女性性工作者规模估计及HIV、梅毒感染状况调查

目的掌握女性性工作者的人群规模及人类免疫缺陷病毒（HIV）、梅毒的感染状况,为开展高危干预及制定相关防控措施提供依据。方法应用枚举法对女性性工作者的规模进行估计;同时抽取823名女性性工作者血样作HIV和梅毒抗体的检测。结果女性性工作者人群的点估计值为4446人,95%可信区间为3879～5012人;823名女性性工作者血样经实验室检测HIV抗体阳性率0.12%,梅毒抗体阳性率2.07%。结论当地女性性工作者的基数较大,作为艾滋病、性病接触传播的桥梁人群,应采取有效措施予以干预。     

农村低档场所暗娼特征及HIV、乙肝、梅毒感染情况调查

目的了解农村地区低档高危场所暗娼人群特征及H IV、乙肝、梅毒感染情况,探讨对农村地区暗娼艾滋病宣传、干预措施。方法对某县低档场所暗娼进行摸底调查,对每次性交易收费在60元以下的低档场所的暗娼进行问卷调查和艾滋病、梅毒、乙肝检测,分析其行为特征、感染情况及危险因素。结果该县低档高危场所共计75家,暗娼274人,完成263份问卷调查表,采血检测250份。低档场所偏僻、隐蔽、经常变迁,暗娼流动性强;低档场所暗娼年龄偏大、文化水平低;落实宣传干预难度较大。HBsAg阳性8例,梅毒抗体阳性8例,阳性率均为3.2%,H IV抗体检测均为阴性。结论应重点加强、普及农村地区艾滋病宣传教育工作,加强对农村地区低档场所暗娼人群的干预工作。     

姜堰市娱乐场所女性性工作者性病感染情况及相关因素分析

目的:了解姜堰市娱乐场所女性性工作者HIV?梅毒?丙型肝炎感染情况,为艾滋病行为干预工作提供科学依据?方法:采取匿名问卷调查方式,对娱乐场所女性性工作者进行询问,获取AIDS相关行为?知识?态度,同时抽取静脉血,进行HIV?梅毒和丙肝抗体检测?结果:调查对象817例,检测出HIV抗体阳性1例?梅毒抗体阳性24例及丙肝抗体阳性1例,其感染率分别为0.1%?2.9%?0.1%;AIDS知识知晓率为79.7%;最近1次与客人发生性行为时使用安全套率84.5%,最近1个月与客人发生性行为时每次均使用安全套率77.4%?在性服务时未使用安全套的女性性工作者梅毒感染率较使用安全套的高(χ2 = 4.64,P < 0.05)?结论:娱乐场所女性性工作者HIV及丙肝感染处于较低水平?梅毒感染处于较高水平,这部分人群存在对艾滋病流行的认知不足,安全套使用率低等多种危险行为,应在娱乐场所女性性工作者中广泛开展艾滋病防治知识宣传教育和推广使用安全套行为干预工作,消除危险因素,防止艾滋病由高危人群向一般人群蔓延,减少性病艾滋病通过性接触传播?     

海南省性病门诊男性就诊者HIV知识、行为和感染影响因素

目的 对海南省性病门诊男性就诊者艾滋病知识、行为、感染状况及影响因素进行调查分析,为开展该人群艾滋病防治工作提供依据。方法 按照《全国艾滋病哨点监测实施方案操作手册》要求,采用连续采样方法对性病门诊男性就诊者进行问卷调查和血清学检测。结果 2013—2015年共监测4 815人,各年度艾滋病知识知晓率分别为67.04%、80.41%和80.49%（线性趋势χ²= 79.582,P<0.05);最近3个月与女性性服务工作者、临时性伴发生过性行为的比例分别为34.11%和30.30%;与同性发生过肛交性行为的比例为1.69%;人类免疫缺陷病毒（HIV）抗体和梅毒抗体阳性率分别为0.93%和6.58%;多因素logistic回归分析显示,性病门诊男性就诊者HIV感染受户籍地、婚姻状况、与同性发生过肛交性行为和梅毒感染等因素的影响。结论 海南省性病门诊男性就诊者艾滋病知识知晓率逐年提高,但HIV抗体和梅毒抗体阳性率均较高;与同性发生过肛交性行为和梅毒感染是HIV感染的危险因素。     

