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.
引文
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