成都市2010-2015年艾滋病疫情特点与趋势估计

Epidemiological analysis and estimate of HIV/AIDS cases in Chengdu from 2010 to 2015

目的分析成都市艾滋病(AIDS)疫情流行特点,预测未来疫情走势,为制定有效的艾滋病防控策略提供依据。方法从国家艾滋病综合防治信息系统中,获取成都市2010-2015年艾滋病报告病例的基本情况、随访和抗病毒治疗信息,各类人群的哨点监测、自愿咨询检测(VCT)等数据。利用Excel统计软件进行描述性分析,运用Workbook法对高危人群基数和艾滋病疫情进行估计。结果2010-2015年新报告艾滋病病毒(HIV)感染者/AIDS病例16 401例,各年病例分别为1 307、1 913、2 356、2 944、3 638和4 243例;各年新报告的艾滋病病例增长率分别为31.09%、46.37%、23.16%、24.96%、23.57%和16.63%。估计截止到2015年底,成都市现存活的艾滋病病毒感染者及病人共19 961例,全人群感染率为0.14%(19 961/14 317 647)。新报告病例的首次CD4+T淋巴细胞(简称CD4细胞)计数<350个/μL所占比例在51.75%(990/1 913)~59.47%(1 401/2 356)之间,CD4细胞计数在500个/μL的病例占9.31%(274/2 944)~11.83%(502/4 243)。在社会经济水平高的一圈城,流动病例占46.76%,同性性传播感染病例占51.42%;在社会经济水平低的三圈城,流动病例占12.36%,异性性传播病例占82.34%。户籍地病例占87.64%。结论近3年来成都市艾滋病疫情增长率有所降低,疫情虽处于低流行状态,但病例晚发现情况较为严重;一圈城艾滋病防治工作重点为流动和同性性行为人群、三圈城为户籍地和异性性行为人群。

Objective To analyze the HIV epidemic trend and characteristics of Chengdu and provide the scien- tific evidences for HIV prevention and control in the future. Methods Data of the HIV/AIDS reported cases from the national AIDS information system, from VCT clinics and HIV sentinel surveillance, were collected between 2010 and 2015, and Excel statistical software was used for the descriptive analysis; and the Workbook method was used to estimate the HIV epidemic. Results The growth rates of HIV/AIDS reported cases during 2010-2015 were 31.09%,46.37%,23.16%, 24.96%, 23.57% and 16.63%. By the endof2015, 19 961 cases survived, with the infection rate of 0. 140%（19 961/14 317 647） in total population. The proportion of CD4＋ below 350/btL of the re- ported eases was between 51.75% （990/1 913） and 59.47% （1401/2356）. The reported AIDS eases accounted for 23.41% （306/1307）-31.96% （941/2944） of all cases. The floating eases accounted for 46.76% and MSM cases for 51.42% of all cases in the central areas of the city, and 87.64% were the local registered residents. Conclusion The growth rate of AIDS in Chengdu has slowed down in the recent three years. However, the serious problem is that the reported cases are detected late. Health education and intervention should focus on the floating population, and MSM in the central areas, and the registered residents and heterosexual in the third Lap ciey.