中国艾滋病疫情分布变化与人口流动性研究

Spatial Changes of AIDS Epidemic and Population Mobility in China

艾滋病是一类严重危害人类健康的恶性传染病,随着全球流动性的增强,其空间蔓延速度越来越快。文章综合采用空间自相关、收敛性检验、主成分回归等方法探讨了中国2004―2014年艾滋病新发疫情的时空变化特征及其与人口流动性的关系。结果表明:1)2004年以来全国艾滋病发病数、发病率快速增长,新发疫情水平在总体上呈现出"南高、北低,西高、东低"空间分布格局和"西快、东慢、中部最慢"异速增长特征;2)各省区新发疫情存在空间自相关现象,地理集聚趋势比较明显,在西南地区形成1处以广西、云南、贵州为中心的高发连片区,在西北、东北等地形成多处低发连片区;3)新发病数的时空变化存在一定收敛性,未来省际差异将不断缩小,发病率的省际差异则无趋同趋势;4)在控制区域经济水平、医疗资源禀赋等变量的条件下,区域人口流动强度与新发疫情同向变化,流出、流入人口的增多会推动发病水平的增加,完善人口流动管理是优化"防艾"策略的可行视角。

AIDS is a kind of serious infectious disease which seriously endangers human health. With the increase of global mobility, the speed of the spatial spreading is faster and faster in China. The cross-region flow of China＇s population continues to increase, and the speed continues to accelerate. In this context, spatial auto-correlation, convergence test and principal component regression were used to investigate the spatial and temporal changes of new AIDS epidemics and its relationship with population mobility in China from 2004 to 2014 in this paper. The basic data used in the study came from ＂The direct online reporting system of National infectious disease and public health emergency network＂ and other authoritative information published by other government departments. The research indicates： 1） Since 2004, the annual number and incidence of new AIDS incidences grew rapidly. Based on the number of incidence and morbidity, the epidemic level of each province was divided into four grades, they were low, moderate, higher and highest grade. It was found that the level of new AIDS epidemic in China showed the spatial distribution pattern, namely ＂high in the south, low in the north, high in the west, low in the west＂. From the perspective of the average annual growth rate of each province, the change of the new epidemic not only showed the obvious growth at the provincial level, but also showed the ＂fastest in the west, fast in the east, the lowest in the central part＂ in the three zones. 2） There is a spatial auto-correlation phenomenon in the new AIDS epidemic situation in each province, which is influenced by the incidence level of adjacent areas, and the trend of geographical agglomeration is obvious. In the southwest region, it formed a high incidence zone which centered Guangxi, Yunnan and Guizhou. In the northwest, northeast and other places, it formed low-incidence closely grouped area. AIDS epidemic distribution has a strong spatial correlation, which was related to the continual improvement of marketization in China and the social-economic factors flow among different provinces, especially the continuous increase in population mobility. 3） The temporal and spatial changes of the incidence of newly diagnosed AIDS in each province showed the trend of convergence, indicating that the increase rate in the lower initial level of the epidemic will be faster than the initial high level, and the growth rate in the initial higher level was slower than that in the lower area. And in that case, the difference will reduce between the two regions, and are expected to gradually converge to a higher level. However, there is no trend of convergence towards provincial difference in the incidence of new AIDS. 4） Under the condition of controlling the regional economic level and medical resource endowment, the intensity of regional population movement and the new epidemic change, the regional outflow and the increase of the population will promote the increase of the incidence level. In order to effectively eradicate the transmission of AIDS and cut off the transmission chain, the government should also consider optimizing the current prevention and control system from the perspective of improving the management of population flow the policy of ＂preventing first, combining prevention and treatment, comprehensive management＂. Whether it is in the outflow or inflow provinces, it should strengthen the propaganda and education on HIV/AIDS prevention and establish the mechanism in mutual-controlling work of inflow and outflow areas.