广州地区不同人群女性性传播感染状况调查与分析

Investigation and Analysis on Sexually Transmitted Infection Among Different Females Group in Guangzhou

目的调查广州地区不同人群女性性传播感染(STI)的流行现状。方法由调查员进行现场问卷调查,采集血液进行HIV、RPR/TPPA、HSV-2抗体检测,采集白带涂片检测白念珠菌、阴道加特纳菌、阴道毛滴虫;宫颈拭子培养萘瑟氏淋病双球菌(GC)、沙眼衣原体(CT)、脲原体(UU)。结果共调查788例不同人群组的女性。流动女工STI总体感染率为41.6%,位居前3位的病原体感染分别为UU(25.1%)、HSV-2(14.9%)、CT(6.2%);妇科门诊人群总体STI感染率为71.1%,位居前3位分别为UU(41.5%)、HSV-2(18.7%)、CT(11.1%);暗娼STI总体感染率为90.1%,前3位感染分别为UU(74.6%)、HSV-2(47.5%)、阴道白念珠菌(17.8%),其它依次为加特纳菌(14.9%)、TP(14.9%)、CT(14.4%)。除了门诊组及暗娼组分别发现1例HIV感染,差异无统计学意义外,不同组间STI感染差异均有统计学意义。结论广州地区3组女性人群中,位居前2位的STI感染率分别为UU(25.1%～74.6%)、HSV-2(14.9%～47.5%),CT感染率为6.2%～14.4%。因此,除了加强妇科门诊STI防治外,加强对流动女工STI感染防治宣传很有必要。

Objective To investigate sexually transmitted infection （STI） prevalence and risk behavior factor among different female populations in Guangzhou. Methods STI/AIDS investigator was organized to provide STI/AIDS health education to target female population. Structured questionnaires were used to collect demographic and behavioral information, clinical and gynecologic examinations were performed to detect clinical signs of STIs. Blood samples were collected to test for antibodies of syphilis, and HSV/HIV. Vaginal discharge smear samples were collected for the detection of Trichomonas vaginalis （ T. vaginalis ）, Candida albican and Bacterial vaginalis （BV）, cervical swabs for Neisseria gonorrhoeae （ N. gonorrhoeae ）, Mycoplasema and Chlamydia trachomatis （ C. trachomatis ）. Results A total of 788 female were enrolled in the study. In subgroup population, STI prevalence among floating female workers was 41.6%, the top 3 infection were UU （25.1%）, HSV-2 （14.9%）, and CT（6.2%）; among gynecologic out-patient females was 71.1%, the top 3 infections were UU（41.5%）, HSV-2（18.7%） and CT（11.1%）; among sex workers was 90.1%, the top 3 infection were UU（74.6%）, HSV-2（47.5%） and Candida vaginal （17.8%）, followed by xx （14.9%）, TP （14.9% and CT （14.4%）. Except one HIV-infected was found in both gynecologic out-patient and sex worker that showed no significant difference, the STI prevalence was significantly different among different female populations （P〈0.001）. Mycoplasma was the most common pathogen of co-infection. More than 3 times sex activities within a week was an important factor for STI infection in the gynecologic out-patient and female sex worker population. Conclusion UU and HSV-2 infection were the top two most prevalence among different female populations. CT infection was increasing among the bearing-age females in Guangzhou. Health education and intervention were important in the STI/AIDS prevention program.