1989-2015年云南省德宏州50岁及以上HIV感染者流行病学特征分析

摘要

Objective To understand the epidemiological characteristics of HIV infection cases aged ≥ 50 years in Dehong prefecture,Yunnan province from 1989 to 2015 and to provide evidence for the targeted intervention in this population.Methods The data of people living with HIV/AIDS (aged ≥50 years)who were clinical and laboratory confirmed in Dehong from 1989 to 2015 were collected from national AIDS information system for a retrospectively analysis.Results A total of 1 193 HIV/AIDS cases aged ≥50 years were reported in Dehong during this period,accounting for 7.98％ of the total cases.The cases fatality rate was 41.58％ (496/1 193).The proportion of HIV/AIDS cases aged ≥50 years increased by year from 2.97％ in 2000 to 19.94％ in 2015.The HIV/AIDS cases aged ≥50 years were distributed in all 5 counties of Dehong,but Mangshi county had the highest case number,accounting for 11.67％,and they were mainly males (773/1 193),accounting for 64.79％.Their average age was (58.31 ±6.96) years.Up to 93.38％ of the cases had only educational level of junior middle school or lower.Framers,the unemployed and the retired accounted for 94.02％.In terms of infection route,89.52％ were infected through sexual contact,10.48％ were infected through injecting drug use.The cases in females,the unmarried and farmers and those infected through sexual contact and detected in clinical test increased during different periods (1989-2003,2004-2011 and 2012-2015).Conclusion The epidemic of AIDS is serious in people aged ≥50 years in Dehong.It is necessary to strengthen the comprehensive prevention and control of HIV infection in this population,including health education.%目的 分析云南省德宏州1989-2015年≥50岁人群艾滋病疫情特征及流行趋势.方法 收集国家“艾滋病防治综合信息系统”中报告现住址为云南省德宏州,年龄≥50岁的临床诊断和实验室诊断艾滋病病毒感染者/艾滋病患者(HIV/AIDS),截至日期为2015年12月31日,对其构成比、三间分布和趋势构成变化等进行分析.结果 现住址累计报告≥50岁HIV/AIDS病例1 193例,占累计报告数的7.98％;1 193例病例中,截至2015年底已死亡496例,病死率为41.58％.自2000年以来≥50岁HIV/AIDS的构成比逐年上升,从2000年的2.97％上升至2015年的19.94％.≥50岁HIV/AIDS在全州5县均有分布,芒市占当地报告HIV/AIDS构成比最高(占11.67％).≥50岁HIV/AIDS人群分布以男性为主(64.79％,773/1 193),平均年龄(58.31±6.96)岁,93.38％患者的文化程度为初中及以下,94.02％的职业为农民、待业和离退休人员.89.52％通过性接触传播,10.48％通过注射吸毒传播.女性、无配偶者、性接触传播者、农民和临床就诊检测发现者所占比例在不同时间段(1989-2003年、2004-2011年和2012-2015年)呈现上升趋势.结论 德宏州≥50岁人群艾滋病流行形式较为严峻,艾滋病防控工作应关注该年龄人群,结合艾滋病防治常规工作开展多元化的性健康教育应成为该人群艾滋病防治工作的重心.