上海市徐汇区2008-2015年VCT情况分析

Analysis of 10815 clients to HIV voluntary counseling &testing clinic in Shanghai Xuhui district from 2008 to 2015

目的对上海徐汇区艾滋病自愿咨询检测(VCT)人群的社会人口学特征、求询原因、艾滋病病毒(HIV)抗体筛查阳性率及其变化趋势等情况进行分析,为进一步拓展VCT门诊服务内涵和覆盖面提出建设性意见。方法采用横断面研究设计,对VCT门诊2008年1月至2015年12月期间求询检测者的相关信息进行描述性分析。结果 10 815名求询检测者男女比例为7.26∶1,平均年龄为(31.65±10.18)岁,20~29岁组人数最多,婚姻状况以未婚者为主,占64.45%(6 970/10 815),大专及以上文化程度的占78.88%(8 531/10 815)。求询原因中,有异性性行为史者(7 040人)居首位,其次为男男性行为者(MSM)(2 370人)。求询检测者的性别、婚姻状况、文化程度以及求询原因的构成情况在不同年份有波动,差异均有统计学意义。VCT门诊筛查阳性率为3.75%(386/10289)。结论徐汇区VCT门诊的求询检测者以年轻、未婚、高学历的男性人群为主。求询原因中MSM人数增长迅速,筛查阳性率居高不下。VCT门诊多项指标均高于国内其他同类地区。上述特征及其变化波动得益于徐汇区疾病预防控制中心不断创新VCT综合服务模式,将VCT工作与高危干预、哨点监测、科研项目等工作紧密结合。建议加强与非政府组织合作,加大宣传力度和深度,扩大暗娼、外来务工人员等人群的检测。

Objective To analyze the social demographic characteristics of VCT clients, reasons of their HIV testing, positive rate of HIV antibody test, their variation trends and associated factors in Shanghai Xuhui district, so as to put forward suggestions. Methods Cross sectional study was conducted, and all the data from Jan. 2008 to Dec. 2015 were collected and under descriptive analysis. Results Among 10 815 VCT clients, the male and female ratio was 7.26. 1. Their average age was 31.65 ± 10.18. Most of the clients were between 20 to 29 years old, 64.45% （6970/10815） unmarried,78.88% （8531/10815） with college or higher education level. The main reasons of their HIV testing were due to their experience in heterosexual and homosexual behavior. The factors of sex, marriage, education level and reasons of HIV testing fluctuated with significant difference in different years. The positive rate of screening was 3.75%. Conclusion Most clients to Xuhui VCT clinics are young, unmarried, male, with higher education level. The homosexual behavior of the clients is growing rapidly, with high HIV positive rate. Xuhui CDC provides comprehensive service of VCT, which is closely integrated with high risk behavior intervention, sentinel surveillance and research project. It is recommended that further cooperation with NGOs should be promo- ted to publicize AIDS knowledge and to expand HIV testing for female sex workers, and migrant workers.