2017—2019年云南省德宏傣族景颇族自治州芒市中缅跨境婚姻人群HIV、丙型肝炎病毒、梅毒感染率及其影响因素分析

The prevalence of HIV, hepatitis C virus and syphilis and related factors among cross-border couples in Mangshi county, Dehong Dai and Jingpo Autonomous Prefecture of Yunnan province from 2017 to 2019

目的了解我国云南省德宏傣族景颇族自治州芒市中缅跨境婚姻人群HIV、丙型肝炎病毒(HCV)和梅毒感染情况及影响因素。方法于2017年5月—2019年4月,采用整群抽样的方法抽取2500对5000名跨境婚姻夫妻为研究对象。通过问卷调查和实验室检测收集人口学特征、艾滋病相关卫生服务及HIV、HCV、梅毒感染情况等信息,使用多因素logistic回归模型分析HIV、HCV和梅毒感染的影响因素。结果2500对跨境婚姻夫妻中,2438对(97.5%)均为中国籍男性和缅甸籍女性。5000名研究对象平均年龄为(34.16±9.00)岁,以少数民族(59.9%)、农民(98.5%)为主,受教育年数多为0~6年(81.4%),婚龄>3年者占80.0%,居住在山区者占61.7%。中国籍和缅甸籍人群的HIV感染率分别为1.7%(43/2500)和2.0%(49/2500);HCV感染率分别为2.0%(49/2500)和1.3%(32/2500);梅毒感染率分别为0.4%(10/2500)和0.2%(4/2500),差异均无统计学意义(P>0.05)。多因素logistic回归模型分析结果显示,与≤30岁、未知晓艾滋病知识、既往未做过HIV检测、HCV阴性和梅毒阴性者相比,年龄>30岁(OR=3.21,95%CI:1.80~5.73)、知晓艾滋病知识(OR=17.41,95%CI:4.27~70.91)、既往做过HIV检测(OR=4.93,95%CI:2.72~8.92)、HCV阳性(OR=5.64,95%CI:2.72~11.70)和梅毒阳性者(OR=8.37,95%CI:1.63~43.08)的HIV感染率相对较高;与年龄≤30岁、婚龄>3年和未感染HIV者相比,年龄>30岁(OR=3.02,95%CI:1.69~5.38)、婚龄≤3年(OR=2.24,95%CI:1.34~3.74)和HIV感染者(OR=6.69,95%CI:3.29~13.59)的HCV感染率相对较高;与未感染HIV者相比,HIV感染者(OR=9.07,95%CI:2.00~41.10)的梅毒感染率相对较高。结论2017—2019年云南省德宏傣族景颇族自治州芒市中缅跨境婚姻人群HIV、HCV和梅毒感染率相对较高;年龄、艾滋病知识知晓、既往HIV检测史、婚龄与HIV、HCV和梅毒感染有关联。

Objective To understand the prevalence of HIV,hepatitis C virus(HCV)and syphilis and related factors among cross-border couples in Mangshi county,Dehong autonomous prefecture,Yunnan province.Methods From May,2017 to April,2019,2500 couples with 5000 cross-border marriages were selected by using cluster sampling method.The demographic characteristics,AIDS-related health services,HIV,HCV,syphilis infection and other information were collected through questionnaires and laboratory tests.The influencing factors of HIV,HCV and syphilis infection were analyzed by multivariate logistic regression model.Results A total of 2500 couples with cross-border marriage were investigated,among which 2438(97.5%)couples were Chinese men with Myanmar women.The average age of 5000 participants was(34.16±9.00)years.Most of them were minority groups(59.9%),farmers(98.5%),education years≤6 years(81.4%),marriage years>3 years(80.0%),and from mountainous areas(61.7%).The HIV prevalence of Chinese and Myanmar populations was 1.7%(43/2500)and 2.0%(49/2500),respectively.The HCV infection rates were 2.0%(49/2500)and 1.3%(32/2500),respectively and the infection rates of syphilis were 0.4%(10/2500)and 0.2%(4/2500),respectively.There were no statistically significant differences in the prevalence of three diseases among Chinese and Myanmar populations(P>0.05).The multivariate analysis showed that compared with those aged≤30 years,having lower AIDS awareness,never receiving HIV testing,without HCV and syphilis infection,HIV prevalence was higher among those aged>30 years(OR=3.21,95%CI:1.80-5.73),having higher AIDS awareness(OR=17.41,95%CI:4.27-70.91),receiving HIV testing(OR=4.93,95%CI:2.72-8.92),with HCV infection(OR=5.64,95%CI:2.72-11.70)and syphilis infection(OR=8.37,95%CI:1.63-43.08).Compared with those aged≤30 years,having marriage years≤3 years,and with HIV negatives,HCV infection rate was higher among those age>30 years(OR=3.02,95%CI:1.69-5.38),having marriage years>3 years(OR=2.24,95%CI:1.34-3.74),and with HIV positives(OR=6.69,95%CI:3.29-13.59).Compared with those having HIV negatives,the syphilis infection rate was relatively higher among participants with HIV positives(OR=9.07,95%CI:2.00-41.10).Conclusion The prevalence of HIV,HCV,and syphilis among cross-border couples in Mangshi county,Dehong autonomous prefecture of Yunnan province is relatively high.Age,AIDS awareness,HIV testing history,and the length of marriage are associated with the HIV,HCV,and syphilis infection.