341名吸毒人员行为学特征及HIV、梅毒感染情况调查

目的 了解吸毒人群吸毒、性行为方式、艾滋病知识及HIV、梅毒感染水平,分析吸毒行为、HIV及梅毒感染情况,为开展针对性干预措施提供依据。方法 采用匿名方式进行向卷调查,同时采静脉血检测HIV抗体、RPR TPPA。结果 吸毒人员以未婚男性青年为主,吸毒方式仍以口吸为主,静脉注射吸毒只占25.22%,共用注射针具吸毒行为的占22.105。吸毒者存在多性伴现象,且安全套使用率较低。吸毒人群HIV抗体检测未发现阳性者,梅毒血清RPR TPPA检测阳性率为8.805。其中女性阳性率为27.40%,男性阳性率为3.73%,女性明显高于男性。结果 吸毒人群静脉注射吸毒、共用注射针具等行为与HIV感染有关。吸毒人群中梅毒的感染率较高,应引起重视。     

广西靖西县1997-2008年HIV监测结果分析

目的为了解百色市靖西县艾滋病(AIDS)流行特征和趋势,为制定艾滋病防制策略提供科学依据。方法对1997~2008年靖西县H IV常规监测、自愿咨询检测、个案调查资料进行统计分析。结果1997~2008年靖西县共报告H IV抗体阳性者49例,H IV抗体阳性率为0.26(49/18540),经性接触感染占71.42%(35/49),经性接触感染是靖西县目前艾滋病感染的主要传播途径。结论针对艾滋病流行现状,应切实采取综合性防控措施,建立健全防控监测体系,争取项目资金支持,广泛开展健康教育,加强高危行为干预和监测工作力度,有效控制艾滋病由高危人群向普通人群扩散传播。     

梅毒合并HIV感染6例报告

目的探讨梅毒合并H IV感染的临床表现及转归。方法对北京佑安医院感染科收治的6例梅毒合并H IV感染者的性别、好发人群、临床表现、实验室检查、诊断方法、治疗经过及转归进行回顾性分析。结果6例梅毒合并H IV感染的患者均为男性同性恋者,其中3例脑脊液有异常改变,所有患者对青霉素治疗均反应良好。结论男性同性恋人群是梅毒和H IV共感染的高危人群,临床表现多样,可以迅速进展到神经梅毒。主要依靠梅毒血清学试验和全面细致的查体进行诊断。青霉素为首选治疗药物,治疗后的密切随访至关重要。     

甘肃省敦煌地区普通人群卡波肉瘤相关疱疹病毒感染的血清学分析

目的 研究卡波肉瘤相关疱疹病毒(KSHV)在甘肃敦煌地区普通人群中的血清阳性率,并分析KSHV感染的危险因素.方法 随机收集1 000例敦煌地区普通人群血清,以KSHV 3个基因片段 orf65、orf73、orf k8.1编码蛋白为抗原,间接ELISA检测样本中KSHV抗体,SPSS软件分析危险因素. 结果 1 000份血清中,KSHV抗体总阳性率为19%,男性阳性率(22.9%)高于女性(16.6%)(P=0.016);KSHV感染与梅毒螺旋体(P=0.004)和丙肝病毒(P=0.027)感染间有相关性,而与年龄、乙肝五项无关.多因素Logistic回归分析显示梅毒螺旋体感染的OR(95% CI)为10.142 (1.920~53.577).结论 甘肃敦煌地区普通人群中KSHV的感染率较高,且与性别有关;梅毒螺旋体感染是该地区KSHV感染最重要的独立危险因素.     

许昌市2002-2010年吸毒哨点艾滋病性病监测情况

目的了解许昌市吸毒人员的高危行为和艾滋病及性病的感染状况,为制定艾滋病性病的预防控制措施提供依据。方法按照国家艾滋病哨点监测实施方案的要求,对监测期间新入所的吸毒人员进行行为学调查和艾滋病、梅毒、丙肝血清抗体检测。结果口吸毒者及注射吸毒者分别占吸毒人员总数的93.2%和6.80%;该吸毒人群中HIV抗体阳性率为0.41%,梅毒感染率为1.04%。结论许昌市吸毒人员艾滋病、性病感染危险因素广泛存在,应加强针对该人群的高危行为干预。     

