泸州市473例新报告50岁及以上男性艾滋病患者性途径感染原因分析

Causes of sexual infection of 473 newly reported HIV/AIDS cases among men aged 50 years and over in Luzhou

目的调查泸州市中老年男性艾滋病疫情高发的原因,为制订有针对性的干预策略提供依据。方法采用整群抽样的方法,2019年对473例新报告的泸州市50岁及以上中老年男性艾滋病感染者/病人展开性伴、安全套使用及商业性行为等主要内容的问卷调查,采用卡方检验进行差异性分析,检验水准α=0.05。结果分别有81.6%、62.8%和10.1%的人有商业性行为、固定性伴/配偶和临时性伴,除固定性伴比例随年龄增长呈下降趋势(χ^(2)_(趋势)=6.934,P=0.008)外,其余性伴类型没有统计学差异。与不同性伴发生性关系,近1年从未使用安全套比例均超过90%。无配偶(35.8%)、配偶不在身边(30.8%)、诱惑/好玩(22.4%)是寻找商业性伴的前3位原因;性交易对象以本地为主,本乡镇占56.0%。固定场所(46.3%)和接头拉客(43.7%)是最主要的寻找商业性伴方式。多数性交易价格低于50元,年龄越大,<50元的占比越大(50岁~59岁、60岁~69岁、≥70岁分别为52.1%、78.0%和80.0%),差异有统计学意义(χ^(2)=22.061,P<0.001)。结论中老年男性通过寻找商业性伴满足其性需求,交易价格偏低。该群体存在多性伴行为、基本不使用安全套行为等现象,是其艾滋病疫情快速增长的重要原因。

Object To investigate the underlying reasons for the high incidence of AIDS among middle-aged and elderly men so as to provide references for formulating targeted intervention strategies.Methods By using a cluster sampling method,473 male cases of newly reported HIV/AIDS aged 50 years and over were recruited.Questionnaire survey was conducted to understand the status of different types of sexual partners and condom use,especially commercial sexual behaviors.Descriptive statistics were performed.Results The prevalence of sexual behaviors with commercial sex partners,regular partners/spouse and temporary partners were 81.6%,62.8%and 10.1%,respectively.Significant difference was observed in the prevalence of sexual behaviors with regular sexual partners with age(χ^(2)_(trend)=6.934,P=0.008).More than 90%of cases had sex behaviors with different partners but never used condoms in the past year.No spouse(35.8%),absence of spouse(30.8%)and having fun(22.4%)were the top three reasons for seeking commercial partners.The sex trading partners were mainly from local,accounting for 56.0%.Fixed places(46.3%)and pick-up(43.7%)were the main ways to find commercial partners.Most of the sex transaction prices were lower than 50 yuan;the older the age of the commercial partners,the greater the proportion of<50 yuan(52.1%,78.0%,80.0%for 50-,60-,and 70-respectively),the difference was statistically significant(χ^(2)=22.061,P<0.001).Conclusions Middle aged and elderly men seek commercial partners to meet their sexual needs,and the transaction price is low.The existence of multiple sexual partners and low rate of condom use are important reasons for the rapid growth of AIDS epidemic.