百色市女性性工作者HIV-1新发感染及其影响因素

Analysis of new HIV-1 infection and its influencing factors among FSW in Baise

目的了解百色市女性性工作者(FSW)I型人类免疫缺陷病毒(HIV⁃1)新发感染率及其影响因素。方法选取百色市2016-2019年国家哨点监测中的6304例FSW为研究对象,应用HIV⁃1限制性抗原亲和力酶联免疫方法(LAg⁃Avidity EIA)对HIV⁃1抗体阳性的血清样本进行检测,判断新发感染,采用横断面研究HIV⁃1新发感染率计算公式(I=(R⁃FRR×P)/[(1⁃FRR)×(w/365)×N]×100%)计算HIV⁃1新发感染率,Logistic回归模型分析HIV⁃1新发感染相关影响因素。结果6304例FSW平均年龄(35.41±8.09)岁,以在婚/同居、壮族、初中及以下文化程度为主,HIV⁃1阳性率为1.57%(99/6304),其中2016-2019年分别为0.93%、1.57%、1.73%和2.21%,呈上升趋势(χ^(2)_(趋势)=7.485,P=0.006);HIV⁃1新发感染率为0.59/100人年(95%CI:0.310~0.956),其中2016-2019年分别为0.48/100人年、0.53/100人年、0.82/100人年和0.55/100人年,各年间差异无统计学意义(χ^(2)=0.477,P=0.924)。多因素Logistic回归模型分析结果显示,在二类场所环境工作(aOR=16.519,95%CI:1.994~136.822)是FSW HIV⁃1新发感染的危险因素,近1个月与客人性行为时每次均使用安全套(aOR=0.237,95%CI:0.070~0.805)则为保护因素。结论FSW仍是HIV⁃1感染的高风险人群,特别是在二类场所环境工作的FSW,提高该人群健康危害意识和健康行为能力,对遏制HIV⁃1感染及传播尤为重要。

Objective To understand the new human immunodeficiency virus type I(HIV⁃1)infection rate and its influencing factors among female sex workers(FSW)in Baise.Methods A total of 6304 FSW from 2016-2019 national sentinel surveillance in Baise were selected as the research objects.HIV⁃1 limiting antigen avidity enzyme immunoassay(LAg⁃Avidity EIA)was used to test HIV⁃1 antibody⁃positive serum samples and determine new HIV⁃1 infections.Cross⁃sectional study of HIV⁃1 new infection calculation formula(I=(R⁃FRR×P)/[(1⁃FRR)×(w/365)×N]×100%)was used to calculate HIV⁃1 new infection rate.Logistic regression model was used to analyze the factors related to new HIV⁃1 infection.Results The average age of 6304 FSW was(35.41±8.09)years old;they were mainly married/cohabitation,Zhuang nationality,with junior middle school or lower education level.The HIV⁃1 positive rates of 2016-2019 years were 0.93%,1.57%,1.73%and 2.21%,respectively,showing an upward trend(χ^(2)_(trend)=7.485,P=0.006).The new infection rate of HIV⁃1 of 2016-2019 years were 0.48/100 person years,0.53/100 person years,0.82/100 person years and 0.55/100 person years respectively,with no significant differences(χ^(2)=0.477,P=0.924).The results of multivariate logistic regression model showed that working in class II low⁃grade places(aOR=16.519,95%CI:1.994-136.822)was the risk factor of new HIV⁃1 infection among FSW,and using condoms every time when having sex with guests in recent month(aOR=0.237,95%CI:0.070-0.805)was the protective factor.Conclusions FSW were still at high risk of HIV infection,especially those working in class II low⁃grade places.Improving FSW awareness of health hazards and health behavior were important for curbing HIV infection and transmission.