2012年天津市性病门诊男性就诊者HIV/梅毒感染现状及影响因素分析

目的了解性病门诊男性就诊者中,艾滋病病毒（HIV）、梅毒（SP）的感染状况及危险因素,为在该人群中开展相关防控措施提供依据。方法对天津市2家性病门诊中符合条件的男性就诊者开展问卷调查,同时抽取血样检测梅毒和HIV抗体。结果800例性病门诊男性就诊者中,HIV抗体阳性16例,阳性率为2．0％。多因素分析表明,最近3个月有同性性行为[比值比（OR）=21．642,95％可信区间（CI）：7．211～64．946]、感染梅毒（OR=3．097,95％CI：1．059～9．055）与HIV感染关系有统计学意义。梅毒阳性129例,阳性率为16．1％。多因素分析表明,最近3个月有商业性行为（OR=6．306,95％CI：3．930～10．118）、最近3个月有同性性行为（OR=5．948,95％CI：3．017～11．725）与梅毒感染关系有统计学意义。结论性病门诊男性就诊者HIV、梅毒感染率较高,危险行为普遍存在,急需采取有效措施来控制性病艾滋病的传播蔓延。     

性病门诊人群泌尿生殖道沙眼衣原体混合感染及分型研究

目的 了解性病门诊人群泌尿生殖道沙眼衣原体混合感染及基因型分布特点。方法 对2048例性病门诊就诊者分别取尿道或宫颈拭子，实时聚合酶链反应（PCR）检测沙眼衣原体（CT）感染，阳性标本用套式PCR扩增ompl VD2区片断，反向线点杂交（RLB）检测特异性型别。结果 CT总体感染率为15．9％（325／2048）。对287份阳性标本成功分型，型别分布为：F21．6％，E20．9％，J19．9％，D12．9％，G8．4％，K4．2％和H1．4％，31份（10．8％）为混合感染。结论 在性病门诊人群中CT感染率较高，主要流行型别为F、E和J型，且具有较高的混合感染率。     

性病性生殖器溃疡的病因学分析

目的 了解性病门诊中以生殖器溃疡为主要表现的疾病和病因。方法 取生殖器溃疡处分泌物进行涂片、培养、荧光定量PCR、暗视野显微镜和血清学检查，同时检测梅毒螺旋体（TP）、单纯疱疹病毒（HSV）、人类乳头瘤病毒（HPV）、杜克雷嗜血杆菌（HD）及人类免疫缺陷病毒（HIV）。结果 在181例病人中，梅毒48例，生殖器疱疹32例、尖锐湿疣9例，分别占26．52％（48／181）、17．68％（32／181）、4．97％（9／181）和0．55％（1／181）。其中梅毒合并生殖器疱疹6例，占3．31％（6／181），合并尖锐湿疣1例，占0．55％（1／181），合并HIV感染1例，占0．55％（1／181）；生殖器疱疹合并尖锐湿疣4例，占2．21％（4／181）；念珠菌6例，占3．31％（6／181），合并梅毒2例，占1．10％（2／181）；细菌7例，占3．87％（7／181），合并梅毒4例，占2．21％（4／181）；未发现软下疳。79例未检出病原体，占43．65％（79／181）。结论 在性病门诊中，生殖器溃疡性疾病的病因以梅毒和生殖器疱疹为主，其次是尖锐湿疣，且存在混合性感染。     

性传播疾病门诊2268例就诊者病原检测分析

目的了解性传播疾病（性病）门诊就诊者泌尿生殖系统病原体感染情况。方法对2005年6月-2007年5月在淮安市第四人民医院性病门诊就诊的2268例患者泌尿生殖道病原体进行检测。结果2268例患者中，有366例检出病原体，阳性率16．14％（366／2268）。单一病原体感染率为69．13％（253／366），其中检出淋球菌68份（42．5％），沙眼衣原体80份（44．44％），解脲支原体153份（68．91％），梅毒23份（27．7％），生殖器单纯疱疹9份（52．94％），尖锐湿疣27份（24．55％）：混合感染为30．87％（113／366），其中检出沙眼衣原体＋解脲支原体＋淋球菌42份（12．88％），沙眼衣原体＋解脲支原体＋梅毒螺旋体12份（6．25％），HPVF＋HIV1份（1．67％），HPV＋梅毒螺旋体2份（3.77％）。结论门诊就诊者中，中青年患者居多，应重视病原学检查，强化性病防治力度。     

