2008-2014年中国艾滋病经异性性途径传播的流行特征分析

Characteristics of HIV transmission through heterosexual contact in China, 2008-2014

目的 了解2008-2014年我国艾滋病经异性性途径传播的主要流行特征及变化趋势,揭示我国经异性性途径传播对未来艾滋病流行形势的影响.方法 收集2008-2014年新发现并报告自述为经异性性传播的≥15岁艾滋病病毒感染者/艾滋病患者（HIV/AIDS）的人口学、暴露史信息,分析其时空分布特征与异性性行为表现方式.结果 2008-2014年共发现经异性性传播HIV/AIDS病例320 889例,每年新发现经异性性传播病例从2008年的23 402例增至2014年的68 671例,各年龄组HIV/AIDS病例数均逐年增加.经异性性传播途径感染的病例所占构成比,从2008年的8.7％上升到2014年的66.4％,其中男性构成比从2008年的55.3％升至2014年的68.2％.异性性行为表现方式的分析显示,通过非婚异性性接触感染病例所占构成比从2008年的78.2％升至2014年的88.2％,其中15～49岁年龄组中非婚异性性传播所占比例（85.2％）略高于≥50岁年龄组（84.2％）.男性HIV/AIDS感染方式为非婚异性性接触的病例所占比例为93.8％,女性中为69.0％,性别差异有统计学意义（x2=36000.000,P＜0.001）.结论 HIV经异性性传播作为我国HIV/AIDS流行的最主要因素,病例中男性多于女性,传播方式以非婚异性性传播为主,且在地域分布、性别、年龄组间存在差异,提示须根据各地区实际情况制定有针对性的健康教育和行为干预策略,以控制艾滋病经异性性途径传播.

Objective To understand the epidemiological characteristics and changing patterns of HIV transmission through heterosexual contact since 2008,and to project the influences of heterosexual transmission mode on the HIV epidemic in China.Methods Demographic data and history of exposure in newly identified HIV/AIDS cases aged 15 years or older,through heterosexual transmission mode from 2008 to 2014,were collected and analyzed.Results The number of HIV/AIDS cases caused by heterosexual transmission increased from 23 402 in 2008,to 68 671 in 2014.The proportion of heterosexual transmission mode increased from 8.7% in 2008 to 66.4% in 2014.Among these cases,the proportion of males increased from 55.3% in 2008 to 68.2% in 2014.Among those who reported acquiring HIV through heterosexual contact,the proportion of cases through extra-marital sexual acts out of all the newly report ones,increased from 78.2% in 2008 to 88.2% in 2014.This mode of infection accounted for 85.2% in the age 15 to 49 years group,comparing to 84.2% in the age group of 50 years old or above.The proportion of reported HIV infections through extra-marital sexual acts appeared 93.8% on males while 69.0% on females,with statistically significant difference （x2=36 000.000,P〈0.001）.Conclusion As the predominant factor of HIV/AIDS epidemic,currently in China,heterosexual transmission showed diversities in different sub-epidemic areas,gender or age groups.Tailored strategies were urgently needed for health education and high-risk behavioral intervention,according to the local epidemic driven factors,respectively.