山东省2015—2018年性病门诊男性就诊者HIV哨点监测分析

Male attendees of sexually transmitted disease clinics in Shandong province,2015–2018:analysis on data from HIV/AIDS sentinel surveillance

目的了解山东省性病门诊男性就诊者艾滋病病毒(HIV)感染的流行趋势,为评价艾滋病防控效果及制定针对性干预措施提供依据。方法于2015—2018年根据《全国艾滋病哨点监测方案》,通过采用连续性横断面调查的方法,对性病门诊男性就诊者进行统一问卷调查,并抽取静脉血进行HIV、梅毒以及丙型肝炎(HCV)抗体检测。结果2015—2018年监测人数分别为6070、6107、6033和6233人,艾滋病知识知晓率分别为82.1%、79.5%、73.8%和84.8%;最近3个月与暗娼发生性行为的比例分别为38.4%、39.9%、35.0%和30.1%;最近3个月与临时性伴发生性行为的比例分别为29.7%、36.3%、29.5%和29.2%;与同性发生肛交性行为的比例分别为2.5%、2.6%、1.9%和3.0%;HIV抗体阳性率分别为0.5%、0.6%、1.0%和1.2%,呈逐年增长趋势(χ趋势2=19.27,P<0.001);梅毒抗体阳性率分别为6.1%、6.4%、5.8%和6.4%,HCV抗体阳性率分别为0.2%、0.2%、0.3%和0.2%,梅毒和HCV抗体阳性率无趋势性变化(P>0.05)。多因素logistic分析结果显示,艾滋病知识知晓者(OR=3.05,P=0.042)、近3个月未与暗娼发生性行为者(OR=0.34,P=0.003)、发生同性肛交行为者(OR=94.21,P<0.001)、梅毒抗体阳性者(OR=9.45,P<0.001)及最近1年未接受过干预者(OR=0.38,P=0.002)感染HIV的风险更高。结论山东省性病门诊男性就诊者HIV感染率呈现上升趋势,梅毒和HCV感染率无趋势性变化。

Objective To examine the prevalence of human immunodeficiency virus(HIV)infection in male attendees of sexually transmitted diseases(STD)clinics in Shandong province,and to provide a basis for evaluating AIDS prevention and control and developing intervention measures.Methods Using the cross-sectional survey recommended by National AIDS Sentinel Surveillance Program,we conducted questionnaire surveys and detections for serum HIV,Treponema pallidum(Tp),and hepatitis C virus(HCV)antibodies among all STD attendees recruited continuously from April to June during a year from 2015 through 2018 in Shandong province.Results During the 4-year period,the yearly number of attendees surveyed were 6070,6107,6033,and 6233,respectively.Among the attendees surveyed in each of the 4 years,the awareness rate of AIDS knowledge was 82.1%,79.5%,73.8%,and 84.8%;the reported proportion of having sex with female commercial sex workers(CSWs)in the latest three months was 38.4%,39.9%,35.0%,and 30.1%;the proportion of having sex with temporary partners in the latest three months was 29.7%,36.3%,29.5%,and 29.2%;the rate of having homosexual anal sex was 2.5%,2.6%,1.9%,and 3.0%,respectively.The annual HIV antibody positive rate among the attendees detected was 0.5%,0.6%,1.0%,and 1.2%,with a significant increasing trend(χ2trend=19.27,P<0.001);the annual positive rate of Tp antibody was 6.1%,6.4%,5.8%,and 6.4%and that of HCV antibody was 0.2%,0.2%,0.3%,and 0.2%,respectively,without obvious changing trend in the two rates(both P>0.05).Multivariate logistic analysis indicated that with poor knowledge about AIDS(odds ratio[OR]=3.05,P=0.042),ever having homosexual anal sex(OR=94.21,P<0.001),and being positive for serum Tp antibody(OR=9.45,P<0.001)were risk factors of HIV infection;while,not having sex with CSWs during latest 3 months(OR=0.34,P=0.003)and participating in HIV/AIDS-related interventions in previous one year(OR=0.38,P=0.002)were protective factors against HIV infection among the attendees.Conclusion HIV infection rate increased but infection rate of Tp and HCV exhibited no significant changing trend among male attendees of STD clinics in Shandong province from 2015 to 2018.