四川省凉山彝族自治州2010-2015年社区人群HIV哨点监测

摘要

目的 了解四川省凉山彝族自治州(凉山州)社区人群HIV流行趋势及HIV感染者相关行为特征的变化情况,探讨艾滋病传播的相关因素.方法 在凉山州社区人群省级艾滋病监测哨点(德昌县、宁南县和布拖县),调查对象为年龄≥15岁城镇和农村居民,采用多阶段、分层、按比例抽样,2010-2015年共需调查样本量14 092人次.采用问卷调查和血样采集收集调查对象社会人口学、行为学和血清学信息,采用X2检验比较不同特征人群和各年HIV感染的差异,非条件logistic回归分析HIV感染的相关因素.结果 2010-2015年凉山州社区人群哨点监测完成调查共14 092人次,发现HIV感染者267人,2010-2015年HIV抗体阳性率分别为3.24％(70/2 162)、3.07％(72/2 345)、1.17％ (28/2 399)、1.38％(33/2 400)、1.42％(34/2 391)和1.25％(30/2 395).彝族聚集为主的布拖县HIV感染风险高于汉族聚集为主的德昌县和宁南县(OR=3.83,95％CI:2.25 ～ 6.52);增加HIV感染风险的相关因素包括男性(OR=1.77,95％CI:1.30～2.40)、彝族(OR=4.40,95％CI:2.56～ 7.57)、离异或丧偶(OR=28.57,95％CI:4.56～ 178.95)、共用针具吸毒(OR=8.53,95％CI:3.99 ～ 18.25);降低HIV感染风险的相关因素包括初中及以上学历(OR=0.59,95％CI:0.37 ～ 0.97)、固定性伴安全性行为(OR=0.21,95％CI:0.05～ 0.96)、临时性伴安全性行为(0R=0.46,95％CI:0.28～ 0.76).结论 2010-2015年,凉山州社区人群中HIV抗体阳性率较高.男性、彝族、小学及以下文化程度、离异或丧偶、共用针具吸毒等因素增加社区人群感染HIV的风险.%Objective To investigate the epidemiologic and behavioral characteristics of HIV among community population in Liangshan prefecture.Methods We collected social demographic,behavioral and serological information by means of the monitoring questionnaire and serological tests.Data was analyzed by using the chi-square test and logistic regression.Results From April to June of 2010 to 2015,14 092 cases of community population were selected as the study objects,with 267 cases diagnosed as HIV positive patients.The HIV positive rates were 3.24％,3.07％,1.17％,1.38％,1.42％ and 1.25％,respectively.We observed that when community population having the following characteristics as:living in Butuo country (OR=3.83),being males (OR=1.77),being Yi nationality (OR=4.40) being widowed (OR=28.57),with history of drug abuse (OR=3.71) or injecting drug use (PWID) (OR=4.92),or history of needle sharing among PWID (OR=8.53),were under higher risks for HIV infection.With histories as:having had secondary or above levels of schooling (OR=0.59),having protected sex with regular parmers (OR =0.21) and with non-regular partners (OR =0.46),they seemed to be somehow protected for getting HIV infection.Conclusion The positive HIV rates of HIV among community population in Dechang,Ningnan and Butuo varied from 0.10％ to 8.77％while the HIV transmission among general population remained challenging.