摘要
目的了解凉山州不同地区吸毒人群艾滋病流行情况和流行因素,为该人群艾滋病防治措施的制定提供参考依据。方法在2017-04/06哨点监测期内,选取吸毒人群监测样本进行现场问卷调查和血清学调查,样本来源于强制戒毒所、社区、美沙酮门诊调查,率的比较采用卡方检验。结果本次监测以男性、彝族、20~50岁、在婚、高中及中专文化程度以下为主,注射吸毒行为和共用针具行为美姑县最高,所占比例分别是81.60%和50.80%,吸毒后性行为最低的是西昌,所占比例是8.18%,各县最近1年,与配偶/同居者有性行为的人数所占比例较高,同时伴有少许的商业性性行为,并且存在从未使用安全套的情况,西昌HIV抗体确认结果阳性率最低(9.23%),HIV抗体确认结果阳性率最高的是越西、昭觉、美姑,阳性率分别为38.0%、33.20%和27.20%。梅毒阳性率最低的2位是美姑县和金阳县,分别为0.80%和1.20%,HCV抗体检测结果阳性率最高的是越西县49.20%,最低的是金阳县20.00%。结论注射吸毒和共用针具行为及吸毒后性行为是感染HIV、梅毒、丙肝的主要因素;其次,安全性性行为能减少HIV、梅毒、丙肝的性传播。安全套宣传和发放/艾滋病咨询与检测、社区药物维持治疗/清洁针具提供/交换、同伴教育均是预防艾滋病传播的良好方式。
Objective To understand the epidemic situation and epidemic factors of AIDS among drug users in different areas of Liangshan prefecture. In order to provide basis for the prevention and treatment strategies and measures of AIDS among drug users. Methods During the sentinel surveillance period from April to June 2017, samples of drug users were selected for on-site questionnaires and serological surveys, and the comparison of rates were analyzed by chi-square test, samples were selected from compulsory drug rehabilitation centers, communities and methadone clinics. Results Male of Yi nationality,20-50 ages old,married,education level was lower than high school was the main sample we selected. Meigu County had the highest injecting drug use and needle sharing behaviors, the rate was 81.60% and 50.80%respectively. Xichang had the lowest sex behavior after drug taking,with a proportion of 8.18%. In recent year of each county, the proportion of people who had sex with their spouses/cohabitants was higher, meanwhile there were some commercial sex behavior, and the situation was existed that some of them were never using condom. The positive rate of HIV antibody confirmation in Xichang was the lowest(9.23%). The highest positive rate of HIV antibody confirmation was Yuexi, Zhaojue and Meigu these three counties, with the positive rate of 38.0%, 33.20% and27.20% respectively. The lowest positive rate of syphilis was Meigu and Jinyang county, which were 0.80% and 1.20% respectively. The highest positive rate of HCV antibody test was 49.20% in Yuexi county,and the lowest was 20.00% in Jinyang county. Conclusion Injection drug use,needle sharing and sexual behavior after drug taking are the main factors of infection of HIV,syphilis and hepatitis C. Secondly,safe sexual behavior can reduce the sexual transmission of HIV,syphilis and hepatitis C. Promotion and distribution of condom, counseling and testing of AIDS, drug maintenance treatment in community,provide and change into the clean needle,education both for couples are all good ways to prevent the spreading of AIDS.
引文
[1]邢健男,郭巍,汪宁,等.中国2005-2011年注射吸毒人群艾滋病感染的空间分析[J].中华流行病学杂志,2014,35(2):151-151.
[2]沈琳,黄竹林,陈剑,等.长沙市2011-2015年吸毒人群艾滋病哨点监测分析[J].疾病监测与控制,2018,12(2):108-111.
[3]周颖,李青青,南磊,等.凉山彝族自治州2008-2010年艾滋病哨点监测分析[J].中国艾滋病性病,2012,18(5):319-322.
[4]孙东玲.2005-2006年连云港市吸毒人群AIDS哨点监测资料分析[J].预防医学论坛,2008,14(5):447-453.
[5]王陇德.中国艾滋病流行与控制[M].北京:北京出版社,2006.164-487.
[6]王毅,周万明,樊静,等.2016年绵阳市男男性行为者艾滋病哨点监测结果分析[J].预防医学情报杂志,2017,33(12):1199-1204.
[7]罗映娟,赖文红,裴晓迪,等.2012-2015年四川省流动人口艾滋病哨点监测结果分析[J].预防医学情报杂志,2018,34(5):594-597.
[8]赵锰.建立AIDS第二代监测的全国网络系统[J].中国艾滋病性病,2003,9(2):104-104.
[9]和宏钧,张春平.对古城区吸毒人群进行艾滋病预防干预的效果评价[J].卫生软科学,2016,30(7):62-64.
[10]李丹,赵楠,朱林,等.北京市东城区2003-2006年吸毒人群哨点监测情况分析[J].中国艾滋病性病,2008,14(1):44-46.
[11]万放换,思志生,聂永英,等.盈江县2011-2013年吸毒人群艾滋病哨点监测结果分析[J].卫生软科学,2015,29(4):211-213.
[12]乔仁平,乔德标,孔继连,等.2013-2015年广西省柳城县艾滋病流行病学现状调查[J].医学动物仿制,2017,33(1):78-80.
[13]田甜,王克云,唐虎,等.2010-2015年眉山市孕产妇艾滋病哨点监测结果分析[J].预防医学情报杂志,2018,34(7):918-922.
[14]关晓霞,王书江,玛吾兰·阿不都哈帕尔,等.2009-2013年新疆伊宁市吸毒人群哨点监测结果[J].江苏预防医学,2016,27(2):144-147.
[15]吴寅徽,杜娜,吕小雅,等.奉化市2013-2015年吸毒人群艾滋病哨点监测分析[J].中国公共卫生管理,2016,32(5):690-692.
[16]陈静华,肖惠,崔熠可,等.江西省吸毒人群HIV、HBV、HCV及TP的感染现状及特点[J].南昌大学学报(医学版),2018,58(6):71-80.