输入性HIV/AIDS危险因素分析及风险管理措施初探

Analysis on risk assessment and management strategies of imported infection cases with HIV/AIDS

目的分析输入性艾滋病病毒感染病例（HIV/AIDS）对我国艾滋病防控的风险,探讨有效的风险管理措施。方法回顾上海口岸2003—2012年出入境人群HIV/AIDS监测结果,与全国艾滋病疫情情况比较,分析口岸HIV/AIDS的流行病学特征。结果 2003—2012年上海口岸共对598 104名出入境人群进行HIV感染监测,共检出HIV/AIDS感染184例,总检出率为30.76/10万,男女比例为7：1。其中,入境人群HIV感染总检出率为42.19/10万,年度检出率呈逐年上升趋势,出境人群检出率为12.57/10万。20~50岁感染者占90.76%;性接触传播占77.18%,其中异性传播占43.48%,男男性传播占33.70%。入境留学生HIV感染率（54.65/10万）与入境就业人群感染率（45.01/10万）相当。结论入境人群HIV/AIDS检出率较高,输入性HIV/AIDS感染存在人数增加、人员流动性大、高危行为机率高,易导致疾病向普通人群扩散等风险。应通过口岸把关、源头监管、协作保障等风险管理措施予以应对。

Objective To understand the epidemiological characteristics of imported HIV/AIDS, and to explore effective health management measures. Methods the retrospective review of HIV/AIDS infections was conducted among international travelers in 2003 to 2012 at Shanghai port, and compared it with the HIV/AIDS epidemic situation throughout China. Epidemiologieal characteristics of imported HIV/AIDS infection cases were analyzed. Results A total of 184 cases of HIV / AIDS infection were detected among 598 104 entry-exit persons at Shanghai port from 2003 to 2010, the ratio of male to female was 7：1, and the total detection rate for HIV-positive was 30.76/100,000. On the other hand, total detection rate of HIV-positive was 42.19/100,000 among entry travelers with an increasing trend in international expatriates, which were refer to personnel employment, education or residence （residence in China more than half a year）, HIV-positive detection rate was 12.57/100,000 among exit travelers. Generally, HIV infected people among entry-exit people, at Shanghai were mainly at the age 20~50 years old. The major transmission route （77.18%） was sexual contact, the transmission rate in heterosexual partners was 43.48%, homosexual transmission rate was 33.70%. HIV-positive detection rate of international student （54.65/100,000） was as much as the rate of international employee （45.01/100,000）. Conclusion The higher HIV positive rate was found in inbound personnel. The imported HIV infection with a trend of more case-quantity, higher staff mobility, higher probability with high-risk behavior contribute to more risk of spreading. Port checking, supervision, and risk management should be adopted.