云南省德宏傣族景颇族自治州2015年新报告缅甸籍HIV感染者高危行为调查

Risk behaviors among newly reported Burmese HIV infection in Dehong, Dai and Jingpo Autonomous Prefectures of Yunnan province, 2015

目的 了解云南省德宏傣族景颇族自治州（德宏州）缅甸籍HIV感染者相关人口统计学与高危行为特征。方法 以德宏州2015年新报告的缅甸籍感染者为研究对象，开展横断面调查，收集其入境德宏地区的目的、住宿地点、停留时间等社会人口统计学信息以及艾滋病高危行为发生情况。结果 共调查489例缅甸籍感染者，其中男性367例（75.1%）；初中以下文化程度者407例（83.2%）；371例（75.9%）来自与德宏州相邻的克钦邦和掸邦； 339例（69.3%）为务工/经商进入德宏州。23.3%（113/485）的感染者存在无保护性行为，多因素logistic回归分析显示，感染者发生无保护性行为的危险因素包括有配偶/固定性伴（OR=12.98，95%CI：6.53～25.83，P〈0.001），居住在打工场所（OR=2.88，95%CI：1.09～7.61，P=0.033）、出租屋（OR=5.36，95%CI：1.94～14.84，P=0.001）和自己家（OR=5.14，95%CI：1.36～19.35，P=0.016）。32.0%（156/487）的感染者有吸毒行为，多因素logistic回归分析结果显示，感染者发生吸毒行为的危险因素包括男性（OR=15.61，95%CI：6.47～37.69，P〈0.001），文盲（OR=2.89，95%CI：1.44～5.84，P=0.003），来自克钦邦（OR=3.01，95%CI：1.50～6.04，P=0.002）、掸邦（OR=5.30，95%CI：2.66～10.58，P〈0.001），经便道/其他方式入境（OR=1.93，95%CI：1.18～3.14，P=0.009），居住在亲友家（OR=5.78，95%CI：2.01～16.61，P=0.001）、打工场所（OR=6.67，95%CI：3.06～14.53，P〈0.001）、出租屋（OR=11.84，95%CI：4.76～29.47，P〈0.001）、自己家（OR=6.77，95%CI：1.84～24.85，P=0.004）。结论 德宏州内缅甸籍HIV感染者流动性大，感染状态知晓比例低而艾滋病相关高危行为发生率较高，给德宏州艾滋病防治工作带来巨大挑战，相关机构需积极探索有效的随访管理办法。

Objective To study the AIDS-related socio-demographic characteristics and high risk behaviors of Burmese HIV-infected individuals, in Dehong prefecture, Yunnan province. Methods A cross-sectional study with questionnaire interview, was conducted. Results Features of the 489 HIV-infected individuals appearfed as：367（75.1%） males, 407（83.2%） illiterate or with primary education, 371（75.9%） from Kachin State or Shan State, 306（62.6%） visited Dehong twice or more per year, 238（48.7%） entered Dehong illegally, 339（69.3%） came to the city looking for jobs or working on cargo transportation, 309（63.2%） of them living in working place/rented house/own house, and 313（64.0%） with the length of stay shorter than six months. Only 36（7.4%） of the interviewees were aware of their HIV sero-positive status, with 23.3% of them （113/485） reported having had unprotected sex experiences in Dehong. Results from the multivariate logistic regression model analysis showed that HIV-infected individuals with the following characteristics：having spouses/regular sexual partners （OR=12.98, 95%CI：6.53-25.83, P〈0.001）, living in working place （OR=2.88, 95%CI：1.09-7.61, P=0.033）, living in rented houses （OR=5.36, 95%CI：1.94-14.84, P=0.001）. Those living in their own houses （OR=5.14, 95%CI：1.36-19.35, P=0.016） were more likely to engage in unprotected sex. 32.0% （156/487） of the interviewees clained that they ever used drugs in Dehong, with 9.7% （47/487） of them sharing syringe. Data also showed that HIV-infected individuals who had the following feartures as：being male （OR=15.61, 95%CI：6.47-37.69, P〈0.001）, illiterate （OR=2.89, 95%CI：1.44-5.84, P=0.003）, coming from Kachin State （OR=3.01, 95%CI：1.50-6.04, P=0.002） or Shan State （OR=5.30, 95%CI：2.66-10.58, P〈0.001）, illegal visiters （OR=1.93, 95%CI：1.18-3.14, P=0.009）, living with friends/relatives （OR=5.78, 95%CI：2.01-16.61, P=0.001）, living in working place （OR=6.67, 95%CI：3.06-14.53, P〈0.001）, or in rented houses （OR=11.84, 95%CI：4.76-29.47, P〈0.001）. The ones who were living in their own houses （OR=6.77, 95%CI：1.84-24.85, P=0.004） were more likely to engage in drug use in Dehong. Conclusion Results from our study showed that the Burmese HIV-infected citizens in Dehong prefecture had the following characteristics：high mobility, low awareness of HIV positive status and high prevalence of AIDS-related risky behaviors. These findings called for greater efforts on HIV/AIDS prevention and management in Dehong city.