宜兴市2010—2015年女性性工作者哨点动态监测结果分析

Dynamic changes of sentinel surveillance results of female sex workers in Yixing from 2010 to 2015

目的了解2010—2015年宜兴市哨点监测女性性工作者人群人口学特征、行为特征及性传播疾病感染状况的动态变化趋势。为开展有效高危行为干预提供依据。方法 2010—2015年,每年4—6月采用分层整群抽样方法,通过现场问卷调查收集目标人群的人口学、行为学信息;同时采集静脉血进行血清艾滋病病毒(HIV)、梅毒螺旋体和丙肝病毒(HCV)抗体检测。结果 2010—2015年,目标人群梅毒、HCV抗体检测阳性率分别为4.2%、0.5%,未检出HIV抗体阳性。艾滋病相关知识知晓率由72.8%上升至96.0%,最近1次与客人发生性行为时使用安全套比例由73.8%上升至98.0%,最近1个月与客人发生性行为时坚持每次使用安全套比例由40.7%上升至75.7%,最近1年接受过干预服务比例为61.8%～97.8%,最近1年接受HIV检测服务比例为20.5%～80.3%,均呈逐年上升趋势(P值均<0.01)。多因素分析显示,文化程度低、场所档次低、对艾滋病相关知识不知晓显著增加性传播疾病感染的风险(P<0.05)。结论宜兴市娱乐场所的女性性工作者梅毒、HCV感染风险较高,应开展持续性高危行为干预,扩大综合干预覆盖面。

Objective To analyze the demographic and behavioral characteristics, together with dynamic trend of sexually transmitted disease（STD） infection status among female sex workers （FSWs） in Yixing city from 2010 to 2015; to provide evidence for conducting effective high-risk behavioral intervention. Methods From 2010 to 2015, stratified cluster sampling method was used to select survey subjects from Apr to Jun every year, whose demographic and behavioral information were collected by field questionnaires, the serum of subjects were collected for HIV, Treponema pallidum and hepatitis C virus （HCV） antibodies analysis. Results From 2010 to 2015, the positive rates of syphilis and HCV antibodies were 4.2% and 0.5%, respectively, no HIV antibody positive cases were detected; the awareness rate of AIDS-related knowledge increased from 72.8% to 96.0%; the proportion of condom use in the last commercial sexual intercourse increased from 73.8% to 98.0%;the proportion of persistent condom use in commercial sexual intercourses in last month increased from 40.7% to 75.7%;the proportion of intervention services received in the last year was from 61.8% to 97.8%. The proportion of FSWs taking HIV testing services in last year was from 20.5% to 80.3%,all demonstrating annual ascending trends （all P 〈0.01）. Multivariate analysis showed that the risk of STD infection was significantly increased with low educational level, low level of venues and ignorance of AIDS-related knowledge （all P 〈0.05）. Conclusion FSWs in entertainment venues in Yixing city had relatively higher risk of syphilis and HCV infection. Continuous high-risk behavioral interventions should be carried out; and the intervention coverage should be expanded.