广西中老年男性人群艾滋病流行现状及相关影响因素分析

HIV/AIDS epidemic and related influencing factors of HIV infection among the middle-aged and elderly male population

目的了解广西中老年男性人群艾滋病流行趋势,初步探索其感染艾滋病病毒(HIV)的相关影响因素。方法从《全国艾滋病综合防治数据信息系统》中导出截至2015年12月31日定时统计数据,对新发现报告HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)年龄构成进行统计,同时对3个县(区)中老年嫖客专题调查数据和20岁及以上男性人群HIV抗体检测数据进行分析。采用PASW Statistics 18.0软件分析中老年男性人群艾滋病流行趋势及相关影响因素。结果广西2006-2015年男性病例中50岁及以上病例从552例增长到了3 314例,占男性报告病例数的比例从15.7%增长到49.9%,呈现显著增长趋势(χ2=2 282.8,P<0.001)。3个县(区)共观察241 195名20岁及以上男性人群,HIV血清阳转率为4.35/万·人年(180/413 549)。男性人群HIV新发感染率随着年龄增长逐渐增高,60~69岁最高(11.51/万·人年)。3个县(区)共调查50岁及以上中老年嫖客1 276人,HIV阳性检出率为1.96%(25/1 276),知道HIV检测机构[比值比(OR)=0.36,95%可信区间(CI):0.15~0.86]是感染HIV的保护因素;使用过壮阳药(OR=4.74,95%CI:1.95~11.50)、离异/丧偶/分居(OR=3.67,95%CI:1.37~9.86)和最近1个月有过性行为(OR=6.42,95%CI:1.16~35.41)是感染HIV的危险因素。结论中老年男性特别是中老年嫖客是艾滋病传播的重点高危人群,中老年男性人群艾滋病流行已对广西艾滋病防控形成新的挑战,应针对性地采取新的防控策略措施。

Objective To understand the HIV epidemic among middle-aged and elderly male population in Guangxi, and to explore the related factors of HIV infection. Methods Data was downloaded from the national AIDS comprehensive information management system and analysis was conducted on the reported HIV/AIDS cases in Guangxi. A special survey was carried out among middle-aged and elderly cases, with HIV antibody test for the male aged ≥20 years in 3 counties of Guangxi. Then the data were analyzed with software PASW Statistics 18.0. Results The number of reported HIV/AIDS of male aged ≥50 years rose from 552 to 3314, and the proportion of male reported cases increased from 15.7%（2006） to 49.9%（2015）, with an increasing tendency（χ2=2282.8, P〈0.001）. A total of 241 195 male aged ≥20 years was screened in 3 counties, with 4.35/10000 PYs（180/413549） of the HIV incidence and the highest in the age group of 60-69 years. Moreover, a total of 1276 male clients aged ≥50 years was investigated in 3 counties, and the HIV infection rate was 1.96%（25/1276）. The factor as ＂knowing where to get HIV testing＂ was protective factor, and ＂aphrodisiac use＂, ＂being widowed/divorced/separated＂ and ＂having commercial sexual behavior last month＂ were the high risk factors for HIV infection. Conclusion The middle-aged and elderly male clients belong to high-risk behavior groups. It is a new challenge tointervene the group for HIV/AIDS prevention in Guangxi. New and evidence-based intervention approaches should be developed for the high risk population.