江西省部分地区性病门诊就诊者艾滋病知识态度行为及感染率调查

性乱人群的高危行为是艾滋病病毒／艾滋病（HIV／AIDS）流行的危险因素。为了研究和探索江西省性病门诊就诊者艾滋病知识知晓情况、行为特征及感染率，为有效控制艾滋病经性途径传播提供科学依据，2005年8-12月，在3个城市对性病门诊就诊者进行了艾滋病综合监测。[第一段]     

西藏某VCT门诊自愿咨询检测者HIV感染状况分析

目的分析艾滋病自愿咨询检测（VCT）门诊,自愿咨询检测者的艾滋病病毒（HIV）感染状况,为西藏预防HIV传播提供科学依据。方法收集整理2003-2012年西藏某VCT门诊自愿咨询者的人口学信息及HIV抗体检测结果,用描述性方法进行统计分析。结果1929名自愿咨询检测者中,检出HIV抗体阳性188例,阳性率9．75％;女性阳性率（12．94％）高于男性（8．40％）;15～44岁年龄组阳性率达9．92％,其阳性人数占所有阳性者中的94．15％（177／188）。小学及以下文化程度HIV阳性率较高,为17．92％,无业者高于其他职业;静脉注射吸毒阳性率高达62．50％。性传播占总数的89．89％。结论青壮年、小学及以下文化程度者及无业者是感染HIV的高危人群,性接触是主要的传播方式,应针对高危人群的特点,加强艾滋病的宣传教育以及行为干预工作,阻断HIV传播。     

571例性病门诊就诊者监测结果分析

性乱人群的高危性行为是传播艾滋病病毒（HIV）和性传播疾病（STD）的危险因素，了解这部分人群的行为及HIV／STD感染的基本情况，可以为进一步实施有效的性病艾滋病防治和干预提供依据。为此，2005年1～12月对性病门诊的就诊者进行监测，现将监测结果报告如下。     

山东省HIV感染者中流动人口感染现况调查

目的：了解山东省自1992年－2001年9月HIV感染者中流动人口的感染情况及其对传播流行HIV／AIDS的影响，为以后如何更好地管理这一特定人群制定相关政策提供科学依据。方法：对全省HIV感染者进行个案流行病学调查，采取在严格保密下，入户面对面询问调查，并填写统一调查表，结果：在110例HIV感染者中78例属流动人口，占70．91％（78／110），其中省间流动者69例，占88．46％（69／78），涉及全国10个省份，省内跨市流动者9例，占11．54％（9／78），分布在全省9个市，16个县区，流动人口的HIV感染者以青壮年为主，年龄在20－39岁有60例，占76．92％（60／78），男女之比为5．9：1。虽对48例流动人口已进行流调，但能每年定期进行追踪和管理的只有26例，占54．16％（26／48），结论：HIV感染中流动人口感染者目前山东省传播HIV／AIDS的最危险因素，相关部门应尽快制定有效措施，加强管理，以防HIV／AIDS在山东省传播蔓延。     

妊娠期弓形虫感染与垂直传播

对492份孕妇妊娠各期外周血及其79份新生儿脐血进行弓形虫IgM抗体检测，对57份有异常妊娠史孕妇及其20份流产物进行弓形虫DNA检测。结果孕妇弓形虫IgM抗体阳性率为10．5％（52／492），其新生儿脐血IgM阳性率为12．6％（10／79），垂直传播北为16．7％（5／30）；孕妇外周血DNA阳性率为12．2％（7／57），相应流产物阳性率为5％（1／20），垂直传播率为14．2％（1／7）。本文中观察5例先天感染的婴儿均为孕早期垂直传播所致，孕妇中期感染者无一婴儿感染，故孕早期垂直传播危险性大，早期诊断十分重要。     

