凉山州2009-2015年孕产妇HIV哨点监测分析
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摘要
目的了解凉山彝族自治州孕产妇艾滋病病毒(HIV)感染和流行情况,为制定当地艾滋病的防治策略提供科学依据。方法选取2009-2015年每年4-6月在凉山州西昌市、彝族聚居地的昭觉县和布拖县妇幼保健院,准备分娩和接受孕产期保健的孕产妇进行连续采样监测,问卷调查了解一般人口学、生育情况和行为特征等情况,并采用酶联免疫吸附试验法检测HIV抗体。采用SPSS 19.0统计软件对数据进行整理和分析。结果 2009-2015年,孕产妇人群哨点共监测有效研究对象6 780人,检出HIV抗体阳性者288例,阳性率4.25%。2009-2015年各年HIV的阳性检出率分别为1.35%(9/665)、2.95%(18/611)、3.57%(36/1 008)、6.86%(82/1 196)、4.57%(48/1 050)、3.71%(39/1 050)和4.67%(56/1 200),呈现缓慢上升趋势(χ2=7.71,P=0.005)。分析发现昭觉和布拖地区的孕产妇HIV感染风险高于西昌地区[比值比(OR)=2.95,95%可信区间(CI)=1.39~6.24]。孕产妇是彝族(OR=6.08,95%CI=1.76~20.96)、生育次数1次(OR=1.55,95%CI=1.06~2.25)和2次(OR=1.74,95%CI=1.20~2.52)、丈夫有外出打工史(OR=1.40,95%CI=1.04~1.87)、丈夫有吸毒史(OR=1.86,95%CI=1.04~3.33)、丈夫患有性病(OR=2.26,95%CI=1.30~3.93),是感染HIV的危险因素。文化程度较高的研究对象感染HIV风险较低(OR=0.34,95%CI=0.13~0.85)。结论凉山彝族自治州孕产妇HIV抗体阳性率较高,HIV在该人群中有升高趋势。特别是对文化程度低,丈夫有吸毒史、外出打工史和患有性病的彝族孕产妇,感染HIV的风险更高。
Objective To understand the HIV epidemic among pregnant women of Liangshan prefecture, so as to provide scientific basis for AIDS prevention and control strategies. Methods Pregnant women receiving prenatal health care were enrolled for sentinel surveillance between 2009 and 2015, with the information collected to know the demographic characteristics, HIV-related knowledge, and behavioral characteristics of both the pregnant women and their spouses. The HIV detection was carried out by ELISA method. SPSS 19.0 was used to analyze the data. Results 6780 pregnant women were under surveillance between Apr. 2009 and Jul. 2015. The annual positive rates for HIV were 1.35%(9/665), 2.95%(18/611), 3.57%(36/1008), 6.86%(82/1196), 4.57%(48/1050), 3.71%(39/1050) and 4.67%(56/1200) from 2009 to 2015, with a slow increasing trend(χ2=7.71 P=0.005). Pregnant women in Zhaojue and Butuo counties had higher risks compared with those in Xichang city(OR=2.95, 95% CI=1.39-6.24). The risk factors for HIV infection included Yi ethnic pregnant women(OR=6.08, 95%CI=1.76-20.96), number of births with one birth(OR=1.55, 95%CI=1.06-2.25) and two births(OR=1.74, 95%CI=1.20-2.52), histories of spouses who were outmigrating for work(OR=1.40, 95%CI=1.04-1.87), drug users(OR=1.86, 95%CI=1.04-3.33), and suffered from sexually transmitted diseases(OR=2.26, 95%CI=1.30-3.93).However, those with higher education had lower risks(OR=0.34, 95%CI=0.13-0.85). Conclusion The HIV infection rate among pregnant women is high, especially those with low education, drug users, out-migrating workers and STDs patients, as well as the Yi ethnic pregnant women.
Objective To understand the HIV epidemic among pregnant women of Liangshan prefecture, so as to provide scientific basis for AIDS prevention and control strategies. Methods Pregnant women receiving prenatal health care were enrolled for sentinel surveillance between 2009 and 2015, with the information collected to know the demographic characteristics, HIV-related knowledge, and behavioral characteristics of both the pregnant women and their spouses. The HIV detection was carried out by ELISA method. SPSS 19.0 was used to analyze the data. Results 6780 pregnant women were under surveillance between Apr. 2009 and Jul. 2015. The annual positive rates for HIV were 1.35%(9/665), 2.95%(18/611), 3.57%(36/1008), 6.86%(82/1196), 4.57%(48/1050), 3.71%(39/1050) and 4.67%(56/1200) from 2009 to 2015, with a slow increasing trend(χ2=7.71 P=0.005). Pregnant women in Zhaojue and Butuo counties had higher risks compared with those in Xichang city(OR=2.95, 95% CI=1.39-6.24). The risk factors for HIV infection included Yi ethnic pregnant women(OR=6.08, 95%CI=1.76-20.96), number of births with one birth(OR=1.55, 95%CI=1.06-2.25) and two births(OR=1.74, 95%CI=1.20-2.52), histories of spouses who were outmigrating for work(OR=1.40, 95%CI=1.04-1.87), drug users(OR=1.86, 95%CI=1.04-3.33), and suffered from sexually transmitted diseases(OR=2.26, 95%CI=1.30-3.93).However, those with higher education had lower risks(OR=0.34, 95%CI=0.13-0.85). Conclusion The HIV infection rate among pregnant women is high, especially those with low education, drug users, out-migrating workers and STDs patients, as well as the Yi ethnic pregnant women.
