2012—2015年中国3个省份低档暗娼HIV和梅毒感染及相关治疗情况

HIV and syphilis infection and related medical treatment status of low-fee female sex workers in three provinces of China, 2012-2015

目的了解我国3个省份低档暗娼HIV和梅毒感染情况及相关治疗状况。方法从国家科技重大专项"低档暗娼减少性病艾滋病感染干预研究"数据库中,获取2012年10月至2015年7月间在广西壮族自治区、云南及湖南省6个市县开展的4次低档暗娼的横断面调查数据,包括社会人口学特征、性服务特征及相关治疗行为等,共2050名暗娼。结果研究对象的年龄为(35.16±9.76)岁,最小为15岁,最大为67岁。每次性行为时都使用安全套者占58.9%(1206名),不使用安全套的原因中,"对方不愿意用"的比例最高,为81.0%(682名)。最近6个月做过HIV抗体检测的比例为38.1%(782名),HIV确证阳性率为6.8%(139例),其中既往阳性占76.3%(106例);抗病毒治疗率为55.4%(77例),截至2015年底,抗病毒治疗失访率为18.2%(14例)。最近6个月自我报告有疑似性病症状者占9.4%(191名),其中50.3%(96名)选择去正规医院就医,23.0%(44名)选择去私人诊所就医,20.4%(39名)选择自己用药。梅毒感染率为13.5%(277例),其中,无症状者占91.3%(253例)。结论低档暗娼HIV和梅毒感染率较高且安全套坚持使用率和HIV抗体及梅毒螺旋体检测率较低;主动就医观念差,抗病毒治疗率和正规医疗机构就医率较低。

Objective To understand the HIV and syphilis infection and related treatment status of low-fee female sex workers (FSWs) in 3 provinces of China.Methods Four cross-sectional survey data of low-fee FSWs from six cities (counties) in Guangxi, Yunnan and Hunan Province between October 2012 and July 2015 were obtained from the national science and technology major special project intervention study for reducing sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS) in low-fee FSWs' database, which included social demographic characteristics, sexual service characteristics and related medical care seeking behaviors, etc. A total of 2 050 subjects were included in the database.Results The age of the subjects was (35.16±9.76) years old, with a minimum age of 15 and a maximum age of 67. Those who use condoms every time in commercial sex accounted for 58.9% (n=1 206). Among the reasons of not using condom, the proportion of client reluctant to use was the highest (81.0% (n=682)). Only 38.1% (n=782) was tested for HIV in the last six months. HIV confirmed positive rate was 6.8% (n=139), previous positive accounts for 76.3% (n=106). Rate of antiviral therapy was 55.4% (n=77). By the end of 2015, the loss rate of antivirus treatment was 18.2% (n=14). Those who self-reported symptoms of sexually transmitted diseases in the last 6 months accounted for 9.4% (n=191). 50.3% (n=96) of reporters chose to go to formal hospitals, 23.0% (n=44) chose to go to private clinics and 20.4% (n=39) chose their own medication. The syphilis infection rate was 13.5% (n=277), among them, 91.3% (n=253) were asymptomatic.Conclusion Among low-fee FSWs, the rates of HIV and syphilis infection are higher, the condom consistent use rate, HIV antibodies and syphilis test rate are lower. In this group, active seeking medical idea is poor, the rate of anti-virus treatment and the rate of seeking medical treatment in formal medical institutions is low.