邵阳市老年人群感染HIV危险因素的病例对照研究

Case-control study on risk factors of HIV infection among the elderly in Shaoyang City

目的了解邵阳市老年艾滋病感染者和病人感染人类免疫缺陷病毒(HIV)相关危险因素,为制定老年人群艾滋病防治政策提供理论支撑。方法采用病例对照研究方法,通过匿名调查获得病例组和对照组人口学、行为学等相关资料,用χ2检验及Logistic回归模型进行危险因素分析。结果共收集有效问卷199份,病例组91份和对照组108份。病例组平均年龄67.8岁,职业以农民和农民工为主占70.3%,小学及初中文化占80.2%,男女比例为4.7:1。在一般人口学方面,病例组和对照组在年龄、性别、职业和文化程度分布上差异无统计学意义(P>0.05)。在行为学方面,病例组与对照组相比,在商业性性行为、非商业性性行为、安全套使用、多性伴、肝炎、结核以及性病方面差异有统计学意义(P<0.05)。Logistic回归模型多因素分析最终进入方程的危险因素包括:单身(OR=9.23)、商业性性行为(OR=8.07)、性病(OR=7.03)、性伴数量≥3个(OR=6.33)。结论单身、多性伴、发生不安全的商业性行为和感染性病是邵阳市老年人群HIV感染的危险因素,应采取针对性的干预措施,保障老年人健康。

Objective To explore the risk factors associated with human immunodeficiency virus （ HIV） intection among old people living with HIV/AIDS （ PLWHA ） in Shaoyang City, and to provide theoretical support for formulating policies regarding HIV/AIDS prevention and treatment among the elderly. Methods In this case-control study, an anonymous questionnaire survey was conducted to obtain the information about demographic and behavior data of the case group and the control group. Chisquare test and Logistic regression model were used to analyze the risk factors. Results A total of 199 valid questionnaires were collected from the case group （n= 91） and the control group （n= 108）. The average age of the case group was 67.8 years. As regards the occupation, farmers and migrant workers accounted for 70.3%. 80.2% reached the educational level of primary school and junior high school. The male to female sex ratio was 4.7： 1. As for the general demography, no statistically significant differences were found in age, gender, occupation and educational level between the case group and the control group （ all P〉0.05）. In regard to the praxiology, there were statistically significant differences in commercial sexual behavior, non-commercial sexual behavior, condom use, multiple sexual partners, hepatitis, tuberculosis and sexually transmitted diseases between the two groups （all P〈 0. 05 ）. Risk factors which entered the multivariate logistic regression analysis at last included living alone （ OR = 9.23 ） , commercial sexual behavior （ OR = 8.07 ） , sexually transmitted diseases （ OR = 7.03 ） and the number of sexual partners ≥ 3 （ OR = 6.33 ）. Conclusions Living alone, multiple sexual partners, unsafe commercial sexual behavior and suffering from sexually transmitted diseases are the risk factors of HIV infection among the elderly in Shaoyang City ; and hence, it is necessary to take the targeted intervention measures to protect the health of the elderly.