文章摘要
秦倩倩,金怡晨,蔡畅,陈方方,汤后林.2018-2022年我国报告60岁及以上农民HIV感染者流行特征分析[J].中华流行病学杂志,2023,44(11):1686-1691
2018-2022年我国报告60岁及以上农民HIV感染者流行特征分析
Epidemiological characteristics of HIV-infected farmers aged 60 years and older reported in China, 2018-2022
收稿日期:2023-04-20  出版日期:2023-11-17
DOI:10.3760/cma.j.cn112338-20230420-00254
中文关键词: 艾滋病病毒/艾滋病  老年  流行特征
英文关键词: HIV/AIDS  Elderly  Epidemiological characteristic
基金项目:
作者单位E-mail
秦倩倩 中国疾病预防控制中心性病艾滋病预防控制中心流行病学室, 北京 102206  
金怡晨 中国疾病预防控制中心性病艾滋病预防控制中心流行病学室, 北京 102206  
蔡畅 中国疾病预防控制中心性病艾滋病预防控制中心流行病学室, 北京 102206  
陈方方 中国疾病预防控制中心性病艾滋病预防控制中心流行病学室, 北京 102206  
汤后林 中国疾病预防控制中心性病艾滋病预防控制中心流行病学室, 北京 102206 tanghl@chinaaids.cn 
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中文摘要:
      目的 分析我国≥60岁农民HIV感染者的流行特征,为老年农民艾滋病防控政策制定提供依据。方法 数据来源于中国疾病预防控制信息系统,选取2018-2022年报告年龄≥60岁、职业为农民的HIV感染者,应用SPSS 24.0软件进行描述性分析,采用χ2检验进行农民和非农民两组间的比较,并选取6个有代表性的指标,通过样品系统聚类方法将31个省份分为A、B和C 3个亚流行区。结果 2018-2022年共报告≥60岁农民感染者113 311例,占全国该年龄段HIV感染者报告数的71.8%(113 311/157 792)。其中,男性86 517例(76.4%),检测来源主要来自医疗机构80 176例(70.8%)、分布在西部地区80 667例(71.2%)。≥60岁农民HIV感染者中,小学及以下文化程度占81.4%(92 191/113 311),高于非农民HIV感染者中的比例(49.8%,22 165/44 481)。≥60岁农民HIV感染者96.7%(109 562/113 311)经异性性传播感染,其中,商业异性性行为占50.4%(55 184/109 562)、固定性伴性行为占9.1%(9 958/109 562)、其他异性性行为占40.5%(44 420/109 562)。聚类分析结果显示,A区为西部6省份(广西壮族自治区、重庆市、贵州省、四川省、云南省和新疆维吾尔自治区),现存活HIV感染者占比(30.2/万)、≥60岁农民HIV感染者占农村人口比例(22.8/万)、报告≥60岁农民HIV感染者县(区)数比例(93.4%)、HIV检测量占人口比例(44.2%),均高于B和C区。农民人均纯收入(1万元/年)低于B和C区,男性商业异性性行为比例(41.0%),略低于B区(46.1%),高于C区(15.2%)。结论 2018-2022年我国报告≥60岁农民HIV感染者主要通过商业异性性行为等传播感染,该人群文化程度低,艾滋病自身防护意识不强,应重视老年农民艾滋病健康教育等干预措施,同时加强对农村卖淫妇女及HIV阳性配偶的预防干预工作。
英文摘要:
      Objective To understand the epidemiological characteristics of HIV-infected farmers aged ≥ 60 years in China and provide evidence for the development of AIDS prevention and control policies for elderly farmers. Methods Data of newly HIV-infected farmers aged ≥ 60 years reported between 2018 and 2022 were obtained from China Information System for Disease Control and Prevention. The differences in epidemiological characteristics of HIV infection between farmers and other populations were compared using χ2 test. Based on 6 representative indicators, 31 provinces were divided into three sub-epidemic areas of A, B, and C by using sample system clustering method in SPSS 24.0 software. Results From 2018 to 2022, a total of 113 311 HIV infection cases in farmers aged ≥ 60 years were reported, accounting for 71.8% of the reported cases in this age group nationwide (113 311/157 792). In the 113 311 HIV infection cases, 86 517 (76.4%) were men, 80 176 (70.8%) were diagnosed by medical institutions, 80 667 (71.2%) were distributed in the western region and 92 191 (81.4%) had education level of primary school or below [higher than the proportion in other populations (49.8%, 22 165/44 481)]. In 113 311 HIV infection cases, 96.7%(109 562/113 311) were infected through heterosexual transmission, in whom 50.4% (55 184/109 562) had commercial heterosexual behavior, 9.1%(9 958/109 562) had fixed sexual partners, 40.5%(44 420/109 562) had other heterosexual behaviors. The clustering analysis indicated that in region A (Guangxi, Chongqing, Guizhou, Sichuan, Yunnan and Xinjiang), the proportions of people living with HIV (30.2/10 000), HIV-infected farmers aged ≥ 60 years in rural population (22.8/10 000), counties reported HIV-infected elderly farmers (93.4%), the population had HIV test (44.2%), were all higher than those in region B and C. Compared with region B and C, The net income of farmers (10 000 yuan) was lower in region A, and the proportion of commercial heterosexual behavior in male farmers in region A (41.0%) was slightly lower than that in region B (46.1%), but higher than that in region C (15.2%). Conclusions HIV infections in farmers aged ≥ 60 years were mainly caused by heterosexual behaviors, such as commercial heterosexual sex, in China from 2018 to 2022. The low awareness of self-protection against AIDS and high-risk sexual behaviors are closely associated with HIV infection in elderly farmers. Attention should be paid to the behavior intervention and health education about AIDS prevention in elderly farmers and the prevention and intervention in rural female sex workers and HIV positive spouses should be strengthened.
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