浙江省台州地区新报告艾滋病毒感染者危险行为网络调查

Risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province

目的 掌握浙江省台州地区新报告艾滋病毒（HIV）感染者的危险行为网络特征.方法 对2008年5月至2010年3月间新报告的HIV感染者及其所提供的高危行为接触者追踪调查和HIV检测（简称＂溯源调查＂）,并详细调查其相关危险行为网络特征.结果 研究期间台州地区共新报告HIV感染者267例,其中191例（71.5%）HIV感染者作为指示病例参与溯源调查,包括第一轮发现报告的158例及随后通过溯源调查从其高危接触者中新发现的33例HIV感染者.HIV感染以经异性性传播途径为主（74.9%,143/191）,其次是经男男性接触传播（19.4%,37/191）,注射吸毒传播11例（5.8%,11/191）.191例HIV感染者共累计报告1152名高危接触者,并提供了其中461名最熟悉者的联络方式,其中129例接受HIV检测,61例（47.3%）检测阳性;以指示病例 的配偶或固定性伴及男男同性性伴中HIV阳性检出率为高,分别为45.6%（47/103）和60.0%（12/20）.指示病例在与高危接触者发生性行为时安全套使用率低,坚持使用安全套者仅占33.9%.结论 浙江省台州地区新报告HIV感染者危险行为网络规模较大,安全套使用率较低,高危行为复杂,HIV传播风险较大;在男男性接触人群中该特征尤为显著.应针对重点人群和网络特征环节实施行为干预以降低HIV传播.

Objective To understand the risk behavioral networks of newly reported HIV infections in Taizhou prefecture, Zhejiang province. Methods Newly reported HIV infections from May 2008 through March 2010 in Taizhou prefecture were invited to participate in a cross-sectional survey which requested numbers and contact information of individuals with whom they had had high risk contacts as well as risk behavioral acts with them. Persons having had risky contacts with HIV-infected cases were thereof approached to participate in this survey and to receive HIV testing.Those who tested positive for HIV were subject to further round of the surveys. Results A total of 267 HIV cases were newly reported during this study period. Among them, 191 participated in the survey and served as ＇index cases＇, including 158 cases identified from routine HIV surveillance programs and 33 cases identified from the present survey. Heterosexual transmission was the primary transmission route （74.9%, or 143/191 ）, followed by homosexual transmission （ 19.4%, or 37/191 ）and injection drug use （5.8%, or 11/191 ）. These 191 HIV cases reported a total of 1152 individuals with whom they had had risky contacts. They were able to provide contact information of 461 risk contacts. Of them, 129 received HIV testing and 61 （47.3%） tested positive for HIV. HIV prevalence was the highest among spouses or long-term sex partners of HIV cases （45.6%, or 47/103） and malesex partners of HIV-infected men having sex with men （MSM） （60.0%, or 12/20）. Condom use wasvery low among them, with only 33.9% consistently using condoms for sex. Conclusion Newlyreported HIV infections in Taizhou prefecture reported a large and complicated risk behavioral networks and low condom use, suggesting a potential risk of HIV among these connected people,especially among MSM. Much efforts are needed to intervene these high risk subgroups and high risk behavioral networks.