中老年HIV/AIDS病人确诊前后高危行为比较及影响因素分析

Comparison of high-risk behaviors among middle-aged and elderly HIV/AIDS patients before and after diagnosis and the impact factors

目的了解中老年艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(HIV/AIDS病人)确诊前的高危行为状况,确诊后的高危行为变化情况及其影响因素。方法使用自制的调查问卷,在调查对象知情同意的原则下进行面对面、一对一的问卷调查。结果共调查≥50岁的HIV/AIDS病人443例,其中男性308例,女性135例。确诊前,调查对象发生过商业性行为、临时性行为的比例,分别为56.2%和27.1%。确诊后,调查对象发生商业性行为、临时性行为的比例,分别为4.5%和4.1%,均较确诊前降低。确诊前一年,调查对象发生商业性行为、临时性行为时每次都用安全套的比例,分别只有0.7%、3.8%;确诊后最近一年发生商业性行为、临时性行为时每次都用安全套的比例,分别为40.0%、30.0%,均较确诊前上升。多因素分析结果显示,男性、确诊前无固定性伴的调查对象,在确诊前发生非固定性行为的可能性较大,其OR值分别为28.180和7.564。结论高危性行为是中老年人感染艾滋病的主要危险因素。应加强对中老年人群艾滋病防治知识的宣传教育,提高安全套的使用率,从根本上控制艾滋病在中老年人群中的流行态势。

Objective To understand the high-risk behaviors among middle-aged and elderly HIV/AIDS patients,the change of high-risk behaviors before and after diagnosis and its impact factors.Methods Using self-designed questionnaires,a face-to-face and one-to-one survey was conducted with informed consent.Information about the demographic characteristics,high-risk behaviors and condom use frequency before and after diagnosis was collected.Results Totally,443 HIV/AIDS Patients aged fifty years or above at the time of diagnosis were investigated,among whom 308 were male and 135 were female.Before the diagnosis,56.2% of the respondents had commercial sexual behavior,27.1% of them had temporary sexual behavior.After diagnosis,4.5% of the respondents had commercial sexual behavior,and 4.1% had temporary sexual behavior,both rates being significantly lower than those before diagnosis.In the year before diagnosis,0.7% of the respondents always used condoms in their commercial sexual behaviors,and 3.8% of them always used condoms in their temporary sexual behaviors.In the year after diagnosis,40.0% of the respondents always used condoms in their commercial sexual behaviors,and 30.0% of them always used condoms in their temporary sexual behaviors,both rates being significantly higher than those before diagnosis.Multivariate Logistic regression analysis showed that males who had no regular sexual partners before diagnosis were more likely to have non-regular sexual behavior before diagnosis,and OR were 28.180 and 7.564 respectively.Conclusions High-risk sexual behavior was the primary risk factor for middle-aged and elderly people to be infected with HIV.Publicity and education about AIDS knowledge should be enhanced among this population group,with the aims to raise the condom use rate and control the epidemic trend of AIDS among them.