云南省边境地区520例外籍感染者相关危险行为分析

Analysis of risk behaviors of 520 cases of infectious foreigners in Yunnan border area

目的了解边境地区外籍艾滋病病毒感染者相关危险行为,为完善该人群综合服务策略提供依据。方法对当地报告的、能随访到的,年龄≥15岁、可进行有效沟通的所有外籍感染者开展问卷调查。其人口社会学特征、危险行为采用构成比、频数等指标描述性分析,Logistic回归用于影响因素分析,结果均以P<0.05为差异有统计学意义。结果有效问卷520份,其中65.8%的外籍感染者与中国人发生过性行为,1.9%与中国人共用针具吸毒,0.6%近一个月吸毒后与中国人发生性行为。在最近一年与中国人之间的性行为中从未、有时使用安全套的比例,配偶/固定性伴性行为占12.1%(34例)、24.8%(70例);临时性行为占6.3%(1例)、50%(8例);暗娼性行为占0%(0例)、18.8%(6例);男性嫖客占20.0%(2例)、30.0%(3例)。多因素分析显示羁押人群是降低外籍感染者经性途径传染中国人的重点干预对象。结论边境地区外籍感染者存在经性、吸毒途径传播HIV给中国人的高危行为。应加强推行外籍感染者综合服务模式,分人群开展针对性服务:对跨境婚姻人群和流动人群借助随访和抗病毒治疗时机,发放安全套并示教以减少高危性行为;重点管控外籍暗娼、嫖客和羁押感染者;除免费发放安全套外为吸毒感染者提供针具交换和美沙酮维持治疗等干预服务。

Objective To understand the related risk behaviors of foreign HIV infected people in border areas, and to provide basis for improving the comprehensive service strategies of this population. Methods Questionnaire survey was carried out among the all 15 years of age and older foreign with HIV infected who were reported locally, and could be followed up andcommunication effectivity. Demographic characteristics, dangerous behavior was analyzed by rate and frequency. Logistic regression analysis was used to analyze the influencing factors, results of P<0.05 was statistically significant. Results A total of 520 questionnaires were effective, 65.8% of foreigner with HIV infected had sex with the Chinese, 1.9% of foreigner with HIV infected shared the needle with the Chinese, 0.6% of foreigner with HIV infected had sex with the Chinese after drug using for nearly a month. Statistics on the percentage of sexual intercourse with Chinese in the last year who never and sometimes used a condom, spouses/fixed companion accounted for 12.1%(34/282)、24.8%(70/282), temporary behaviors accounted for 6.3%(1/16)、50%(8/16) the proportion of having sex with foreign prostitutes was 0%、18.8%(6/32).Man clients accounted for 20.0%(2/10)、30.0%(3/10).The multifactor analysis shows that the detained population is the key target of reducing infection between foreign and Chinese. Conclusion The foreigner with HIV infected have the high risk behavior of transmitting HIV to Chinese by sexual behavior and drug use. The comprehensive service should be strengthened and targeted services should be carried out by the population category:The cross-border marriages and the floating population should be provided condoms and education to reduce high-risk sexual behavior at the time of follow-up and antiviral treatment,enhance control of foreign sex workers and clients and custody cases. In addition to free distribution of condoms, intervention services such as needle exchange and methadone maintenance treatment are provided for drug addicts.