引文
[1]龚煜汉,王启兴,余刚,等.四川省凉山州1995-2012年HIV/AIDS病人死亡情况分析[J].中国艾滋病性病,2014,20(11):849-851.
[2]梁鹏艳,龚煜汉,廖强,等.应用BED-CEIA方法估算四川省凉山州2013年多类人群HIV-1新发感染率[J].现代预防医学,2016,43(9):1675-1678.
[3]赵庆革,龚煜汉,廖强,等.凉山彝族自治州2011-2013年基于BED捕获酶联免疫法估算HIV-1新发感染率[J].中华流行病学杂志,2016,37(8):1105-1107.
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[6]刘刚,毛晓英,秦光明,等.四川省艾滋病高发区孕妇HIV感染及相关危险因素调查分析[J].预防医学情报杂志,2002,18(3):211-212.
[7]汤雪娟,肖霞,林丽萍,等.嘉兴市292 507例孕产妇HIV感染状况[J].中国艾滋病性病,2014,20(3):176-177.
[8]袁智,曹文杰,姚永明,等.2010-2015年贵州省孕产妇艾滋病哨点监测分析[J].中国艾滋病性病,2016,22(11):917-920.
[9]赵会勇,宋先毅,武红娟,等.云南楚雄州1991-2013年艾滋病流行情况分析[J].中国皮肤性病学杂志,2015,29(12):1265-1266.
[10]陈栏心,董柏青,陈怡,等.广西孕产妇艾滋病相关流行病学横断面调查研究[J].中国热带医学,2013,13(11):1323-1326.
[11]孙定勇,王奇,杨文杰,等.河南省孕产妇人群中HIV/AIDS流行情况及母婴传播预防与控制[J].中国艾滋病性病,2008,14(4):351-353.
[12]陆娟,倪明健,董永慧,等.新疆部分地区孕产妇HIV/AIDS感染调查及影响因素分析[J].疾病预防控制通报,2012,6:6-8.
[13]张素华,罗敏,杨淑娟,等.四川省凉山彝族自治州2011-2013年农村未婚青年HIV感染相关行为特征及因素分析[J].中华流行病学杂志,2017,38(4):486-490.
[14]周如南,周大鸣.情境中性的社会网络与艾滋病风险—凉山地区通过性途径传播艾滋病的风险研究[J].开放时代,2012,2:145-158.
[15]杨淑娟,罗敏,张素华,等.凉山彝族相关文化习俗与艾滋病流行的关系及干预对策[J].中国艾滋病性病,2017,23(3):271-272.
[16]吴汉奇,潘池梅,张学锋,等.农村外出务工人员艾滋病知识、态度及高危行为分析[J].预防医学情报杂志,2009,25(8):638-640.
[2]梁鹏艳,龚煜汉,廖强,等.应用BED-CEIA方法估算四川省凉山州2013年多类人群HIV-1新发感染率[J].现代预防医学,2016,43(9):1675-1678.
[3]赵庆革,龚煜汉,廖强,等.凉山彝族自治州2011-2013年基于BED捕获酶联免疫法估算HIV-1新发感染率[J].中华流行病学杂志,2016,37(8):1105-1107.
[4]中华人民共和国卫生部,联合国艾滋病规划署,世界卫生组织.2011年中国艾滋病疫情估计[J].中国艾滋病性病,2012,18(2):1-5.
[5]梁莉,刘莉,裴晓迪,等.2008-2011年四川省艾滋病HIV检测分析[J].预防医学情报杂志,2013,29(6):453-456.
[6]刘刚,毛晓英,秦光明,等.四川省艾滋病高发区孕妇HIV感染及相关危险因素调查分析[J].预防医学情报杂志,2002,18(3):211-212.
[7]汤雪娟,肖霞,林丽萍,等.嘉兴市292 507例孕产妇HIV感染状况[J].中国艾滋病性病,2014,20(3):176-177.
[8]袁智,曹文杰,姚永明,等.2010-2015年贵州省孕产妇艾滋病哨点监测分析[J].中国艾滋病性病,2016,22(11):917-920.
[9]赵会勇,宋先毅,武红娟,等.云南楚雄州1991-2013年艾滋病流行情况分析[J].中国皮肤性病学杂志,2015,29(12):1265-1266.
[10]陈栏心,董柏青,陈怡,等.广西孕产妇艾滋病相关流行病学横断面调查研究[J].中国热带医学,2013,13(11):1323-1326.
[11]孙定勇,王奇,杨文杰,等.河南省孕产妇人群中HIV/AIDS流行情况及母婴传播预防与控制[J].中国艾滋病性病,2008,14(4):351-353.
[12]陆娟,倪明健,董永慧,等.新疆部分地区孕产妇HIV/AIDS感染调查及影响因素分析[J].疾病预防控制通报,2012,6:6-8.
[13]张素华,罗敏,杨淑娟,等.四川省凉山彝族自治州2011-2013年农村未婚青年HIV感染相关行为特征及因素分析[J].中华流行病学杂志,2017,38(4):486-490.
[14]周如南,周大鸣.情境中性的社会网络与艾滋病风险—凉山地区通过性途径传播艾滋病的风险研究[J].开放时代,2012,2:145-158.
[15]杨淑娟,罗敏,张素华,等.凉山彝族相关文化习俗与艾滋病流行的关系及干预对策[J].中国艾滋病性病,2017,23(3):271-272.
[16]吴汉奇,潘池梅,张学锋,等.农村外出务工人员艾滋病知识、态度及高危行为分析[J].预防医学情报杂志,2009,25(8):638-640.