2015—2017年崇左市女性性工作者艾滋病相关知信行现状及HIV感染因素
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摘要
目的分析崇左市2015—2017年女性性工作者(FSW)艾滋病流行情况和行为变化特征,以及梅毒、丙型肝炎病毒(HCV)的流行状况,为制定全市艾滋病预防控制策略提供科学且有针对性的依据。方法根据全国艾滋病哨点监测项目,于2015—2017年哨点监测期内,对崇左市辖区内的FSW进行问卷调查,并采集静脉血进行艾滋病病毒(HIV)、梅毒和HCV抗体检测。结果 2015—2017年共调查FSW 5 611人。2015—2017年,艾滋病相关知识知晓率分别为95.04%,96.06%和97.41%,各年间知晓率差异有统计学意义(χ2=14.10,P<0.05),三年平均知晓率为96.15%。HIV抗体阳性48名(0.86%),梅毒抗体阳性255名(4.54%),HCV抗体阳性52名(0.93%)。HIV感染的多因素Logistic回归分析结果中,离异或丧偶[比值比(OR)=2.88,95%可信区间(CI):1.00～8.40]、年龄≥35岁(OR=2.88,95%CI:1.24～6.66)、吸毒(OR=17.96,95%CI:6.57～49.14)和最近一年患过性病(OR=4.02,95%CI:1.80～8.98)是FSW感染HIV的危险因素,而本地工作时间<1年(OR=0.34,95%CI:0.14～0.74)和在婚(OR=0.29,95%CI:0.10～0.82)则是FSW HIV感染的保护因素。结论 2015—2017年崇左市FSW对艾滋病相关知识的知晓水平较高,HIV、HCV和梅毒感染率较高。离异或丧偶、年龄≥35岁、吸毒、最近一年患性病是崇左市FSW HIV感染的影响因素,应有针对性对该人群进行监测和精准干预,以预防艾滋病在该人群的传播。
Objective To analyze the prevalence of syphilis and hepatitis C virus(HCV),AIDS and behavior changes among female sex workers(FSW)in Chongzuo city during 2015-2017,and provide a basis for AIDS behavior intervention for the future.Methods According to the national AIDS sentinel surveillance guidelines,female sex workers were surveyed and HIV,syphilis and HCV antibody were tested each year.Results A total of 5 611 FSW were surveyed from 2015 to 2017.The AIDS knowledge awareness rate was 95.04%,96.6%,and 97.41%respectively,with difference of the rates in the three years statistically significant(χ2=14.10,P<0.05).The average awareness rate of AIDS-related knowledge was 96.15%.The number of HIV,syphilis and HCV infected persons detected were 48(0.86%),255(4.54%)and 52(0.94%).The multivariate logistic regression analysis showed that risk factors for HIV infection in FSW included being devoiced and widowed(OR=2.88,95%CI=1.00-8.40),age≥35years(OR=2.88,95%CI=1.24-6.66),drug abuse(OR=17.96,95%CI=6.57-49.14)and sexually transmitted diseases(OR=4.02,95%CI=1.80-8.98)in the most recent year.Local working time<1year(OR=0.34,95%CI:0.14-0.74)and marriage(OR=0.29,95% CI:0.10-0.82) were protective factors.Conclusion Female sex workers in Chongzuo have high awareness rate of AIDS-related knowledge during2015-2017.However,the rates of HIV,syphilis and HCV infection are high.Being devoiced/widowed,age≥35years,drug abuse and sexually transmitted diseases in the most recent year are risk factors for HIV infection.Monitoring and intervention should be strengthened so as to prevent HIV infection among FSW.
Objective To analyze the prevalence of syphilis and hepatitis C virus(HCV),AIDS and behavior changes among female sex workers(FSW)in Chongzuo city during 2015-2017,and provide a basis for AIDS behavior intervention for the future.Methods According to the national AIDS sentinel surveillance guidelines,female sex workers were surveyed and HIV,syphilis and HCV antibody were tested each year.Results A total of 5 611 FSW were surveyed from 2015 to 2017.The AIDS knowledge awareness rate was 95.04%,96.6%,and 97.41%respectively,with difference of the rates in the three years statistically significant(χ2=14.10,P<0.05).The average awareness rate of AIDS-related knowledge was 96.15%.The number of HIV,syphilis and HCV infected persons detected were 48(0.86%),255(4.54%)and 52(0.94%).The multivariate logistic regression analysis showed that risk factors for HIV infection in FSW included being devoiced and widowed(OR=2.88,95%CI=1.00-8.40),age≥35years(OR=2.88,95%CI=1.24-6.66),drug abuse(OR=17.96,95%CI=6.57-49.14)and sexually transmitted diseases(OR=4.02,95%CI=1.80-8.98)in the most recent year.Local working time<1year(OR=0.34,95%CI:0.14-0.74)and marriage(OR=0.29,95% CI:0.10-0.82) were protective factors.Conclusion Female sex workers in Chongzuo have high awareness rate of AIDS-related knowledge during2015-2017.However,the rates of HIV,syphilis and HCV infection are high.Being devoiced/widowed,age≥35years,drug abuse and sexually transmitted diseases in the most recent year are risk factors for HIV infection.Monitoring and intervention should be strengthened so as to prevent HIV infection among FSW.
引文
[1]Chen Y,Shen Z,Morano JP,et al.Bridging the Epidemic:AComprehensive Analysis of Prevalence and Correlates of HIV,Hepatitis C,and Syphilis,and Infection among Female Sex Workers in Guangxi Province,China[J].PLoS One,2015,10(2):e0115311.
[2]张世京.1996-2007年崇左市HIV/AIDS流行特征及趋势分析[J].内科,2008,3(6):932-935.
