文章摘要
樊盼英,白玉洁,杨文杰,李宁,孙定勇,朱谦,王哲.河南省部分地区新报告经异性性传播HIV/AIDS病例确诊前后高危性行为变化及影响因素分析[J].中华流行病学杂志,2016,37(3):367-370
河南省部分地区新报告经异性性传播HIV/AIDS病例确诊前后高危性行为变化及影响因素分析
Factors associated with high-risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnosis in some areas in Henan province
收稿日期:2015-09-23  出版日期:2016-03-15
DOI:10.3760/cma.j.issn.0254-6450.2016.03.015
中文关键词: 艾滋病病毒;确诊感染前后;行为变化;影响因素
英文关键词: HIV;Before and after confirmation of HIV infection;Behavior change;Influencing factors
基金项目:国家科技重大专项(2012ZX10004905)
作者单位E-mail
樊盼英 450016 郑州, 河南省疾病预防控制中心  
白玉洁 466000 周口市疾病预防控制中心  
杨文杰 450016 郑州, 河南省疾病预防控制中心  
李宁 450016 郑州, 河南省疾病预防控制中心  
孙定勇 450016 郑州, 河南省疾病预防控制中心  
朱谦 450016 郑州, 河南省疾病预防控制中心  
王哲 450016 郑州, 河南省疾病预防控制中心 wangzhe@hncdc.com.cn 
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中文摘要:
      目的 为了解河南省部分地区新近发现并报告的经异性性传播感染的HIV感染者/艾滋病患者(HIV/AIDS)在确诊前后的高危性行为变化情况,评估其二代传播HIV风险。方法 2015年1-5月使用自制的调查问卷,对随访到的经异性性传播的HIV/AIDS病例进行面对面的问卷调查。结果 361名调查对象中,有商业异性性行为和临时性伴性行为的比例分别由确诊前的77.3%(279/361)和28.5%(103/361)下降至确诊后的13.6%(49/361)和2.5%(9/361),差异均具有统计学意义(χ2=16.66,P<0.001; χ2=4.80,P=0.03);确诊感染前后,调查对象商业异性性行为发生地较多的省份均是河南、广东和浙江,寻找商业性伴的途径均以场所内等待为主;确诊感染后,与商业性伴、固定性伴和临时性伴使用安全套的比例分别是51.0%(25/49)、88.5%(184/208)和88.9%(8/9);多因素非条件logistic回归分析显示,商业异性性行为史、既往接受过HIV检测、35岁以上人群是发生二代传播高危性行为的危险因素。结论 非婚异性性传播成为艾滋病防制的重点和难点,强化HIV检测结果告知及干预技巧,加强对既往商业异性接触人群和35岁以上人群的行为干预和安全套使用等综合措施。
英文摘要:
      Objective To understand the factors associated with high risk behaviors among people newly diagnosed to be infected with HIV through heterosexual contact before and after diagnoses in some areas in Henan province, and evaluate the risk of secondary transmission. Methods A face to face interview was conducted among people infected with HIV through heterosexual contact by using self-designed questionnaires during January-May in 2015. Results Among 361 HIV infected persons, the proportions of those with commercial heterosexual behaviors or sex with irregular sex partners decreased from 77.3%(279/361) and 28.5%(103/361) before diagnosis to 13.6%(49/361) and 2.5%(9/361) after diagnosis, the difference was significant (χ2=16.66, P<0.001; χ2=4.80, P=0.03). The subjects surveyed always had more commercial heterosexual behaviors in Henan, Guangdong and Zhejiang provinces before and after diagnosis. After HIV infection confirmation, the condom use rates were 51.0%(25/49) for commercial heterosexual behaviors, 88.5% (184/208) for sex with regular partners and 88.9%(8/9) for sex with irregular partners, respectively. Multivariate logistic regression analysis indicated that risk behaviors associated with HIV transmission included commercial sexual behaviors, previous HIV detection and age of 35 years or older. Conclusions Extra-marital heterosexual behavior has posed serious challenge to the prevention and control of HIV spread. It is necessary to inform the HIV test results, improve the intervention and promote condom use in people with history of commercial sex and people aged ≥35 years.
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