西安市2010-2013年性病门诊男性就诊者哨点监测分析

Analysis of AIDS Sentinel Surveillance among Male STD Clinic Attendants in Xi'an,2010-2013

目的了解西安市性病门诊男性就诊者艾滋病病毒(HIV)感染的流行趋势,为评价西安市艾滋病防控效果及制定防治策略提供依据。方法通过横断面调查的方法,对男性就诊者进行行为学调查及血清学检测。结果2010-2013年,西安市男性就诊者哨点的HIV抗体阳性率分别为0、1.75%(7/400)、2.75%(11/400)、5.00%(20/400),HIV感染率显著上升(趋势χ2=22.182,P<0.01)。梅毒阳性率分别0.74%(3/403)、0.75%(3/400)、1.25%(5/400)、3.00%(12/400),梅毒感染率显著上升(趋势χ2=7.470,P<0.01)。多因素Logistics回归分析显示,有同性肛交性行为史的性病门诊男性就诊者感染HIV的风险,是没有同性肛交性行为史者的5.297倍;梅毒阳性的性病门诊男性就诊者感染HIV的风险,是梅毒阴性者的12.041倍。结论西安市男性就诊者HIV感染情况不容乐观,应加强针对有同性性行为的男性就诊者的干预工作,规范性病门诊的梅毒诊疗,提高医疗服务能力,从而促进该人群主动、及时就医,降低感染艾滋病性病的风险。

Objective To analyze human immunodeficiency virus（HIV）epidemic among men who visited sexually transmitted diseases（STD）clinics,and evaluate the effectiveness of HIV/AIDS prevention and control and provide evidence for strategy development in Xi＇an.Methods Cross-sectional sentinel surveys were conducted to understand the sexual behaviors and serological test among the STDs clinic attendants.Results From 2010 to 2013,the rates of HIV positive detected among STD clinic attendants in Xi＇an were 0,1.75%（7/400）,2.75%（11/400）and 5%（20/400）respectively.The rates of syphilis positive among the STD clinic attendants were 0.74%（3/403）,0.75%（3/400）,1.25%（5/400）and 3%（12/400）respectively.HIV and syphilis prevalence both increased significantly（P0.01）.Multivariate logistics regression analysis showed that history of anal sex and syphilis were influencing factors for STD clinic attendants to get HIV infection,with OR of 5.297 and 12.041,respectively.Conclusions The situation of HIV infection among STD is comparatively serious in Xi＇an.The intervention of those having homosexual acts must be strengthened and the syphilis diagnosis and treatment should be standardized to improve the quality of medical services,so as to promote accessibility of medical treatment among STD clinic attendants,and to reduce the risk of HIV spreading.