云南省部分县（市）50岁及以上HIV感染者高危行为现状调查分析

Prevalence of high risk behaviors in HIV infected persons aged≥50 years in selected counties of Yunnan province

目的 了解≥50岁HIV感染者高危行为的现状和影响因素。方法 2015年6月采用随机抽样方法,抽取云南省疫情较重的红河州建水县、个旧市、蒙自市≥50岁HIV感染者进行一对一问卷调查,样本量450人。结果 41.2%（122/296）的感染者最近1年曾发生婚内性行为,婚内性行为安全套使用率为66.4%（81/122）。8.9%（28/313）的男性感染者在最近1年有商业性行为,商业性行为坚持使用安全套比例为17.9%（5/28）。7.1%（32/450）的感染者最近1年有临时性行为,临时性行为坚持使用安全套的比例为18.7%（6/32）。城镇感染者商业性行为比例为13.4%（19/115）,高于农村的4.5%（9/198）差异有统计学意义（χ^2=11.715,P=0.001）。男性、50～59岁、城镇居民、收入相对较高、缺乏家庭社会支持为发生商业和临时性行为的危险因素;文化程度较低、居住在农村、收入相对较高、缺乏家庭社会支持为感染者不坚持使用安全套的危险因素。结论 仍有一定比例的≥50岁感染者继续发生高危性行为,成为HIV二代传播的推动因素。应进一步加强对感染者的艾滋病知识教育和安全性行为促进,提高家庭成员和社会的支持力度,进一步加强低档暗娼行为干预。

Objective To understand the prevalence of high risk behaviors and influencing factors among HIV infected persons aged ≥50 years. Methods Face to face questionnaire interview was conducted among the HIV infected persons selected in Jianshui, Gejiu and Mengzi counties in Yunnan province through random sampling in June 2015. The sample size was 450. Results Among the HIV infected persons surveyed, 41.2% （122/296） had sexual behaviors with their spouses during past year, and the consistent condom use rate was 66.4% （81/122）. Among the HIV infected males, 8.9%（28/313） had commercial sexual behaviors during past year, and the consistent condom use rate was 17.9%（5/28）. Among the HIV infected females, 0.7% were still engaged in commercial sex service during past year. Among the 450 HIV infected persons, 32（7.1%） reported having casual sex behaviors during past years, and the consistent condom use rate was 18.7% （6/32）. The rate of commercial sexual behavior in urban residents （13.4%, 19/115） was higher than that in rural residents （4.5%, 9/198）, the difference was statistically significant （χ^2=11.715, P=0.001）. The risk factors for commercial sex behaviors included lack of family and social support, aged 50-59 years, living in urban area, higher income and being male. The risk factors for using no condom included living in rural area, lower education level, lack of family and social support and higher income. Conclusions Risk sex behaviors are still prevalent in HIV infected people aged 〉50 years, which exacerbated HIV transmission. Further efforts should be focused on the education about AIDS prevention and control and promoting protected sexual behaviors. Additional effort should be done to improve the family and social support for HIV infected people aged 〉50 years. Moreover, comprehensive intervention for low-paid female sex workers also needs to be strengthened.