广西中部地区中老年嫖客使用助性药西地那非的相关危险因素研究

Sildenafil use and relevant risk factors among middle-aged or elderly male clients of female commercial sex workers in the central areas of Guangxi, China

目的 了解广西中部地区中老年嫖客使用西地那非助性药情况及其相关危险因素,评估使用此类助性药对中老年嫖客感染HIV的影响.方法 在调查地区低档暗娼场所对≥50岁嫖客进行问卷调查,获取社会人口学、行为学及西地那非助性药使用史等信息,采集血样本检测HIV和梅毒抗体,使用PASW Statistics 18.0软件进行统计分析.结果 共获得有效问卷2 056份,23.1％使用过西地那非助性药.＜60岁者使用助性药风险低于≥60岁者（OR=0.586,95％CI：0.459～ 0.749）;最近30 d内商业性行为的次数≤1次（OR=0.184,95％ CI：0.090 ～ 0.378）、2次（OR=0.187,95％CI：0.089～0.378）和3次（OR=0.181,95％CI：0.085～0.384）的嫖客,使用助性药的风险低于≥5次者;未婚（OR=0.608,95％ CI：0.396 ～ 0.933）、已婚/同居（OR=0.533,95％CI：0.391～0.727）、有临时性伴（OR=0.558,95％CI：0.393～0.792）是中老年嫖客使用助性药的保护因素,商业性行为时从不使用安全套（OR=1.642,95％CI：1.125～ 2.397）、偶尔使用安全套（OR=1.840,95％CI：1.278～2.648）则是嫖客使用助性药的危险因素.检出HIV抗体阳性的嫖客47人,阳性率为2.29％,＜60岁嫖客使用助性药感染HIV的风险高于≥60岁者（OR=12.933,95％CI：4.479～ 37.347）.结论 ≥60岁、离婚/丧偶/分居和最近30 d内发生商业性行为的次数为≥5次、商业性行为时从不使用安全套和偶尔使用安全套是中老年嫖客使用西地那非助性药的危险因素,西地那非助性药可能是中老年嫖客经商业性途径感染HIV的重要影响因素.

Objective To understand the illegal sidenafil use among middle-aged and elderly male clients of female sex workers （FSWs） in central region of Guangxi as well as on related risk factors.Initial evaluation regarding the effect of illegal sidenafil use on HIV infection among the middle-aged and elderly men was also conducted.Methods A survey was conducted among the over 50-year-olds male clients of low-grade prostitutions in central areas of Guangxi.Information on demographics,related behavior,and illegal sidenafil use was collected.5 ml blood sample were taken to test antibodies of HIV and syphilis.PASW Statistics 18.0 was used for data analysis.Results 2 056 questionnaires were completed.23.1% of the participants said they had ever used illegal sidenafil.The risk of sildenafil use was low among the male clients who were not over 60 years old （OR=0.586,95% CI：0.459-0.749）.The risks of sildenafil use among the male clients with frequencies （in the past 30 days） of having commercial sex behavior were：only once （OR =0.184,95%CI：0.090-0.378）,twice （OR=0.187,95%CI：0.089-0.378） or three times （OR=0.181,95%CI：0.085-0.384） lower than those with more than five times.Being single （OR=0.608,95% CI：0.396-0.933）,married/cohabiting （OR=0.533,95% CI：0.391-0.727）,having unstable partners （OR=0.558,95%CI：0.393-0.792） seemed to be protective on those who used sildenafil,among the study population.Factors as ‘never use the condom （OR=1.642,95%CI：1.125-2.397） or ‘seldom use as condom （OR=1.840,95%CI：1.278-2.648） when having commercial sex,were under high risk among the sildenafil users.Forty-seven subjects were HIV positive,with the prevalence as 2.29% in this study population.Male clients of the FSWs who used sidenafil were under 60 years of age and with higher risk of HIV infection.Conclusion people who were ≥60 years old,divorced/widowed/separated,with frequencies （in the past 30 days） of having commercial sex more than 5 times,never or occasionally using a condom when having commercial sex etc.,appeared at high risk.Middle-aged and elderly male clients who used sildenafil or sildenafil-like drugs were under high risk of contracting HIV infection.