东湖区男男性行为人群HIV 梅毒 HCV 感染状况及高危行为调查分析

目的 了解东湖区男男性行为(MSM)人群HIV感染状况,和有关艾滋病/性传播疾病(AIDS/STD)知识、态度及行为(KAP)特征,为针对该人群今后开展有效的干预工作提供经验和依据.方法 对东湖区106名MSM进行匿名问卷调查,采集血样本进行检测.结果 106名MSM平均年龄22岁,多为高校学生,文化程度较高.艾滋病病毒(HIV)阳性率为13.21%,梅毒阳性率为6.6%,丙型肝炎病毒抗体(抗-HCV)阳性率为1.89%,调查对象AIDS/STD知晓率较高,但有较高的高危行为,近6个月与男性发生肛交性行为时每次使用安全套的仅占26.52%,平均性伴数为2人.结论 东湖区MSM人群HIV感染率较高,高危行为普遍,必须采取有效的干预措施,同时应加强对高校青少年的性健康教育.     

Estimation of Population-Size Changes and HIV Prevalence among Female Sex Workers from 2006 to 2009 in Kaiyuan, Yunnan, China

ObjectiveThis study is to estimate the population size and prevalence of HIV and herpes simplex virus type 2 (HSV-2) infections among female sex workers (FSWs) in Kaiyuan, Yunnan Province, China.MethodsEight cross-sectional studies were conducted among FSWs in Kaiyuan from 2006 to 2009. Based on the data from two study time points each year, the total numbers of FSWs and HIV positive FSWs were estimated by using the capture-recapture technique (CR).ResultsEstimated sizes of FSWs in Kaiyuan were 1 629, 1 672, 1 186, and 1 014 in the respective years from 2006 to 2009. Although the crude prevalence rates of HIV and HSV-2 varied over time, the adjusted prevalence among this population was relatively stable at 10%–12% and the adjusted HSV-2 prevalence ranged from 67% to72%.ConclusionThe reason for the slight decrease of the size of the FSW population is unknown. The adjusted prevalence rates of HIV and HSV-2 among them were stable over the course of this study.     

Effects of HIV status notification on reducing the risk of sexual transmission of HIV in China

Background The risk of HIV sexual transmission is much higher among people unaware of their HIV status than among those aware. Only a few studies have indicated that the incidence of unsafe sex can be reduced when people know their HIV status. This study was to investigate this effect in China.

Methods A cohort study consisting of two surveys was conducted at two different times among a group of people living with HIV/AIDS, whose status was newly diagnosed with HIV via sexual contact, in Shanghai, Chongqing, and Kunming. The first survey was conducted among 823 people tested positive for HIV before notifying them of the HIV status. The second survey was conducted among 650 HIV-positive people at six months following the first survey (after notification of HIV status). The scope of survey covered unsafe sex practices, number of unsafe sexual partners, and frequency of unsafe sexual behaviors over the prior six months. Unsafe sex is defined as unprotected anal or vaginal sex with partners who are HIV positive or whose HIV status is unknown.

Results The proportion of unsafe sex was reduced by about 85% after HIV status notification. The risk of HIV sexual transmission was 15 times higher among persons unaware of their HIV status than among those aware. Approximately 95% of new sexually transmitted HIV infections stemmed from 56% of the infected persons unaware of their HIV status in China.

Conclusion Timely HIV status notification has the potential to significantly reduce unsafe sex among HIV-infected persons and reduce the risk for HIV transmission via unsafe sex.

     

性病门诊男性就诊者艾滋病哨点监测结果分析

目的:了解性病门诊男性就诊者艾滋病流行状况和流行因素,为制定相应防控措施提供科学依据。方法:2012年4月至6月对首次到眉山市人民医院性病相关门诊就诊的400名年龄在15周岁及以上的男性就诊者进行面对面问卷调查,并采集血样进行艾滋病、梅毒、丙肝检测。结果:艾滋病知识总知晓率87.00%;14.25%的调查对象承认在最近3个月有商业性行为;10.75%的调查对象承认最近3个月与临时性伴发生过性行为;0.25%的人承认与同性发生过肛交性行为;16.50%的被调查者最近1年接受过有关预防艾滋病性病服务;0.50%最近1年做过艾滋病病毒(HIV)检测并知晓检测结果。HIV抗体检出率2.25%;梅毒抗体检出率3.75%;丙肝抗体检出率0.75%。结论:性病门诊就诊者存在知识和行为分离的现象;应对性病门诊就诊者开展针对性的行为干预,控制艾滋病经高危人群向一般人群扩散。     

