临沂市HIV感染者检测阳性前配偶感染状况调查

Prevalence of infection in spouses before their HIV infection spouses being tested positive in Linyi

目的观察近5年临沂市新发现HIV感染者检测阳性前配偶的感染状况以及影响配偶间经性传播的主要影响因素,为制定针对单阳家庭的防预措施提供依据。方法选取经培训合格的调查人员对相关医院和疾控中心所登记的具备调查条件的已婚HIV感染者及其配偶进行一对一、面对面的问卷调查,对合格的问卷调查结果进行统计分析,对夫妻中先确证HIV感染者一方感染途径、先确证HIV感染者和后确证感染者或未感染者的人口学特征以及影响家庭内配偶经性传播HIV的主要影响因素进行比较和分析。结果根据纳入和排除标准符合调查并自愿参与的HIV感染者458例,HIV感染者中感染途径为非夫妻性行为215例(46.94%),静脉吸毒传播61例(13.32%),男性同性恋性行为5例(1.09%),不详32例(6.99%),单阳先感染者和双阳新感染者均以非夫妻性行为为主要感染途径;单因素方差分析显示,单阳先感染者与双阳先感染者在性别、文化程度、既往性病感染情况、既往安全套使用情况、是否接受免费艾滋病防治教育以及是否接受抗病毒治疗方面存在明显差异(P<0.05);与单阳感染者相比,双阳先感染者男性感染人数、本科以上文化程度、既往有性病感染史人数以及接受抗病毒治疗的人数均明显减少(P<0.05),多因素logistic回归分析显示,先感染者性别、既往感染情况、既往安全套使用情况、是否接受免费艾滋病防治教育以及确诊后是否接受抗病毒治疗情况与配偶感染呈正相关,先感染者为男性、既往有性病感染史、既往少用安全套、确诊后未接受免费艾滋病防治教育以及未接受抗病毒治疗是配偶后感染HIV的危险因素。结论性传播依然是目前临沂市新发HIV感染的主要传播途径,增强艾滋病防治以及安全套使用意识,加强对性病感染者和确诊HIV感染人群的艾滋病知识教育以及抗病毒治疗是改善HIV感染率以及先感染者配偶感染状况的重要影响因素。

OBJECTIVE To observe the situation of HIV infection of spouse of newly detected positive HIV infection in recent five years in Linyi city,and the main influencing factors of sexual transmission between spouse,so as to provide evidence for establishing prevention measures for single-positive families.METHODS The one to one and face to face questionnaire survey for new HIV infection and their spouses checked in by the hospital and the centers for disease control and prevention by qualified investigators with training were carried out,then the qualified questionnaire results were statistically analyzed,the infectious route of earlier HIV infection and the uninfected demographic characteristics and influence of transmission between spouses of later infection or uninfected in the family were compared and analyzed.RESULTS Totally 458 cases of HIV infected persons were investigated and volunteered according to the inclusion and exclusion criteria.There were 215 cases of infections infected by the way of non-husband and wife sex（46.94）,61 cases of infections infected by the way of intravenous drug abuse（13.32%）,5 cases of infections infected by the way of male homosexual sex（1.09%）,and 32 cases of infections infected by the way of unknown（6.99%）.The non-husband and wife sex was the primary infection of earlier infection in single-positive and double-positive.The single factor analysis of variance showed that there had differences in the factors of genders,educational levels,previous STD infection situation,previous condom usage,whether to accept free of HIV/AIDS prevention education,and whether to accept antiviral treatment between earlier single-infection and double-infection（P〈0.05）.Compared with single-positive infections,the male earlier infection,bachelor or above degree of educational level,the number of earlier infection with STD infection history and the number of earlier infection with antiviral treatment of double-positive infections were significantly reduced（P〈0.05）.The multiple logistic regression analysis showed that the infection status of infection gender,previous STD infection situation,previous condom usage,whether to accept a free AIDS prevention education,and whether to accept antiviral treatment after confirmed infections were positively correlated with the spouse infection.Male infection,with STD infection history,previous underuse condom,without free AIDS prevention education after diagnosis,and without antiviral therapy were risk factors for spouse HIV infection.CONCLUSIONSexual transmission is still the main route of HIV infection transmission in Linyi city.Strengthening the consciousness of AIDS and condom use,and strengthening AIDS knowledge education in the STD diagnosed HIV infected people and antiviral treatment were important influencing factors for improving the HIV infection rate and infection first spouse infection status.