部分地区50岁及以上男性HIV感染者确诊前高危行为核实调查

Verification investigations of pre-diagnosis high-risk behaviors among male HV-infected individuals aged≥50 years in some areas of China

目的 了解50岁及以上男性HIV感染者确诊前高危行为特征,为制定50岁及以上人群艾滋病预防干预策略提供依据。方法 2022年7-11月,在湖北省与江西省选取≥50岁HIV感染者数量较多的地区开展调查。通过艾滋病防治基本信息系统收集基本人口学信息及传播途径等信息作为病例报告信息。通过调查问卷收集确诊前一年内的高危行为等信息作为专题调查信息,将病例报告与专题调查信息进行对比核实。结果 共调查410名≥50岁男性HIV感染者,平均确诊年限为1.22年;全部为汉族;70.73%(290人)已婚有配偶;农民/农民工占65.61%(269人);文化程度初中及以下占86.83%(356人);居住地为农村者占52.68%(216人)。调查对象在病例报告与专题调查中报告的确诊前高危行为史有显著不同,病例报告中确诊前有商业性性行为史、非婚非商性性行为史的感染者所占比分别为79.27%(325人)、14.39%(59人),专题调查中为70.98%(291人)、4.88%(20人),男男性行为史所占比例在病例报告和专题调查中分别为4.63%(19人)和13.41%(55人)。男男性行为误报比例为8.78%(36人误报)。Logistic回归分析显示,职业为农民/农民工(OR=5.06, 95%CI:1.13~22.77)、确诊前做过HIV检测(OR=6.60, 95%CI:1.02~42.62)的感染者男男性行为调查结果误报的可能性高。结论 我国部分地区≥50岁男性HIV感染者报告病例传播途径中异性性传播被高估,男性同性性传播被低估,建议应加强对该人群传播途径的深入研究。

Objective To understand the pre-diagnosis high-risk behavior characteristics of male HIV-infected individuals aged≥50 years,so as to provide evidence for the development of more effective HIV prevention and intervention strategies for people aged≥50 years.Methods From July to November 2022,a survey was conducted in areas with the larger number of HIV-infected cases aged≥50 years in Hubei and Jiangxi Province.The case report information was collected from AIDS Prevention and Control Basic Information System,including the demographic information and transmission routes.High-risk behaviors and other information 1 year before diagnosis were collected as thematic survey information through a survey questionnaire,which was compared with case report information for verification.ResultsTotally 410 HIV-infected men aged≥50 years were enrolled,with the average diagnosis duration of 1.22 years,out of which,all were Han ethnic,70.73%(290)were married or had spouses,65.61%(269)were farmers or migrant workers,86.83%(356)had junior middle school education or below,and 52.68%(216)live in rural areas.The history of high-risk behavior of respondents was significantly different between case reports and thematic survey.The proportion of HIVinfected individuals with a history of commercial sex before diagnosis and a history of non-marital non-commercial sexual activity were 79.27%(325)and 14.39%(59)in case report,respectively,while that were 70.98%(291)and 4.88%(20)in thematic survey,respectively.The proportions of respondents with a history of male homosexual activity were 4.63%(19)in case report and 13.41%(55)in thematic survey,respectively.The false positives proportion of male homosexual activity was 8.78%(36).Logistic regression analysis showed that there was a high likelihood of false positives in the respondents who were farmers/migrant workers(OR=5.06,95%CI:1.13-22.77)and had been tested HIV before diagnosis(OR=6.60,95%CI:1.02-42.62).Conclusions The proportion of the heterosexual transmission of HIVinfected men aged≥50 years is overestimated,while the homosexual transmission is underestimated.Further study focused on the transmission route is needed for this special populations.