澄江县中英艾滋病项目基线调查分析

Baseline survey analysis of the China-UK Program in Chengjiang

[目的]为持续有效控制ADIS在澄江县的传播,支持ADIS控制规划和新一轮行动计划的实施。[方法]在全县范围内所有娱乐场所的CSW及社区(含戒毒所)全部IDU人群采用国家项目办统一的调查方案开展综合监测(包括知识及行为问卷调查和静脉采血样进行HIV及梅毒抗体检测)。[结果]在凤麓镇、新河口及禄充3个片区调查CSW366例,在350名采血检测的CSW中,HIV阳性6例,HIV阳性检出率1.7%;在梅毒抗体阳性15例,梅毒检出率为4.3%。在凤麓、阳宗、龙街、右所、9村5个镇调查IDU203例,202名采血的IDU中,检出HIV阳性70例(其中既往阳性43例),HIV阳性检出率34.7%;梅毒抗体阳性1例,梅毒检出率0.49%。在知识与行为问卷调查中,普遍表现为知识知晓率提高而行为改变较缓慢的态势。CSW最近1次与客人发生性关系时坚持使用安全套的比例为95.3%。最近1个月与客人发生性关系时每次都坚持使用安全套的比例78.6%。CSW不使用安全套的原因主要是:客人不用占62.5%,身边没有占13.63%,采用其他避孕方式9.09%,没想到、忘记使用和信任对方13.63%。IDU最近一次吸毒与他人未共用针具比例达92.10%,最近1个月从未与他人共用针具的比例为83.7%。[结论]通过新一轮项目实施,各项工作均取得一定成效,但也存在干预力度不够、宣传还不广泛、深入;VCT网络体系建设不完善、管理不健全;VCT资源整合不够、不配套等问题。必须加大对高危人群的干预工作力度,加强自愿咨询检测工作,最大限度发现艾滋病病毒感染者并适时进行必要的干预和治疗。

Objective In order to control HIV/AIDS epidemic in Chengjiang and support the AIDS control strategy and the implementation of action planning in China-UK Program further, Methods In the whole county, the commercial sex workers （CSWs） in entertainment establishments and injecting drug users （IDUs） in community and detoxification centers were under comprehensive surveillance according to the survey scheme of National Office, including questionnaire survey of knowledge and behavior, and HIV ＆ syphilis testing by drawing intravenous blood. Results 366 CSWs from Fenglu, Xinhekou and Luchong three communities were surveyed; among the 350 blood samples, there are 6 with HIV positive （1.7%） and 15 with syphilis （4.3%）; among 203 IDUs, 202 people were drawn blood, 70 cases were tested HIV positive （ including 43 old cases before tested）, the 1 case was tested syphilis. In the questionnaire of knowledge and behavior survey, the findings show that the knowledge awareness is rising but the behavior change is slow. The rates of using condom among CSWs having sex with clients in last time and in last month were 95,3% and 78.6% respectively, The reasons of not using condom were： clients refusal accounting for 62.5%, without condoms at hand being 13.63%, using other contraception methods being 9.09%, and the other factors（ forgetting, not knowing and believing clients） being 13.6%, The rates of not sharing injectors in last time, in last month when using drugs were 92.10% and 83.7%, Conclusion Through the implementation of this round China-UK Program, there are some achievements, but some intervening measures were not so powerful and the dissemination and education are not wide and deep enough; the VCT network system and its management were not so perfect, and the VCT resource integration had some problems, The intervention should be strengthened among the high risk populations, and VCT work should be improved to identify the people with HIV and provide the intervention and treatment.