2011年滦南县女性性工作者人群哨点监测结果分析

目的了解滦南县女性性工作者艾滋病流行状况和流行因素,分析女性性工作者性病艾滋病流行趋势,为制定艾滋病防治策略和干预措施及效果评价提供依据。方法按照《全国艾滋病哨点监测实施方案》的要求,采用统一的调查问卷和试剂,对400例女性性工作者进行问卷调查和血清学检测。结果本次调查女性性工作者的平均年龄为28.62±5.99岁,未婚占57.25%,户籍所在地遍布全国各地,本省占67.00%,省外占33.00%,文化程度以初中为主,占60.00%。艾滋病防治知识知晓率为88.00%,最近一次与客人发生性行为安全套使用率为56.75%,有吸毒行为的很少,仅有4人,均不是注射吸毒。最近1年接受过有关预防艾滋病的服务的有298人,占74.50%。血清学检测没有发现人类免疫缺陷病毒阳性感染者,梅毒抗体阳性2例,丙型肝炎病毒抗体阳性9例。结论女性性工作者人群中安全套的使用率与艾滋病防治知识知晓率存在一定的差距,应改变行为干预方式方法,加强同伴教育服务的开展,提高同伴教育服务的可及性,促进她们的行为改变。同时,女性性工作者人群中性病感染率较高,在预防艾滋病的同时应该加强性病的宣传教育。     

Effect of Condoms on Reducing the Transmission of Herpes Simplex Virus Type 2 From Men to Women

Context  Herpes simplex virus type 2 (HSV-2) is one of the most common sexually transmitted infections in the United States. No prospective study has shown the ability of condoms to reduce transmission of HSV-2. Objective  To evaluate risk factors for HSV-2 acquisition and efficacy of condoms in prevention of HSV-2 transmission. Design  Analysis of data from a randomized, double-blind, placebo-controlled trial conducted December 13, 1993, to June 28, 1996, of an ineffective candidate HSV-2 vaccine with 18 months of follow-up. Setting  Eighteen clinical trial centers in the United States. Participants  A total of 528 monogamous couples discordant for HSV-2 infection, including an HSV-2–susceptible population of 261 men and 267 women. Main Outcome Measure  Acquisition of HSV-2 infection by susceptible partners, compared with those remaining free of HSV-2 with regard to demographic characteristics, sexual activity, and condom use. Results  Twenty-six women (9.7%) vs 5 men (1.9%) acquired HSV-2, for a rate per 10 000 sex acts (episodes of sexual intercourse) of 8.9 vs 1.5, respectively (P<.001). In multivariable analysis, younger age (adjusted hazard ratio [HR] per 5 years, 1.57; 95% confidence interval [CI], 1.22-2.04), seropositivity for HSV-1 and HSV-2 vs HSV-2 alone in the source partner (adjusted HR, 2.34; 95% CI, 1.14-4.82), and more frequent sexual activity (adjusted HR per additional sex act per week, 1.10; 95% CI, 1.01-1.19) were associated with higher risk of HSV-2 acquisition. Condom use during more than 25% of sex acts was associated with protection against HSV-2 acquisition for women (adjusted HR, 0.085; 95% CI, 0.01-0.67) but not for men (adjusted HR, 2.02; 95% CI, 0.32-12.50). Risk of HSV-2 transmission declined from 8.5 per 100 person-years in the initial 150-day interval to 0.9 per 100 person-years in the final 150-day interval (P = .002 for trend), concurrent with a decrease in sexual activity and proportion of sex acts occurring when the source partner had genital lesions. Conclusions  Condom use offers significant protection against HSV-2 infection in susceptible women. Changes in sexual behavior, correlated with counseling about avoiding sex when a partner has lesions, were associated with reduction in HSV-2 acquisition over time. These data suggest that identification of discordant couples can reduce transmission of HSV-2, especially for heterosexual couples in which the male partner has HSV-2 infection.      