广东省江门市性病门诊促进HIV及梅毒检测效果分析

目的了解广东省江门市性病门诊艾滋病病毒(HIV)及梅毒检测工作现况,评估性病门诊促进HIV及梅毒检测的效果。方法选择广东省江门市的4家医疗机构,收集快速评估、性病门诊就诊者个案表等资料进行分析。结果快速评估2014年第一季度性病门诊1404例就诊者,其HIV和梅毒检测率分别28.35%(398例)、39.89%(560例)。研究期间共计纳入性病门诊就诊者1409例,男女性别之比为1∶1.11,平均年龄为34岁。门诊类别中皮肤性病科比例最大,占78.64%(1108例)。1409例中,650例就诊者有性病症状(46.13%)。799例接受HIV检测(56.71%),确诊HIV新发病例15例,阳性率1.88%;966例接受梅毒检测(68.56%),确诊梅毒新发病例85例,阳性率为8.80%;HIV(χ2=264.9,P0.01)及梅毒(χ2=293.2,P0.01)的检测率差异有统计学意义。超过半数的拒绝者认为没有必要进行检测。结论该研究从医疗机构、医务人员、性病门诊就诊者三个方面综合考虑,证实性病门诊促进HIV及梅毒检测的有效性及可行性,有助于推动HIV及梅毒的综合防控。     

广西南宁市流动建筑民工STD/AIDS的知识态度行为调查分析

目的了解南宁市流动建筑民工对性传播疾病/艾滋病(STD/AIDS)知识、态度、行为,为对流动人口实施预防AIDS干预提供决策参考。方法采取随机抽样方法,抽取南宁市施工期限在6个月以上的2个建筑工地,调查其中从事建筑施工的236名流动工人对STD/AIDS相关知识的掌握及态度、行为特征等。结果236名民工中98.31%听说过AIDS,对4个常见性病病征同时回答正确的仅占1.27%。AIDS传播途径回答正确的占26.70%。对一些保护性知识的知晓率仅达到33%。但对一些消除恐惧、有利于营造社区关怀与支持的非AIDS问题有较高的知晓率。回答曾经患过性病的人数占5.51%。患性病后求医时选择综合医院或专科医院/门诊就医的占85.17%。在综合医院就医时选择性病科和专家门诊就医的占82.21%。首次性行为年龄<15岁占4.24%,有不固定性伴的占16.95%,有吸毒行为的占5.93%。结论南宁市流动建筑民工对STD/AIDS的相关知识的知晓率仍处于较低水平。对STD/AIDS的接纳程度有限。民工求医行为较为理智,对STD/AIDS仍较为脆弱。对其实施干预的重点在普及知识,同时提高和规范综合医院和专科医院医疗服务能力。     

The link between sexually transmitted disease clinics and HIV counseling and testing centers: who is not getting referred?

A total of 236 clients attending human immunodeficiency virus (HIV) counseling and testing (C&T) centers and sexually transmitted disease (STD) clinics were interviewed to evaluate who is being reached by C&T services and if STD clients are being referred to HIV C&T centers. Respondents receiving HIV C&T reported significantly more sexual risk based on characteristics of their partners, whereas STD clinics respondents more frequently reported previous STD diagnoses and sex with prostitutes. Over 50% of the high-risk individuals attending STD clinics were not referred to HIV C&T centers. The differences in perceived risk of current and future infection between STD and HIV C&T centers and the low referral rates of high-risk individuals for HIV C&T indicate a need for increased education efforts, more effective risk-assessment policies in STD clinics, and a tightening of the link between STD clinics and HIV C&T centers.     

Cross-sectional survey of the extent and indicators of hepatitis C virus infection in Houston Department of Health and Human Services' sexually transmitted disease clinics

