| 梁妍,徐亚珂,樊盼英,赵东阳,施建春,闫江舟,姬晓宇,张国龙.河南省1995-2020年新报告50岁及以上HIV感染者流行特征分析[J].中华流行病学杂志,2022,43(12):1912-1919 |
| 河南省1995-2020年新报告50岁及以上HIV感染者流行特征分析 |
| Epidemiological characteristics of newly reported HIV-infected cases aged 50 years and above in Henan province, 1995-2020 |
| 收稿日期:2022-04-19 出版日期:2022-12-17 |
| DOI：10.3760/cma.j.cn112338-20220419-00320 |
| 中文关键词: 艾滋病 新报告 流行特征 |
| 英文关键词: AIDS Newly reported Epidemiological characteristics |
| 基金项目:河南省科技发展计划（202102310672）；河南省医学科技攻关计划（LHGJ20190697）；国家科技重大专项（2018ZX10715009） |
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| 中文摘要: |
| 目的 分析河南省1995-2020年新报告≥50岁HIV感染者流行特征，为艾滋病防控提供参考依据。方法 资料来源于中国疾病预防控制信息系统艾滋病防治基本信息系统1995-2020年河南省新报告≥50岁HIV感染者个案信息，分析其社会人口学和行为学特征，并采用基于CD4+T淋巴细胞（CD4）计数反推法混合线性模型推算HIV感染年限、感染时间及感染年龄。结果 1995-2020年河南省新报告≥50岁HIV感染者 25 038例（25.8%，25 038/96 867），≥50岁的构成比从1995-2000年的4.5%（18/396）上升至2016-2020年的35.5%（9 666/27 239）（趋势χ2=3 105.53，P<0.001）。≥60岁年龄组构成比呈逐年增加，男性在各年龄组的构成比随着年龄而增加，由医疗机构检测发现的比例呈逐年上升趋势。传播途径以性传播为主，异性性传播和男男性行为传播的构成比分别从1995-2000年的5.5%（1/18）和0.0%上升至2016-2020年的86.2%（8 334/9 666）和13.5%（1 304/9 666）。异性性传播途径中，以非婚非商业性行为传播为主（48.1%，4 007/8 334），呈上升趋势；男性以商业性行为传播为主（54.9%，3 169/5 775），随着年龄而增加；女性以非婚非商业性行为传播为主（62.5%，1 600/2 559），呈上升趋势，已婚/同居的构成比则呈下降趋势。CD4计数反推法推算结果显示，新报告≥50岁HIV感染者中，感染年龄（54.8±10.2）岁，感染年龄<50岁者占33.8%（4 263/12 621），感染年限（5.7±6.2）年，感染年限<3年和≥5年的比例分别占34.7%（4 384/12 621）和52.6%（6 636/12 621），感染年限的变化无明显的线性趋势。结论 1995-2020年河南省新报告≥50岁HIV感染者逐年增多，主要流行特征为性传播、男性、≥60岁、文化程度较低、医疗机构检测发现为主。艾滋病防控应重点关注非婚非商业异性性行为、商业异性性行为和男男性行为的传播途径，加强重点人群和流动人员的HIV检测及病例发现。 |
| 英文摘要: |
| Objective To analyze the epidemiological characteristics of newly reported HIV-infected cases aged 50 years and above in Henan province during 1995-2020, and to provide evidence for strategies on HIV/AIDS prevention and control. Methods Information about newly reported HIV-infected cases aged 50 years and above in Henan between 1995 and 2020 were collected from the National Comprehensive HIV/AIDS Information System. The demographic and behavioral characteristics of HIV-infected cases aged ≥50 were analyzed, and the mixed linear model based on CD4+T lymphocyte (CD4) counts back calculation was used to estimate the years, time and age of the HIV infection. Results During 1995-2020, a total of 25 038 HIV-infected cases aged 50 years and above were newly reported, accounting for 25.8% (25 038/96 867) of the total number of newly reported HIV-infected cases in Henan. The proportion of newly reported cases over 50-years-old gradually increased from 4.5% (18/396) in 1995-2000 to 35.5% (9 666/27 239) in 2016-2020, with statistically significant difference (χ2=3 105.53, P<0.001). Among them, the proportion of HIV-infected cases aged 60 years and above were increasing year by year. The proportion of male cases were increasing along with ageing. The proportion of HIV-infected cases detected by medical institutions also showed an upward trend. The newly reported HIV-infected cases aged 50 years and above were mainly transmitted through sexual contact. The proportion of heterosexual transmission increased from 5.5% (1/18) in 1995-2000 to 86.2% (8 334/9 666) in 2016-2020, and the proportion of MSM-behavior-related transmission increased from 0.0% in 1995-2000 to 13.5% (1 304/9 666) in 2016-2020. The majority of cases had extra-marital and/or non-commercial heterosexual behavior (48.1%, 4 007/8 334) and the proportion showed an upward trend. The majority of male cases had commercial heterosexual behavior (54.9%, 3 169/5 775), and with increasing proportion along with the increase of age. The majority of female cases had extra-marital and/or non-commercial heterosexual behavior (62.5%, 1 600/2 559), with increasing proportion of extra-marital and/or non-commercial heterosexual behavior. The proportion of heterosexual behavior with spouse or stable sexual partners showed a downward trend. The estimations based on CD4 counts back calculation model showed that among the newly reported HIV-infected cases aged 50 years and above, the average age being infected was (54.8±10.2) years, with 33.8% (4 263/12 621) infected before 50. The interval between infection and diagnosis was (5.7±6.2) years, of which 52.6% (6 636/12 621) were infected for 5 years or longer and 34.7% (4 384/12 621) were in the last 3 years. There was no linear correlation trend in the composition of infection years among the newly reported HIV-infected cases over 50-years-old.Conclusions In Henan, from 1995 to 2020, the number of newly reported HIV-infected cases aged 50 years and above was increasing and sexual transmission becoming the main transmission route. The increase of prevalence was mostly seen in 60-years-old men, low education level and detected mainly by medical institutions. For this age group, the focus of HIV/AIDS prevention and control should target on those who were transmitted through extra-marital and/or non-commercial heterosexual, commercial heterosexual and MSM behavior and it is necessary to strengthen the HIV testing and detection in this population and in the elderly floating group. |
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