy dau tien va hien nay khdng cd nam thanh nien dang tiem chfeh ma tuy ma chi hut, hft hoac nudt ma tuy. Stf thay dd'i nay mdt phan cd the la do xu the cua thanh nien thieh dung cae loai ma tuy stf dung bang du'dng hut, hft, nudt nhU: amphetamin, can sa, bd da,... mdt phan khac cd the la do nam thanh nien da cd nhan thtfc day du hdn ve tac hai cua tiem chfeh ma tuy, nhat la viec lay nhiem HIV, nen da chu ddng stf dung ma tuy bang each khdng tiem chfeh [5,7].
Mac du theo ket qua phdng van thi khdng cd nam thanh nien nao bao cao hien dang stf dung eac loai ma tuy dang thudc phien, nhu'ng ket qua xet nghiem nu'dc tieu bang test nhanh heroin cho thay, cd 1,1% ed ket qua du'dng tinh vdi cac chat dang thudc phien. Oieu nay cho thay, mac du cude dieu tra da stf dung phu'dng phap nghien ctfu khuyet danh va phdng van bang dTa CD qua tai nghe de bao dam tfnh bf mat eae thdng tin ve stf dung ma tuy, nhu'ng van edn nhij'ng nam thanh nien khdng bao cao chinh xac thtfc trang stf dung ma tuy cua hp, nen ty le stf dung ma tuy theo ket qua phdng van thu'dng thap hdn rat nhieu so vdi tinh trang thtfc te ve stf dung ma tuy [6,7]. Oay la diem can chu y khi tien hanh cac cude dieu tra ve stf dung ma tuy va khi phien giai thtfc trang stf dung ma tuy ttf ket qua eac cude dieu tra bang phu'dng phap phdng van.
V. KET LUAN
- Ty le nam thanh nien 15-24 tud'i tai Ha Long da ttfng stf dung ma tuy eao (10,5%), ty le da ttfng TCMT la 0,18%.
- Ty le nam thanh nien hien dang stf dung ma tuy la 1,4%, khdng cd nam thanh nien hien dang TCMT.
- Can sa, bd da va amphetamin la cae loai ma tuy chinh dPdc stf dung.
- Hinh thtfc stf dung ma tuy chu yeu la hut hft hoac nudt ma tuy.
- Cd 1,1% nam thanh nien 15-24 tud'i cd ket qua xet nghiem du'dng tfnh vdi eac ma tuy dang thudc phien trong nu'dc tieu.
T A I LIEU THAM KHAO
1. Ban Chi dao Phong chong HIV/AIDS tinh Quang Ninh: Bao cao cong tac phong chong HIV/AIDS nam 2008, djnh hu'dng ke hoach nam 2009. Sd Yte Quang Ninh, thang 12, 2008 2. Bo Y te: Bao cao Quoc gia lan thtf ba ve viec thtfc
hien tuyen bo cam ket ve HIV/AIDS. Ha Npi, 2008.
3. Uy ban Quoc gia Phong chong AIDS, Phong chong ma tuy, mai dam: Bao cao tong ket cong tac phong chong HIV/AIDS nam 2008, trpng tam ke hoach nam 2009. Tai lieu Hoi nghi Tong ket cong tac Phong chong AIDS nam 2008, Ha Noi, thang 01, 2009.
4. Uy ban Dan so, Gia dinh va Tre em - Bo Y te:
Bao cao ket qua dieu tra lu'dng gia nguy cd nhiem HIV/AIDS d 7 tinh: Thanh Hoa, Nghe An, Ha Tinh, Binh Phu'dc, Binh Du'dng, Long An, Soe Trang nam 2002. Nha Xuat ban Yhoc, 2003
5. Vien Ve sinh Djeh te Trung Udng: Ty le hien nhiem HIV, STI va mtfc do hanh vi nguy cd qua nghien ciJu cong dong. Kit qua ehu'dng trinh giam sat ket hap hanh vi vdi cac chi so sinh hoc (IBBS) tai Viet Nam nam 2005-2006, Ha Noi, 2009.
6. Akiminola B. et al: Risk and Protection: Youth and HIV/AIDS in sub-Saharan Africa. The Alan Guttmacher Institute, NewYod< & Washington, 2004.
7. Monasch R., Mahy M.: Young people: Center of the HIV epidemic. Preventing HIV/AIDS in young people: a systematic review of the evidence from developing countries. WHO, Geneva, 2006, pp.15-36.
8. UNAIDS: 2008 report on global AIDS epidemic.
Geneva, 2008.S'