[3]刘娟,梁庆香,冯献湘,等.2012年柳州市400名嫖客艾滋病哨点监测结果分析[J].中华疾病控制杂志,2012,16(12):1060-1063.
[4]黄洪光,赵秀昌.2004-2011年崇左市淋病、梅毒、艾滋病流行特征分析[J].预防医学论坛,2013,19(3):237-239.
[5]葛宪民,唐振柱,朱秋映,等.广西2010-2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[6]Liao M,Nie X,Pan R,et al.Consistently Low Prevalence of Syphilis among Female Sex Workers in Jinan,China:Findings from Two Consecutive Respondent Driven Sampling Surveys[J].PLoS One,2012,7(4):e34085.
[7]Yang Y,Yang C,Latkin CA,et al.Condom Use During Commercial Sex Among Male Clients of Female Sex Workers in Sichuan China:A Social Cognitive Theory Analysis[J].Aids Behav,2016,20(10):2309-2317.
[8]Xu J,Smith MK,Ding G,et al.Drug use and sex work:competing risk factors for newly acquired HIV in Yunnan,China[J].PLoS One,2013,8(3):e59050.
[9]董玉连,农桂德,董秀明,等.广西钟山县不同档次场所FSWs HIV感染及高危行为调查[J].职业与健康,2016,32(13):1789-1792,1796.
[10]Ma Q,Jiang J,Pan X,et al.Consistent condom use and its correlates among female sex workers at hair salons:a cross-sectional study in Zhejiang province,China[J].Bmc Public Health,2017,17(1):910.
[11]Zhou C,Rou K,Dong WM,et al.High prevalence of HIV and syphilis and associated factors among low-fee female sex workers in mainland China:a cross-sectional study[J].BMC Infectious Diseases,2014,14(1):1-9.
[12]Zhou Y,Li X,Zhang C,et al.Rates of HIV,syphilis,and HCV infections among different demographic groups of female sex workers in Guangxi China:Evidence from 2010national sentinel surveillance data[J].Aids Care,2013,25(11):1433-1441.
[13]Lu F,Jia Y,Sun X,et al.Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China[J].Southeast Asian J Trop Med Public Health,2009,40(2):263-272.
[14]Liu J,Calzavara L,Mendelsohn JB,et al.Impact evaluation of a community-based intervention to reduce risky sexual behaviour among female sex workers in Shanghai,China[J].Bmc Public Health,2015,15(1):1-15.
[15]Zhang C,Li X,Liu Y,et al.Human immunodeficiency virus,syphilis and hepatitis C virus prevalence trends among cross-border migrant Vietnamese female sex workers in Guangxi,China[J].BMC Public Health,2015(15):1223.doi:10.1186/s12889-015-2561-0.
[2]张世京.1996-2007年崇左市HIV/AIDS流行特征及趋势分析[J].内科,2008,3(6):932-935.
[3]刘娟,梁庆香,冯献湘,等.2012年柳州市400名嫖客艾滋病哨点监测结果分析[J].中华疾病控制杂志,2012,16(12):1060-1063.
[4]黄洪光,赵秀昌.2004-2011年崇左市淋病、梅毒、艾滋病流行特征分析[J].预防医学论坛,2013,19(3):237-239.
[5]葛宪民,唐振柱,朱秋映,等.广西2010-2015年艾滋病流行特征及趋势分析[J].中国艾滋病性病,2017,23(1):40-43.
[6]Liao M,Nie X,Pan R,et al.Consistently Low Prevalence of Syphilis among Female Sex Workers in Jinan,China:Findings from Two Consecutive Respondent Driven Sampling Surveys[J].PLoS One,2012,7(4):e34085.
[7]Yang Y,Yang C,Latkin CA,et al.Condom Use During Commercial Sex Among Male Clients of Female Sex Workers in Sichuan China:A Social Cognitive Theory Analysis[J].Aids Behav,2016,20(10):2309-2317.
[8]Xu J,Smith MK,Ding G,et al.Drug use and sex work:competing risk factors for newly acquired HIV in Yunnan,China[J].PLoS One,2013,8(3):e59050.
[9]董玉连,农桂德,董秀明,等.广西钟山县不同档次场所FSWs HIV感染及高危行为调查[J].职业与健康,2016,32(13):1789-1792,1796.
[10]Ma Q,Jiang J,Pan X,et al.Consistent condom use and its correlates among female sex workers at hair salons:a cross-sectional study in Zhejiang province,China[J].Bmc Public Health,2017,17(1):910.
[11]Zhou C,Rou K,Dong WM,et al.High prevalence of HIV and syphilis and associated factors among low-fee female sex workers in mainland China:a cross-sectional study[J].BMC Infectious Diseases,2014,14(1):1-9.
[12]Zhou Y,Li X,Zhang C,et al.Rates of HIV,syphilis,and HCV infections among different demographic groups of female sex workers in Guangxi China:Evidence from 2010national sentinel surveillance data[J].Aids Care,2013,25(11):1433-1441.
[13]Lu F,Jia Y,Sun X,et al.Prevalence of HIV infection and predictors for syphilis infection among female sex workers in southern China[J].Southeast Asian J Trop Med Public Health,2009,40(2):263-272.
[14]Liu J,Calzavara L,Mendelsohn JB,et al.Impact evaluation of a community-based intervention to reduce risky sexual behaviour among female sex workers in Shanghai,China[J].Bmc Public Health,2015,15(1):1-15.
[15]Zhang C,Li X,Liu Y,et al.Human immunodeficiency virus,syphilis and hepatitis C virus prevalence trends among cross-border migrant Vietnamese female sex workers in Guangxi,China[J].BMC Public Health,2015(15):1223.doi:10.1186/s12889-015-2561-0.