暗娼人群2005-2007年行为监测主要指标分析

Analysis of core indicators of behavioral surveillance surveys among female sex workers from 2005 to 2007

目的分析中国暗娼人群艾滋病相关行为变化及艾滋病病毒(HIV)感染流行趋势,为艾滋病综合防治和科学干预提供信息和依据。方法对2005-2007年连续开展监测的41个暗娼综合监测点,以重复横断面调查的方法,对社区娱乐场所及街头的暗娼人群进行问卷调查并采血。结果2005-2007年连续开展监测的41个暗娼综合监测点中,三年间监测对象最近一次商业性行为安全套使用率分别为73.7%、81.1%和81.5%;最近一个月商业性行为坚持使用安全套的比例分别为49.3%、56.4%和55.4%;约有1/3的监测点发现监测对象中有注射吸毒暗娼;艾滋病传播途径知晓率分别为62.4%、57.3%和64.8%;接受过HIV检测并知晓检测结果者的比例分别为:10.9%、16.6%和24.9%;最近一年内接受过干预服务者的比例分别为:51.3%、78.8%和89.8%;HIV阳性检出率(中位数)均为0.0%;梅毒阳性检出率分别为0.6%、1.0%和1.2%。结论暗娼人群安全套使用率和艾滋病知识知晓率有待于进一步提高,最近一次安全套使用率判断趋势可能造成高估。接受过干预服务者的比例呈上升趋势,行为干预、自愿咨询检测、宣传教育的覆盖面逐步扩大,可及性不断提高。HIV感染率总体水平低,局部地区流行水平较高,部分暗娼有注射吸毒行为、高危行为状况不容乐观,提示干预工作长期而艰巨,需不断开展综合防治,保证干预的力度、效果和持续性。

bjective To analyze behavioral changes related to HIV/AIDS and trends of HIV epidemic among female sex workers（FSWs）, and to provide information for integrated HIV prevention and evaluation of interventions. Methods Continuous surveillance was provided in 41 sites from 2005 to 2007, when cross-sectional surveys were conducted among institution - based and street based female sex workers,and blood samples were faken. Result The rate of using condoms in the last commercial sex activities among the surveyed FSWs was：73.7 % ,81.1% and 81.5 % in the respective 3 years from 2005 to 2007;while the rate of consistently using condoms in sex with clients during the last month was：49.3 %, 56.4 % and 5.4 % in the respective 3 years. Female sex workers who had injecting drug use were identified in one third surveillance sites. The rate of awareness of HIV/AIDS transmission among the FSWs was 62.4 %, 57.3 % and 64.8 % , respectively. The proportion of the FSWs who attended HIV VCT services was 10.9 % , 16.6 % and 24.9 % , respectively. The proportion of the FSWs who received intervention service within the last year was 51.3 % , 78.8 % and 89.8 % , respectively. The HIV detection rate was 0.0 % （median value）in all the 3 years while the syphilis detection rate was 0.6 %, 1.0 % and 1.15 % respectively. Conclusion Rate of condom use and HIV awareness need to be further enhanced among female sex workers. The rate of condom use in the last sex with clients may be over estimated. The proportion of female sex workers who have received intervention service tends to increase; the coverage of behavioral intervention, voluntary counseling and testing and public education is increased gradually. HIV prevalence rate among female sex workers is generally low, but relatively high in some regions. High risk behaviors , such as unprotected sex and injecting drug use are not uncommon among FSWs. All this means that behavioral intervention is a longterm tough task, and to ensure its effectiveness and sustainability integrated HIV/AIDS prevention and control program will be needed.