2016—2020年自贡市新报告异性性传播HIV/AIDS特征分析

Analysis on characteristics of newly reported heterosexual HIV/AIDS in Zigong City from 2016 to 2020

目的 分析2016—2020年自贡市新报告的经异性性接触途径传播的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS)流行特征、表现形式及其影响因素,为控制艾滋病经异性性传播提供参考依据。方法 从“中国疾病预防控制信息系统”下载历史卡片,筛选出2016年自贡市新报告的经异性性接触传播的HIV/AIDS病例,利用CochranArmitage趋势检验和logistic回归分析等方法进行统计分析。结果 2016—2020年自贡市共报告经异性性传播HIV/AIDS病例5 484例,占新报告病例的94.13%(5 484/5 826);其中商业性性传播3 458例(63.06%)、非婚非商业性性传播1 547例(28.21%)、配偶/固定性伴间传播438例(7.99%);异性性传播病例数占当年新报告病例数的比例呈逐年上升趋势(Z=6.392 9,P<0.000 1)。随着报告年份的增加,商业性性传播(Z=-3.176 3,P=0.000 7)占比呈下降趋势,非婚非商业性性传播(Z=2.266 3,P=0.011 7)占比呈上升趋势;随着年龄的增加,商业性性传播(Z=7.738 8,P<0.000 1)和配偶/固定性伴间传播(Z=3.015,P=0.001 3)占比呈上升趋势,非婚非商业性性传播(Z=-9.707 5,P<0.000 1)占比呈下降趋势;随着文化程度的增加,商业性性传播(Z=-5.055 8,P<0.000 1)和配偶/固定性伴间传播(Z=-2.940 9,P=0.001 6)占比呈下降趋势,非婚非商业性性传播(Z=7.008 1,P<0.000 1)比例呈上升趋势。多因素Logistic回归分析结果显示:男性、≥40岁、单身(离异/丧偶/未婚)、文化程度低是商业性性传播的高危因素;女性、<40岁、单身(离异/丧偶/未婚)、文化程度高是非婚非商业性性传播的高危因素;女性、≥40岁是配偶/固定性伴间传播的高危因素。年龄与文化程度或者婚姻状况对商业和非商业性性传播有联合作用。结论 异性性接触传播是自贡市艾滋病最主要的传播方式,其表现形式以商业性性传播为主,其次是非婚非商业性性传播。男性、≥40岁、单身(离异/丧偶/未婚)、文化程度低是商业性性传播的高危因素;女性、<40岁,单身(离异/丧偶/未婚)、文化程度高是非婚非商业性性传播的高危因素;女性、≥40岁是配偶/固定性伴间传播的高危因素。应对不同的人群开展针对性的干预措施,实施精准防控。

Objective To analyze the epidemiological characteristics, manifestations and influencing factors of heterosexual HIV/AIDS cases reported in Zigong City from 2016 to 2020 so as to provide scientific basis for the prevention and control of HIV/AIDS with heterosexual transmission.Methods The history cards were downloaded from “China Information System for Disease Control and prevention” with license to screen out the newly reported AIDS cases transmitted by heterosexual contact in Zigong City from 2016 to 2020. Cochran-Armitage trend tests and logistic regression models were used for statistical analysis. Results From 2016 to 2020, a total of 5 484cases of heterosexual HIV/AIDS were reported in Zigong City,including 3458 cases(63.06%) of commercial heterosexual transmission(CHT),1 547 cases(28.21%) of non-marital but noncommercial heterosexual transmission(NMNCHT), 438 cases(7.99%) of spouse or regular partners′ transmission(SRPT), accounting for 94.13%(5 484/5 826) of the new reported cases.The proportion of heterosexual cases to the number of newly reported cases in each of those years is increasing year by year(Z=6.392 9,P<0.000 1). From 2016 to 2020,the proportion of CHT decreased(Z=-3.176 3,P=0.000 7),and the proportion of NMNCHT increased(Z=2.266 3,P=0.011 7). With the increase of age, the proportion of CHT(Z=7.738 8, P<0.000 1) and SRPT(Z=3.015, P=0.000 1) increased, and the proportion of NMNCHT(Z=-9.707 5, P<0.000 1)decreased. With the increase of education level,the proportion of CHT(Z=-5.055 8,P<0.000 1)and SRPT(Z=-2.940 9,P=0.001 6) decreased,and the proportion of NMNCHT increased(Z=7.008 1,P<0.000 1). Multivariate logistic regression analysis showed that males,aged ≥40 years,single(divorced/widowed/unmarried) and low education level were the risk factors of CHT.Females, aged <40 years, single(divorced/widowed/unmarried) and high education level were the risk factors of NMNCHT. Females, aged ≥40 years were the risk factors of SRPT. Age and education level or marital status had a combined effect on CHT and NMNCHT. Conclusions Heterosexual sexual contact is the main mode of transmission of AIDS in Zigong City. CHT has been the main type, followed by NMNCHT. Males, aged ≥40 years, single(divorced/widowed/unmarried) and low education level were the risk factors of CHT. Female,aged <40 years,single(divorced/widowed/unmarried) and high education level were the risk factors of NMNCHT. Female,aged ≥40 years were the risk factors of SRPT. Targeted intervention measures should be implemented for different groups to achieve precise prevention and control.