HIV and syphilis infections among street-based female sex workers in China, 2010–2012

Background Female sex workers （FSW） were high-risk population for HIV and other sexually transmitted diseases （STD） earlier,and now are an important driver of the HIV/AIDS epidemic in China.Sentinel surveillance for FSW was set up to monitor the trend of HIV prevalence and risk behavior-related HIV infection.This study collected the data on street-based FSW from HIV sentinel surveillance system to understand HIV and syphilis infections,risk behaviors,and intervention in China from 2010 to 2012.Methods The study population was the street-based FSW who were recruited for the national HIV integrated biological and behavioral surveillance between 2010 and 2012.Demographic information,HIV-related risk behaviors,and HIV and syphilis testing results were described and trend analysis was performed.Results Between 2010 and 2012,the number of street-based FSW surveyed was 3725,3425,and 3335,respectively.HIV knowledge awareness rate significantly increased from 74.6% in 2010 to 76.8% in 2011 and 82.2% in 2012 （P 〈0.01）.More FSW consistently used condom in the last month （49.0% in 2010; 51.0% in 2011; and 59.0% in 2012） and in the last commercial sex （72.0% in 2010; 78.5% in 2011; and 80.0% in 2012） over time.The proportions of individuals who received HIV testing in the last year were 31.2% （2010）,37.0% （2011）,and 36.9% （2012） （P-trend 〈0.01）.HIV prevalence rate changed from 1.5% in 2010 to 1.4% in 2011 and 2.3% in 2012 （P-trend=0.01）.Syphilis prevalence rate was 6.9%,7.2%,and 7.1% in the same period.The top three provinces with the highest average HIV prevalence rates over the 3 years were Guangxi （5.9%）,Yunnan （4.2%）,and Sichuan （1.2%）.Conclusions Street-based FSW are at high risk of HIV and syphilis infections.Intervention efforts need to target streetbased FSW who are of old age and minority,who use illicit drugs and have syphilis infection.     

生殖器溃疡患者杜克雷氏链杆菌、梅毒螺旋体及人类单纯疱疹病毒2型抗体血清学检测及其与HIV感染的关系

目的：检测女性生殖器溃疡患者血清杜克雷氏链杆菌抗体、梅毒螺旋体血清学、人类单纯疱疹病毒2型抗体，并探讨其与人类免疫缺陷病毒(HIV)感染之间的关系。方法：将102例女性生殖器溃疡患者作为研究对象。采用酶联免疫吸附法(ELISA)测定血清HIV抗体，并以蛋白印迹试验(western blot)进行确认；采用快速血浆反应试验(RPR)筛查梅毒，对螺旋体感染患者进一步进行梅毒螺旋体红细胞凝集试验(TPHA)；采用Westem blot测定人类单纯疱疹2型特异糖蛋白抗体；采用酶免法(EIA)测定抗杜克雷氏链杆菌抗体IgA及IgG。结果：杜克雷氏链杆菌IgG或／及IgA阳性共计30例(30．61％)；梅毒RPR或／及TPHA阳性51例(52．04％)；单纯疱疹2型特异糖蛋白抗体阳性17例(17．35％)。98例患者中，HIV抗体阳性47例(47．96％)。30例软下疳患者中19例HIV抗体阳性(63．33％)，51例梅毒病例中21例(41.18％)呈HIV感染，17例单纯疱疹病毒2型特异糖蛋白抗体阳性者中7例(41．18％)HIV抗体阳性；三者之间HIV抗体阳性率无显著差异，但均有易感倾向。结论：杜克雷氏链杆菌、梅素螺旋体及单纯疱疹2型感染所致的女性生殖器溃疡与HIV感染有密切联系。     

Frequent Recovery of HIV-1 From Genital Herpes Simplex Virus Lesions in HIV-1-Infected Men

