2004～2018年临沂市感染HIV农村外来媳妇配偶间传播状况与影响因素研究

Survey on status and influencing factors of transmission between spouses among marriage-based migrant women,Linyi city,2004-2018

目的分析临沂市农村外来媳妇配偶间HIV二代传播状况及其影响因素,为完善艾滋病感染者的干预措施提供科学依据。方法采用回顾性研究的方法,在临沂市农村外来媳妇HIV感染状况调查资料的基础上,根据不同的研究目的建立队列;收集整理该人群常规监测、流行病学调查和随访等资料。结果自2004年始至2018年5月31日止,共调查检测外来媳妇16 605人,238例配偶接受了HIV抗体检测,确证HIV阳性73例,HIV夫妻传播率为30.67%(73/238);其中58例为外来媳妇感染者确诊前感染,传播率为24.37%(58/238);单阳家庭配偶间传播15例,HIV夫妻传播率为8.57%(15/175)。'无保护性生活年限'(OR=0.73)、'以前是否听说过艾滋病'(OR=0.18)和'夫妻一方确证HIV阳性前性生活频次'(OR=0.53)为导致未知情家庭夫妻间HIV传播的影响因素(P<0.01);单阳家庭中夫妻性生活中安全套使用率低会增加HIV感染风险(P<0.01)。所有被感染的配偶均未发生过静脉吸毒、多性伴、有偿供血、输血等感染HIV的高危行为,排除了非配偶传播的可能。结论临沂市农村外来媳妇感染者导致家庭内配偶间传播。

Objective To analyze the secondary transmission between spouses among marriage-based migrant women and its risk factors,so as to provide scientific basis for perfecting intervention measures to HIV-positive people.Methods A retrospective cohort study was conducted which built based on the baseline data of HIV infection among marriage-based migrant women in Linyi city,and then the data of routine surveillance was collected and sorted,and the epidemiological investigation and follow-up were conducted.Results From 2004 to May 31,2018,a total of 16 605 marriage-based migrant women were surveyed,238 spouses accepted HIV antibody test,and 73 of them were confirmed as HIV-positive,the spousal transmission rate was 30.67%(73/238);15 spouses were infected in single-positive families and the transmission rate of HIV between husband and wife was 8.57%(15/175);'years of unprotected sexual life'(OR=0.73),'whether they had heard of AIDS before'(OR=0.18),and'the frequency of sexual life before 1 spouse being confirmed HIV positive'(OR=0.53)were the influencing factors of HIV transmission between husband and wife in uninformed households(P<0.01);the low condom use rate in the sexual life of couples in single-positive families increased the risk of HIV infection(P<0.01).All HIV infected spouses did not have high risk behaviors including intravenous drug use,multiple sex partners,paid blood(plasma)donation or transfusions,therefore the possibility of non-spousal transmission was ruled out.Conclusion The HIV infected marriage-based migrant women lead to the transmission between spouses.