2013-2015年广西边境地区长途卡车司机艾滋病相关流行病学调查

HIV/AIDS-related epidemiological investigation in long-distance truck drivers in the border region of Guangxi,2013-2015

目的了解广西边境地区长途卡车司机艾滋病病毒(HIV)、梅毒及丙型肝炎病毒(HCV)感染状况,行为特征变化趋势及其感染梅毒的危险因素,为长途卡车司机针对性干预策略的建立提供科学依据。方法根据《国家级HIV综合监测点监测方案》,将2013-2015年的4-6月确定为监测时间,监测期间内在广西浦寨边境贸易城的停车场采用"滚雪球、同伴推动"等方法招募调查对象,调查其人口学特征、艾滋病相关知识、性行为特征,并采集3~5 ml静脉血进行HIV、梅毒及HCV抗体检测,分析其中HIV、梅毒、HCV感染状况及感染梅毒的危险因素。结果 2013-2015年每年调查400名长途卡车司机,三年间HIV抗体阳性率为0.08%(1/1 200);梅毒抗体阳性率为3.08%(37/1 200),梅毒抗体阳性率各年分别为2.25%(9/400)、2.25%(9/400)和4.75%(19/400),有上升的势头(χ2=4.180,P=0.041),但各年差异无统计学意义(χ2=5.577,P=0.064);HCV抗体阳性率为0.75%(9/1 200),HCV抗体阳性率各年分别为0.50%(2/400)、0.50%(2/400)和1.25%(5/400),差异无统计学意义(χ2=1.76,P=0.258)。答对6条以上艾滋病知识总体知晓率为99.08%(1 189/1 200),知识知晓率各年分别为97.25%(389/400))、100%(400/400)和100%(400/400),有逐年上升的趋势(χ2=16.639,P=0.000),差异有统计学意义(χ2=19.198,P=0.000)。最近1年发生商业性行为的比例为11.50%(138/1 200),发生商业性行为的比例各年分别为15%(60/400)、9.75%(39/400)和9.75%(39/400),有逐年下降的趋势(χ2=5.412,P=0.020),差异有统计学意义(χ2=7.222,P=0.030);最近1年发生商业性行为时每次都坚持使用安全套的比例为81.16%(112/138),每次坚持使用安全套的比例各年分别为80%(48/60)、87.18%(34/39)、76.92%(30/39),差异无统计学意义(χ2=1.435,P=0.511)。通过单因素和多因素logistic回归分析显示,年龄大、HCV抗体阳性是长途卡车司机感染梅毒的危险因素。结论2013-2015年广西边境地区长途卡车司机HIV感染率尚处于较低水平,梅毒和HCV感染率略高,应重点关注年龄较大的长途卡车司机,需要不断采取有针对性的综合干预措施,以切断经性途径的传播扩散。

Objective To investigate the infection status of HIV, syphilis and hepatitis C virus （ HCV ） , changing tendency of behavior characteristics and risk factors of syphilis infection among long-distance truckers in the border region of Guangxi so as to provide scientific evidence for formulating targeted intervention strategy. Methods According to the National AIDS Sentinel Surveillance Protocol, the surveillance period was identified from April to June in 2013-2015. During the surveillance period, we recruited the research objects by snowball sampling and respondent-driven sampling methods in the parking lots of Puzhai border trade zone of Guangxi. Their demographic characteristics, HIV/AIDS-related knowledge and sexual behavior characteristics were survyed with questionnaires. The venous blood samples （3-5 ml ） were collected to test antibodies against HIV, syphilis and HCV, and the infection status of HIV, syphilis and HCV and the risk factors of syphilis infection were analyzed. Results During the surveillance period of 2013-2015, 400 long-distance truckers were surveyed in each year. The positive rates of HIV and syphilis antibodies over the three years were 0.08% （ 1/1,200） and 3.08% （ 37/1,200） respectively. The antibody positive rates of syphi- lis in 2013, 2014 and 2015 were 2.25% （9/400）, 2.25% （9/400} and 4.75% （ 19/400） respectively, showing an increasing tendency （X2 =4.180, P=0.041 ） , but having no statistically significant differences （X2 = 5.577, P= 0.064}. The positive rate of HCV antibody was 0.75 % （ 9/1,200 ） over the three years, 0.50% （ 2/400 } in 2013 and 2014, and 1.25% （ 5/400 ） in 2015, showing no statistically significant differences （X2= 1.76,P=0.258）. The awareness rate of AIDS-related knowledge was 99.08% （ 1,189/1,200} for total, 97.25% （ 389/400） , 100% （400/400） and 100% （400/400） in 2013, 2014 and 2015 respectively, showing a gradually increasing tendency （X2 = 16. 639, P = 0.000 ） and statistically significant differences （22 = 19. 198, P = 0.000 ）. The proportion of commercial sexual behavior was 11.50% （ 138/1,200 ） in 2013-2015, 15% （ 60/400 ）, 9.75% （ 39/400 ） and 9. 75% （ 39/400 ） in 2013, 2014 and 2015 respectively, showing a gradually decreasing tendency （X2 = 5.412, P = 0.020 ） and statistically significant differences （X2= 7.222 ,P= 0.030）. The proportion of condom use in each commercial sexual behavior in the recent year was 81.16% （112/138） in 2013-2015, 80% {48/60}, 87.18% （34/39） and 76.92% （30/39） in 2013, 2014 and 2015 respectively, without statistically significant differences （X2 = 1.435, P = 0.511）. Univariate and multivariate logistic regres- sion analyses showed that older age and positive serum HCV antibody were the risk factors of syphilis infection. Conclusions The HIV infection rate of the long-distance truck drivers in the border region of Guangxi in 2013-2015 is at a low level, while the infection rates of syphilis and HCV are slightly higher. We should pay special attention to older long-distance truckers and con- stantly implement targeted comprehensive intervention measures so as to cut off the transmission through sexual route.