广西部分地区老年男性嫖客商业性行为特征及HIV感染相关危险因素研究

陆华湘; 朱宇佳; 吴兴华; 陈欢欢; 罗柳红; 蔡开祥; 李剑军; 覃春伟; 张世真; 梁英芳; 李丽; 张鸿满

Abstract

陆华湘,朱宇佳,吴兴华,陈欢欢,罗柳红,蔡开祥,李剑军,覃春伟,张世真,梁英芳,李丽,张鸿满.广西部分地区老年男性嫖客商业性行为特征及HIV感染相关危险因素研究[J].Chinese journal of Epidemiology,2015,36(1):31-34

广西部分地区老年男性嫖客商业性行为特征及HIV感染相关危险因素研究

Study on the characteristics of commercial sexual behavior and the risk factors analysis of HIV infection among the old male clients, in Guangxi

Received:July 30, 2014

DOI：10.3760/cma.j.issn.0254-6450.2015.01.008

KeyWord: 人类免疫缺陷病毒老年男性嫖客商业性行为

English Key Word: Human immunodeficiency virus Old male clients Commercial sex behavior

FundProject:国家科技重大专项(2012ZX10004910);广西自然科学基金(2013GXNSFAA019225);贵港市科学研究与技术开发攻关项目(1105014)

Author Name	Affiliation	E-mail
Lu Huaxiang	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Zhu Yujia	Guigang City People's Hospital	ggzhuyujia@163.com
Wu Xinghua	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Chen Huanhuan	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Luo Liuhong	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Cai Kaixiang	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Li Jianjun	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Qin Chunwei	Guigang City Center for Disease Control and Prevention
Zhang Shizhen	Binyang Center for Disease Control and Prevention
Liang Yingfang	Luzhai Center for Disease Control and Prevention
Li Li	Qintang Center for Disease Control and Prevention
Zhang Hongman	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China

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Abstract:

目的了解广西部分地区老年男性嫖客商业性行为的基本情况和特点, 初步探索其感染HIV的相关危险因素. 方法选择广西老年男性艾滋病流行地区, 在暗娼场所现场对≥60岁的嫖客开展调查, 采5 ml静脉全血样本检测HIV和梅毒抗体, 用logistic多因素分析相关危险因素. 结果调查共获得有效问卷1 236份, 65.61%来自低档场所, 53.64%的人商业性行为中从未使用安全套, 47.33%的人商业性行为暴露时间≥10年, 53.32%的人近30 d内商业性行为≥2次, 检出HIV抗体阳性的嫖客30人(2.43%), 梅毒阳性40人(3.24%);有固定性伴(OR=0.302, 95%CI:0.140～0.650)是老年嫖客感染HIV的保护因素, 商业性行为暴露时间(1～5)年(OR=2.552, 95%CI:1.086～5.998)和近30天内发生商业性行为次数≥4次(OR=3.002, 95%CI:1.047～8.607)是危险因素. 结论广西老年男性嫖客HIV、梅毒的感染率较高, 以低档场所来源和低档消费为主, 商业性行为有暴露起点早, 时间跨度长、密度高、缺乏防护等特征, 感染HIV的相关危险因素可能包括无固定性伴及频繁发生的商业性行为.

English Abstract:

Objective To understand the current situation and characteristics of commercial sexual behavior among old male clients in Guangxi, and to explore the associated risk factors of HIV infection. Methods The areas in Guangxi where more old male HIV cases were reported followed by survey on those male clients who were over 60 years of age, were selected. A total of 5 ml blood sample was collected to test antibodies of HIV and syphilis. Risk factors were calculated by the multivariate logistic analysis method. Results A total of 1 236 questionnaires were completed in the survey. 65.61% of the old male clients were from low-grade venues with 53.64% of them never using a condom when engaging in commercial sex behavior. 47.33% of them patronized sex workers for around 10 years. 53.32% of them patronized prostitutes not less than 2 times in the last 30 days. Thirty subjects were HIV positive (2.43%) and 40 were syphilis positive (3.24%). Factor as ‘having fixed partners' (OR=0.302, 95%CI:0.140-0.650) appeared protective for the old male clients of HIV infection, with a history of patronizing sex workers from 1 to 5 years (OR=2.552, 95%CI: 1.086-5.998). Frequency of patronizing sex workers not less than 4 times in the last 30 days (OR=3.002, 95%CI:1.047-8.607) seemed the high risk factor of HIV infection. Conclusion Older-aged male clients showed high HIV and syphilis infection rates in Guangxi, and most of them were using the low-grade venues. Commercial sexual behaviors in the areas would include early and, frequent exposure, but with poor protections. High risk factors of HIV infection might relate to "no fixed sexual partners" and "frequently commercial sexual behavior".

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