江西省某县嫖客人群艾滋病流行病学分析

Prevalence of HIV infection and AIDS among clients of female sex workers in a county of Jiangxi province

目的了解2014—2015年江西省某县嫖客人群的艾滋病知识、商业性行为特征、安全套使用情况及其艾滋病病毒(HIV)、梅毒、性病的检测情况等,为指导在嫖客人群中开展防治艾滋病行为干预提供依据。方法于2014—2015年在江西省某县对近1年内发生过异性商业性性行为的男性开展横断面调查。结果 2014—2015年共调查662名嫖客,平均年龄为(37.93±12.35)岁,以在婚(占79.3%,525人)、初中文化(占50.3%,333人)、本省(占99.1%,656人)为主;艾滋病知识总知晓率82.8%,较2014年,2015年调查人群的艾滋病知识知晓有所上升;最近1年在本县区找小姐的次数主要为2～3次,找小姐的地点主要为洗脚屋/发廊;最近1次与小姐发生性行为时,安全套使用率有明显提高(χ~2=6.339,P=0.012);最近1年与配偶发生性行为时每次使用安全套的比例较低;较2014年,2015年梅毒抗体阳性检出率有所下降,所有调查对象尿液吗啡、冰毒、K粉检测均为阴性。结论江西省某县嫖客人群年龄较小、以本省的在婚男性为主、文化程度较低;艾滋病防治知晓率有所提高;HIV、梅毒呈现低流行水平,嫖客人群感染性病的比例较高;安全套使用率有所提高。

Objective To examine the statuses of knowledge about human immunodeficiency virus/acquired immune deficiency syndrome（HIV/AIDS）, commercial sexual behaviors, and condom use and the prevalence of HIV infection,syphilis, and sexually transmitted diseases（STDs） among clients of female sex workers in a county of Jiangxi province during the period from 2014 through 2015 for providing evidences to implementation of interventions on HIV/AIDS among the clients. Methods Using respondent driven sampling,we conducted a cross-sectional questionnaire survey and laboratory tests among males having heterosexual commercial sex during previous one year in a county of Jiangxi province from 2014 to 2015. Results The mean age of the 662 clients of female sex workers was 37.93 ± 12.35 years. Of the clients,79.3% were married; 99.1% were permanent residents of Jiangxi province; and 50.3% reported the education of middle school. The clients＇ overall awareness rate of AIDS knowledge was 82.8%, with a higher rate in 2015 than that in 2014. For the clients,the times of having sex with female sex workers in local regions during previous one year was 2 to 3 and major places for having the sex services were foot massage rooms or hair salons. A significantly higher rate of condom use during the latest commercial sex was reported by the clients（X^2 = 6.339, P = 0.012） but the clients reported a lower rate of condom use in every sex with spouse during previous one year. Among the clients, the rate of positive syphilis antibody was lower in 2015 than in 2014. No positive sample was detected in urinalysis for morphine, methamphetamine, and ketamine. Conclusion In a county of Jiangxi province, the majority of the male clients of female sex workers are at younger age, married, with local registered residence, and having low education; both the awareness rate of AIDS prevention and control and the rate of condom use have been improved. The prevalence of HIV infection and syphilis are low but that of STDs is high among the clients.