Workbook模型在武汉市艾滋病疫情估计中的应用

Estimation of AIDS epidemic in Wuhan using Workbook model

目的对2017年武汉市艾滋病疫情流行现状进行估计,为艾滋病防控决策提供依据。方法依据武汉市人口学数据、艾滋病流行病学资料,利用Workbook模型,对武汉市2017年艾滋病疫情流行现状进行估计,并用卡方检验比较疫情估计与病例报告数据中性别及传播途径构成差异。结果估计2017年武汉市现存活成年艾滋病病毒感染者(HIV)和艾滋病患者(AIDS)人数为6008例,HIV总体感染为0.064%,估计检测发现比例为75.02%。现存活者中,同性途径传播4017(66.86%)例,异性途径传播1803(30.01%)例,注射毒品传播188(3.13%)例,估计上述不同传播途径病例检测发现比例分别为73.89%、78.81%和48.94%。结论武汉市艾滋病疫情仍处于低流行状态,但仍有近1/4的感染者尚未被发现。传播途径以同性传播为主,异性传播中配偶/固定性伴传播也占有一定比例。在下一步工作中,有必要探索和尝试更有效的艾滋病监测检测实践,特别是高危人群及其性伴的检测覆盖,以最大限度的早发现HIV/AIDS病例,降低二代传播的风险。

Objective To estimate the current status of the epidemic of acquired immunodeficiency syndrome(AIDS)in Wuhan in 2017,and to provide a scientific basis for developing HIV/AIDS prevention strategies.Methods A Workbook model was used to estimate the 2017 HIV/AIDS epidemic in Wuhan using Wuhan demographic data and HIV/AIDS epidemiological data.The Chi-square test was used to compare the differences in gender and transmission routes between the epidemic estimates and the case report data.Results It was estimated that there were 6008 surviving adult HIV/AIDS cases in Wuhan in 2017.The estimated prevalence of HIV infection in Wuhan was 0.064%in 2017.The estimated detection rate for HIV/AIDS was 75.02%.Among the 6008 adult HIV/AIDS cases,4017(66.86%)were transmitted through homosexual behaviors,1803(30.01%)were transmitted through heterosexual behaviors,and 188(3.13%)were transmitted through injecting drugs.The estimated detection rates of HIV/AIDS cases infected by homosexual behavior,heterosexual behavior and drug injection were respectively 73.89%,78.81%and 48.94%.Conclusion The HIV/AIDS epidemic in Wuhan was still in a low prevalence state,but nearly a quarter of the infected HIV/AIDS cases had not been detected yet.Homosexual behaviors contributed most to HIV/AIDS epidemic in Wuhan,and heterosexual behaviors among spouse/fixed sexual partners also accounted for a certain proportion of HIV/AIDS epidemic.In order to further improve HIV detection rate and curb HIV transmission,it is necessary to explore more effective HIV monitoring and testing practices to detect HIV/AIDS cases as early as possible,especially among high-risk populations and their sexual partners.