天津市2012-2014年女性性服务者HIV梅毒HCV感染情况及相关行为学调查

Survey on HIV/Syphilis/HCV Infection and Associated Factors among the FSW from 2012 to 2014 in Tianjin

目的了解天津市女性性服务者（FSW）艾滋病病毒（HIV）、梅毒、丙型肝炎病毒（HCV）的流行现状及影响因素,为在该人群中开展相关防治工作提供依据。方法参照《全国艾滋病哨点监测实施方案操作手册》的要求,在2012-2014年随机抽取4个区县,在每年的4-6月对FSW进行问卷调查和血清学检测。结果共监测FSW4738人,HIV、梅毒和HCV阳性检出率分别为0.06%、3.6%和0.6%。多因素分析表明,年龄[比值比（OR）=1.447,95%可信区间（CI）：1.157～1.809]、民族（OR=0.405,95%CI：0.236～0.694）、场所档次（OR=0.525,95%CI：0.394～0.699）、最近一次与客人发生性行为安全套使用情况（OR=0.583,95%CI：0.388～0.876）、最近一年被诊断患性病的情况（OR=2.858,95%CI：9.272～32.758）、最近一年接受有关艾滋病的干预服务或者咨询检测服务情况（OR=0.466,95%CI：0.317～0.684）,与梅毒感染关系有统计学意义。同时多因素分析表明,年龄（OR=1.361,95%CI：1.133～1.634）、民族（OR=0.395,95%CI：0.234～0.668）、场所档次（OR=0.546,95%CI：0.412～0.723）、最近一年接受有关艾滋病的干预服务或者咨询检测服务情况（OR=0.471,95%CI：0.332～0.668）,与HCV感染关系有统计学意义。结论天津市FSW HIV、梅毒与HCV感染率较低,但是与客人发生性行为时安全套使用比例较低,接受有关艾滋病的干预服务或者咨询检测服务的比例较低,感染与传播性病艾滋病的风险较高。

Objective To understand the epidemics of HIV/syphilis/HCV infections and their associated factors,so as to provide evidence for prevention of HIV/STD among female sex workers（FSW）in Tianjin.MethodsThe questionnaire surveys and serological detection were conducted following the national AIDS sentinel surveillance protocol between April to June annually among FSW from 2012 to 2014in four districts of Tianjin.Results The number of 4738 FSW was investigated and the infection rate of HIV was 0.06% among them,the rate of syphilis was 3.8%and of HCV 0.6%.Binary logistic regression analysis showed that the factors associated with syphilis infection included age（OR=1.447,95%CI：1.157～1.809）,ethnic groups（OR=0.405,95%CI：0.236～0.694）,grades of entertainment places（OR=0.525,95%CI：0.394～0.699）,condom used the last time of sex with clients（OR=0.583,95%CI：0.388～0.876）,having STI last year（OR=2.858,95%CI：9.272～32.758）,receiving behavior intervention or VCT last year（OR=0.466,95%CI：0.317～0.684）.The analysis also showed that the factors associated with HCV infection included age（OR=1.361,95%CI：1.133～1.634）,ethnic groups（OR=0.395,95%CI：0.234～0.668）,grades of entertainment places（OR=0.546,95%CI：0.412～0.723）,and receiving behavior intervention or VCT last year（OR=0.471,95%CI：0.332～0.668）.Conclusion The rate of HIV/syphilis/HCV infections among FSW are relatively low in Tianjin.The rate of condom use as well as the rate of behavior intervention or VCT is low,indicating the high risk of HIV/STI spreading among FSW in Tianjin.