2017—2019年南宁市≥50岁暗娼人群艾滋病感染及安全套使用影响因素分析

Analysis on factors influencing AIDS infection and condom use in female sex workers aged ≥50 years old in Nanning City from 2017-2019

目的 了解2017—2019年南宁市≥50岁暗娼人群高危行为特征、人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染状况及其影响因素,为制定有效干预措施提供参考依据。方法 按照《全国艾滋病哨点监测实施方案》的要求,于2017—2019年,每年4—7月在南宁市市区和艾滋病(acquired immune deficiency syndrome,AIDS)疫情较严重的H县和BY县采用整群抽样方法,对公共娱乐场所的暗娼人群开展问卷调查和血清学检测,分析其中≥50岁暗娼人群的HIV感染状况及探讨影响其感染HIV的可能因素。结果 2017—2019年共调查≥50岁暗娼421人,AIDS知识知晓率和商业性行为安全套坚持使用率分别为92.40%和81.47%,均呈现逐年上升的趋势,差异均有统计学意义(均P<0.05)。HIV感染率为6.89%,呈现逐年下降的趋势,差异有统计学意义(P<0.05)。AIDS知识知晓率和商业性行为安全套坚持使用率县域均高于市区,HIV感染率县域高于市区,差异均有统计学意义(均P<0.05)。知晓AIDS知识、接受宣传干预、2019年调查的暗娼是≥50岁暗娼商业性行为坚持使用安全套的促进因素,≥60岁年龄是≥50岁暗娼商业性行为坚持使用安全套的障碍因素。商业性行为中坚持使用安全套是≥50岁暗娼感染HIV的保护因素,场所位置为县域是≥50岁暗娼感染HIV的危险因素。结论 2017—2019年南宁市≥50岁暗娼AIDS知识知晓率和商业性行为安全套坚持使用率均已达到了较高水平,但HIV感染率仍处于较高水平。应针对该人群的特征,继续深入、持久地开展综合干预服务,提高其自我保护意识和安全套使用率。

Objective To understand the high-risk behavior characteristics,human immunodeficiency virus(HIV) infection status and its influencing factors of female sex workers aged ≥50 years old in Nanning City from 2017-2019,provide scientific basis for formulating effective intervention measures. Methods According to the requirements of the National sentinel surveillance program for AIDS,the female sex workers in public entertainment places were collected from the urban area of Nanning City and H County and BY County with severe acquired immune deficiency syndrome(AIDS) epidemic by the cluster sampling method from April to July in every year of 2017-2019,to conduct the questionnaire survey and serological test. The HIV infection status of female sex workers aged ≥50 years old was analyzed and the possible factors influencing their HIV infection were discussed. Results From2017 to 2019,a total of 421 female sex workers aged ≥50 years old were investigated. The awareness rate of AIDS knowledge and the persistent condom use rate at commercial sex were 92.40% and 81.47% respectively,showing an increasing trend year by year,and the differences were statistically significant(all P<0.05). The HIV infection rate was 6.89%,showing a downward trend year by year,and the difference was statistically significant(P<0.05). The awareness rate of AIDS knowledge and condom adherence rate of commercial sexual behavior in counties were higher than those in urban areas,the HIV infection rate in counties was also higher than that in urban areas,the differences were statistically significant(all P<0.05). The awareness of AIDS knowledge,acceptance of publicity and intervention,and investigation of female sex workers in 2019 were the promoting factors for female sex workers aged ≥50 years old to insist on using condoms,while the age ≥60 years old was the barrier factor of condom use at commercial sexual behavior in this population. Insisting on condom use in commercial sex was the protective factor of HIV infection among female sex workers aged ≥50 years old,while location in county is a risk factor for HIV infection in this population. Conclusions From2017 to 2019,the awareness rate of AIDS knowledge and condom use rate of commercial sex among female sex workers aged ≥50 years old in Nanning City have reached a high level,but the HIV infection rate is still at a high level. It is necessary to continue to carry out comprehensive intervention services deeply and persistently according to the characteristics of the population,and improve their self-protection awareness and condom use rate.