Context.— Genital ulcer disease has been epidemiologically linked as a risk factor in the transmission of the human immunodeficiency virus 1 (HIV-1). While herpes simplex virus 2 (HSV-2) is the most common cause of genital ulcers, no study has systematically evaluated the frequency or titer of HIV-1 virus in HSV-2 lesions. Objective.— To compare lesional HIV-1 RNA levels during and after genital HSV-2 reactivation and to evaluate the frequency, titer, and duration of HIV-1 RNA shedding in lesions due to HSV-2. Design.— Convenience sample. Setting.— Sexually transmitted disease research clinic at the University of Washington, Seattle. Patients.— Twelve HIV-infected men with a history of symptomatic HSV-2 infection who underwent daily sampling of genital lesions for HIV-1 RNA by polymerase chain reaction assay and HSV-2 by culture. Main Outcome Measure.— Detection of lesional HIV RNA and HSV-2. Results.— HIV-1 RNA was detected from lesional swabs in 25 of 26 consecutively studied HSV-2 episodes and on 67% of days in which genital lesions were noted. The HIV-1 RNA titers in lesional swabs exceeded 10000 copies/mL of swab sample in 75% of samples (range, 2.2-3.2x10⁵ copies/mL of swab sample). HIV-1 RNA in genital lesion swabs was seen in persons with high and low titers of plasma HIV-1 RNA and was not associated with plasma HIV-1 RNA levels. Conclusions.— HIV-1 virions can consistently be detected in genital ulcers caused by HSV-2, which suggests that genital herpes infection likely increases the efficiency of the sexual transmission of HIV-1.      

Efficacy of Risk-Reduction Counseling to Prevent Human Immunodeficiency Virus and Sexually Transmitted Diseases: A Randomized Controlled Trial

Context.— The efficacy of counseling to prevent infection with the human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs) has not been definitively shown. Objective.— To compare the effects of 2 interactive HIV/STD counseling interventions with didactic prevention messages typical of current practice. Design.— Multicenter randomized controlled trial (Project RESPECT), with participants assigned to 1 of 3 individual face-to-face interventions. Setting.— Five public STD clinics (Baltimore, Md; Denver, Colo; Long Beach, Calif; Newark, NJ; and San Francisco, Calif) between July 1993 and September 1996. Participants.— A total of 5758 heterosexual, HIV-negative patients aged 14 years or older who came for STD examinations. Interventions.— Arm 1 received enhanced counseling, 4 interactive theory-based sessions. Arm 2 received brief counseling, 2 interactive risk-reduction sessions. Arms 3 and 4 each received 2 brief didactic messages typical of current care. Arms 1, 2, and 3 were actively followed up after enrollment with questionnaires at 3, 6, 9, and 12 months and STD tests at 6 and 12 months. An intent-to-treat analysis was used to compare interventions. Main Outcome Measures.— Self-reported condom use and new diagnoses of STDs (gonorrhea, chlamydia, syphilis, HIV) defined by laboratory tests. Results.— At the 3- and 6-month follow-up visits, self-reported 100% condom use was higher (P<.05) in both the enhanced counseling and brief counseling arms compared with participants in the didactic messages arm. Through the 6-month interval, 30% fewer participants had new STDs in both the enhanced counseling (7.2%; P = .002) and brief counseling (7.3%;P=.005) arms compared with those in the didactic messages arm (10.4%). Through the 12-month study, 20% fewer participants in each counseling intervention had new STDs compared with those in the didactic messages arm (P = .008). Consistently at each of the 5 study sites, STD incidence was lower in the counseling intervention arms than in the didactic messages intervention arm. Reduction of STD was similar for men and women and greater for adolescents and persons with an STD diagnosed at enrollment. Conclusions.— Short counseling interventions using personalized risk reduction plans can increase condom use and prevent new STDs. Effective counseling can be conducted even in busy public clinics.      

男男性接触者社会心理特征

目的 了解男男性接触者社会心理特征,为开展HIV/STDs预防干预活动提供依据。方法以同性恋酒吧为研究现场,以酒吧中男男性接触者为对象进行问卷调查,调查内容包括社会人口特征,焦虑和抑郁症状及性行为方式。结果 调查对象平均年龄为 26. 14岁,文化程度普遍较高; 85. 1%的人居住在本市,MSM家庭和社会支持度低,焦虑、抑郁心理症状检出率分别为 45. 5%和 57. 5%;MSM中多性伴现象普遍,安全套使用率较低;HIV和STDs感染报告率分别为 3. 4%和 10. 3%,自杀行为报告率为 16. 7%。结论 如何针对男男性接触者社会心理特征开展HIV/STDs干预活动应成为进一步研究的方向。