温州市≥60岁HIV/AIDS病例行为特征和感染来源

Behavioral characteristics and sources of HIV/AIDS cases aged 60 and above in the area with high AIDS prevalence among the elderly in Wenzhou

目的了解温州市老年人艾滋病(AIDS)高发地区新发现老年艾滋病病毒(HIV)感染者/AIDS病例(简称HIV/AIDS病例)行为特征和感染来源,为制定针对性的干预措施提供依据。方法招募2017年1月至2018年9月温州市老年人艾滋病疫情高发地区新报告的≥60岁的HIV/AIDS病例,采用个案调查问卷面对面收集研究对象的人口学、行为学、性伴特征、感染途径和感染来源等信息。采用Epi Data 3.1和SPSS 20.0进行数据整理和统计分析。结果共调查126例≥60岁的HIV/AIDS病例,男性占76.19%,60~69岁占66.67%,已婚有配偶占77.78%,文盲占42.06%,本市户籍占98.41%,30.95%独居。男性商业异性性行为感染占93.75%,女性异性配偶/固定性伴感染的占68.18%。男性发生异性商业性行为比例明显高于女性(χ^2=87.976,P<0.001)。有85.56%男性通过自己主动寻找商业性伴,交易价格<100元/次占76.66%。女性发生异性非商业临时性行为比例明显高于男性(P<0.001)。有64.29%病例确证前1年与配偶发生性行为,安全套坚持使用率为1.59%。配偶阳性比例为42.22%,女性配偶阳性比例明显高于男性(χ^2=15.043,P<0.001)。确诊前均未主动做过HIV抗体检测,95.24%病例不知晓艾滋病预防措施。感染时间在3年以内占29.03%,女性感染时间在3年以内的比例高于男性(χ^2=3.928,P=0.047);本地感染占87.70%。结论温州市老年人艾滋病疫情高发地区≥60岁病例艾滋病知识知晓水平低,主动检测意识弱,以本地感染为主,需采取针对性防控措施控制艾滋病在该人群中蔓延。

Objective To understand the behavioral characteristics and infection sources of newly detected HIV/AIDS cases aged 60 and above in the areas with high AIDS prevalence in Wenzhou and provide scientific basis for effective AIDS prevention and control.Methods From Jan 2017 to Sept 2018,the newly reported HIV/AIDS cases were recruited as the objects and were requested to complete a questionnaire.Information on demographic,behavioral,and sex partner characteristics,infection routes and sources were collected.Data were statistically analyzed by using EpiData 3.1 and SPSS20.0 software.Results A total of 126 HIV/AIDS patients aged 60 years and above were investigated,with 76.19%male,66.67%between 60-69 years old,77.78%married,42.06%illiterate,98.41%registered permanent residence and 30.95%living alone.93.75%of men were infected by commercial heterosexual sex,and 68.18%of women were infected via heterosexual/fixed sexual partners.The rate of heterosexual commercial sex in males was significantly higher than that in females(χ^2=87.976,P<0.001).85.56%of the male cases actively sought commercial partners by themselves,with the transaction price<100 yuan per time,accounting for76.66%.The proportion of heterosexual non-commercial behaviors in females was significantly higher than that in male cases(P<0.001).64.29%of the cases had sex with spouses one year before diagnosis,and the condom use rate was 1.59%.The positive rate of spouses of elderly patients was 42.22%and the rate of female spouse was significantly higher than that of male(χ^2=15.043,P<0.001).None of the elderly patients received HIV antibody test before diagnosis,and 95.24%of the patients were unaware of the AIDS prevention knowledge.29.03%of them had the infection time within 3 years,with more females than that of the males(χ^2=3.928,P=0.047).87.70%of elderly cases were locally infected.Conclusion In the area with high AIDS prevalence among the elderly aged 60 years and above in Wenzhou,the awareness rate of HIV/AIDS knowledge is low and the HIV detection is inadequate.Most of them are infected with HIV locally.Targeted measures should be taken to prevent and control the spread of HIV/AIDS in the elderly group.