芜湖市2011-2015年暗娼人群梅毒感染变化趋势及影响因素

Prevalence of syphilis and influencing factors among female sex workers from 2011 to 2015 in Wuhu city

目的分析芜湖市2011-2015年暗娼人群梅毒感染率变化趋势及影响因素,为制定控制措施提供依据。方法采用SPSS 19.0软件对2011-2015年芜湖市暗娼人群哨点监测中梅毒感染数据进行趋势χ2检验,并使用单因素和多因素Logistic回归模型分析梅毒感染率的影响因素。结果 2 026名暗娼中,高、中、低档者分别占11.06%、70.68%和18.26%,平均年龄(29.16±7.19)岁,在婚者占57.35%,初中文化程度占56.86%。2011-2015年低档暗娼梅毒感染率分别为19.59%、8.00%、21.33%、3.51%和4.55%,呈下降趋势(χ2趋势=8.11,P=0.004)。而最近一次与客人安全套使用率、最近一个月与客人安全套坚持使用率均呈增长趋势(P<0.05),前者分别为79.38%、89.33%、97.33%、96.49%、100%,后者分别为41.24%、72.00%、44.00%、80.70%、83.33%。多因素非条件Logistic回归分析结果显示,暗娼梅毒的感染率平均每年减少22%[调整比值比(AOR)=0.78,95%可信区间(CI):0.67~0.91],35岁及以上者感染梅毒的危险为25岁以下者的2.09倍(95%CI:1.15~3.79);低档暗娼感染梅毒的危险为高档者的2.68倍(95%CI:1.07~6.66),最近一个月与客人未坚持使用安全套的暗娼感染梅毒的危险为坚持使用者的1.97倍(95%CI:1.30~2.99)。结论 2011-2015年芜湖市低档暗娼梅毒感染率呈下降趋势,而安全套使用呈上升趋势;低档暗娼和35岁以上暗娼感染梅毒的风险更大,应加强对低档暗娼的监测和干预。

Objective To analyze the trends of prevalence of syphilis and influencing factors among female sex workers（FSW） from 2011 to 2015 in Wuhu city to improve prevention and control measures. Methods SPSS19.0 software was applied for trends of χ2 test on syphilis infection based on sentinel surveillance data, and univariate and multivariate logistic regression analyses were used to determine influencing factors. Results Among 2026 participants with average age of 29.16 years and 57.35% in marriage, 56.86% finished junior middle school, and proportions of FSW working in low, middle and high-tier venues were 18.26%, 70.68%, 11.06%, respectively. The prevalence of syphilis among low-tier FSW was 19.59%, 8.00%, 21.33%, 3.51% and 4.55% with a declining trend from 2011 to 2015（χ2 trends=8.11; P〈0.004）, while rates of consistent condom use for commercial sex in last intercourse（79.38%, 89.33%, 97.33%, 96.49% and 100%） and in the past month（41.24%, 72.00%, 44.00%, 80.70% and 83.33%） both increased from 2011 to 2015（P〈0.05）. Multivariate logistic regression analysis showed that the prevalence of syphilis among FSW reduced 22% every year（AOR=0.78, 95% CI： 0.67-0.91）. The risk of syphilis infection among participants aged more than 35 years was 2.09（95%CI： 1.15-3.79） times than that of those younger than 25 years. Compared with the high-tier ones, low-tier FSW got 2.68（95%CI： 1.07-6.66） times of risks in syphilis infection. Inconsistent condom use of commercial sex in the past month was risk factor（AOR=1.97, 95% CI：1.30-2.99）. Conclusion The prevalence of syphilis among low-tier FSW is decreasing from 2011 to 2015 in Wuhu city and the rates of consistent condom use are on the rise. Low-tier FSW and those older than 35 year-old have higher risks of syphilis infection. Intervention and surveillance among low-tier FSW should be strengthened.