2009-2016年新疆阿克苏地区HIV感染监测分析

Surveillance of HIV infection in Akesu prefecture of Xinjiang from 2009 to 2016

目的了解2009—2016年新疆阿克苏地区HIV的感染现状及流行特征,为制定预防控制措施提供依据。方法收集阿克苏地区各确证实验室的检测数据,采用EXCEL 2010建立数据库,以描述流行病学方法分析数据。结果 2009—2016年阿克苏地区HIV感染累计检测4 350 637人次,确证阳性6 530例、阳性率150.09/10万;HIV感染者报告率2009—2012年呈上升趋势(χ~2=98.30,P<0.05),2013—2016年处于平稳状态(χ~2=0.68,P>0.05);感染者集中在库车县、阿克苏市、沙雅县和新和县,占阿克苏地区报告病例总数的74.78%,2016年乌什县报告率上升明显;感染者男性年均报告率为36.03/10万、女性30.83/10万,差异有统计学意义(χ~2=39.26,P<0.05);以农民最多(2 544例,38.96%),其次是家务及待业(1 890例,28.94%)和商业服务(720例,11.03%),几类人群占病例总数的78.93%;感染者集中在20～49岁、小学和初中文化程度以及传播途径以异性传播为主的人群中。结论阿克苏地区HIV感染形势依然严峻,今后应关注重点县男性青壮年农民、家务及待业和商业人群的艾滋病监测,HIV检测纳入全民健康体检项目,将最大限度地早期发现感染者并进行规范化管理,提高其抗病毒治疗质量及生存质量。

Objective To understand the HIV infection status and epidemic characteristics in Akesu prefecture of Xinjiang during 2009—2016, and provide the basis for formulating measures of prevention and control. Methods The confirmation test results from all confirmation laboratories in Akesu prefecture were collected for database establishment by EXCEL2010, and analyzed by descriptive epidemiology. Results Totally 4 350 637 person-times HIV infection tests were carried out accumulatively in Akesu prefecture from 2009 to 2016, and 6 530 cases were confirmed HIV positive with positive rate of 150.09/100 000. The reported rate of HIV infectors had uptrend from 2009 to 2012（χ^2=98.30, P〈0.05）, and steady trend from 2013 to 2016（χ^2=0.68, P〉0.05）. The infectors concentrated in Kuche county, Akesu city, Shaya county and Xinhe county, and accounted for 74.78% of the total reported infectors in Akesu prefecture. The reported rate of Ushi county increased obviously in 2016. The average reported rate of the male and female infectors was 36.03/100 000 and 30.83/100 000 respectively with statistical difference（χ^2=39.26, P〈0.05）. The infectors were mainly farmers（2 544, 38.96%）, then people living at home and waiting for employment（1 890, 28.94%） and business services providers（720, 11.03%）, with ratio of 78.93% of the total infectors. Most infectors concentrated in people at age of 20-49 years, with sexual transmission and education background of primary and junior middle school. Conclusions The epidemic of HIV infection is still serious, and HIV surveillance should be focused on the male, adolescent and adult farmers, people living at home and waiting for employment and business services providers in the key counties. HIV testing is included in the national health examination program, and the infectors will be identified to the maximum extent and enrolled into standardized management. These measures will improve the quality of antiretroviral treatment and infector＇s life.