长春市2016～2018年性病门诊男性就诊者艾滋病哨点监测分析

Analysis of HIV/AIDS sentinel surveillance of male patients in STD clinic at Changchun from 2016 to 2018

目的:了解长春市性病门诊男性就诊者艾滋病监测情况,为制定相关防控措施提供依据。方法:按照《全国艾滋病哨点监测实施方案(2017版)》,在2016～2018年哨点监测期内,对性病门诊男性就诊者开展问卷调查和血清学检测。结果:2016～2018年共监测1 200名性病门诊男性就诊者,发现就诊者以20～40岁、未婚、本市户籍者和汉族为主。调查对象中,689例(57. 42%)既往诊断患有性病,其中653例(94. 78%)患有一种性病,36例(5. 22%)患两种及以上性病。1 200名就诊者中,HIV抗体、梅毒抗体和HCV抗体阳性率分别是1. 17%(14例)、23. 00%(276例)和0. 75%(9例)。近3个月与性工作者发生性行为的比例为49. 50%(594例),近3个月与临时性伴发生性行为的比例为26. 75%(321例),男男性行为的发生率为15. 83%(190例),近3年发生率差异均具有统计学意义(P<0. 05)。3年艾滋病知识总体知晓率为90. 33%。结论:性病门诊男性就诊者应作为长春市艾滋病防治重点关注人群,应加强对高危人群多方位的、全面的宣传教育和行为干预,尤其是离异或丧偶的就诊者,同时调动医务人员的积极性,探索行而有效的干预机制与方式,减少性传播疾病的蔓延。

Objective: To understand the AIDS surveillance situation of male patients in STD clinics in Changchun,and to provide evidence for the development of relevant prevention and control measures. Methods: According to the National Protocol of AIDS Surveillance( 2017 Edition),questionnaires and serological tests were conducted on male patients in STD clinics during the 2016-2018 sentinel surveying period. Results: In 2016-2018,a total of 1 200 male STD patients were detected. The majority of patients were aged20-40,unmarried,local residents and Han nationality. In the patients,689 cases( 57. 42%) had a previous digamous of STD,653 cases( 94. 78%) of them had one kind of STD,and 36 cases( 5. 22%) of them had more than one STD. The positive rates of HIV antibody,syphilis antibody and HCV antibody were 1. 17%( 14 cases),23. 00%( 276 cases) and 0. 75%( 9 cases),respectively. The49. 50%( 594 cases) of patients admitted having sex with female sex works,26. 75%( 321 cases) of patients having sex with temporary sex partners,and 15. 83%( 190 cases) having homosexual behavior. The rates were statistically significant( P<0. 05). The overall awareness rate of AIDS knowledge in 2016-2018 was 90. 33%. Conclusion: AIDS prevention in Changchun should focus the male patients in STD clinics. It is necessary to strengthen multi-faceted,comprehensive publicity and behavioral interventions for highrisk groups,especially divorced or widowed patients,and mobilize the enthusiasm of medical staffs to explore effective intervention mechanisms and methods,and reduce the spread of sexually transmitted diseases.