summary. To evaluate the prevalence and indicators of hepatitis C virus (HCV) infection in Houston and determine the effectiveness of targeted HCV screening in sexually transmitted disease (STD) clinics. We performed a cross-sectional survey in low-risk and high-risk groups in Houston. This included a blinded survey of HCV conducted in 1010 STD clinic clients having serological syphilis tests, and 1885 multi-speciality group practice patients having metabolic blood work. This was followed with a targeted hepatitis C survey of 822 high-risk clients from STD clinics. The seroprevalence of hepatitis C infection in the blinded survey was 3.9% (95% CI 3.0–4.8) in the multi-speciality group and 5.0% (95% CI 3.7–6.3) in the STD clinics. Prevalence of hepatitis C infection among targeted STD clinic clients was significantly higher at 15.3% (95% CI 12.7–17.7). Risk factors that correlated with HCV infection after logistic regression included: injection drug use (OR = 10, 95% CI =  3.4–30.3), heroin use (OR = 6.6, 95% CI = 2.2–20.5), non-transfusion/ transplantation blood exposure (OR = 3.0, 95% CI = 1.3–6.9), sharing equipment to snort drugs (OR = 2.5, 95% CI 1.2–5.4), and age above 25 years (OR = 51, 95% CI = 9–47). This study demonstrates that targeting clients in STD clinics for known risk behaviours is an effective way to identify cases of HCV infection. STD clinics allow access to clients with both drug use and sexual risk behaviours and are a useful location for targeting hepatitis C screening and prevention efforts.     

Frequent detection of acute primary HIV infection in men in Malawi

BACKGROUND: Acute (antibody-negative) HIV infection is associated with high transmission potential but is rarely recognized. DESIGN: Cross-sectional study. METHODS: We examined the prevalence and predictors of acute HIV infection among 1361 consecutive male outpatients attending sexually transmitted disease (STD; n = 929) and dermatology (n = 432) clinics in Lilongwe, Malawi. Serum specimens negative for HIV antibodies were screened by HIV RNA PCR using a highly specific pooling/resolution testing algorithm. RESULTS: Five-hundred and fifty-three men (40.6%) were HIV antibody positive and 24 (1.8%) had acute HIV infection; 23 of 24 acutely infected men were from the STD clinic, where they represented 4.5% of all HIV antibody-negative men and 5.0% of all HIV infections. HIV RNA levels for acutely infected men were significantly higher [median (interquartile range), 6.10 (5.19-6.54) log10 HIV RNA copies/ml] than for 58 HIV antibody-positive men [4.42 (3.91-4.95) log10 copies/ml; P < 0.0001]. The factor most strongly associated with acute HIV infection was STD clinic attendance: (odds ratio, 15.2; 95% confidence interval, 2.04-113.0). In multivariate analysis considering only STD patients, factors associated with acute HIV infection included inguinal adenopathy, genital ulceration and age 24-26 years, the age stratum associated with peak incidence of HIV infection among Malawian men. CONCLUSIONS: Traditional HIV antibody tests alone are not sufficient to exclude HIV infection among men with acute STD in Malawi due to a surprising proportion of acute HIV infections in this population. Alternative screening methods are required for diagnosis of acute HIV infection; such screening could be important for research and for prevention of the sexual transmission of HIV in select populations.     

2008-2020年重庆市巴南区学生艾滋病病毒感染者和病人流行病学特征分析

目的分析巴南区92例学生HIV/AIDS病例的流行病学特征,为制定学生人群艾滋病防控策略提供依据。方法在中国疾病预防控制信息系统传染病监测子系统中的艾滋病防治基本信息模块中筛选出现住址为巴南区且职业为学生的HIV/AIDS病例的信息数据,采用描述性流行病学方法对其流行病学特征进行分析。结果巴南区92例学生HIV/AIDS病例中,男性90例、女性2例,报告时平均年龄为19.82±3.87岁,以20~岁组(52.17%)、汉族(97.83%)、大专及以上文化程度(81.52%)、现住址城区(80.90%)及区内户籍(52.17%)人群所占构成比最大。艾滋病自愿咨询检测(VCT)是学生病例发现的主要途径(48.91%);同性性传播是主要的感染方式(81.52%)。经性传播途径感染的学生,在最后一次高危性行为发生后10 d内来检测的占57.30%;在确诊后10 d内完成CD4+T淋巴细胞检测的占43.82%;首次CD4+T淋巴细胞检测结果>500个/μl的占24.72%,5例学生首次CD4+T淋巴细胞检测即被诊断为艾滋病;半年内开始抗病毒治疗的有69.66%。结论男男同性性传播是巴南区学生感染艾滋病的主要方式,已报告的学生病例存在抗病毒治疗开始时间晚的情况。应加强针对性防控措施的落实,尤其减少学生同性性传播艾滋病病例的发生。     

新疆性病门诊病人HIV感染情况调查

目的了解和掌握新疆经性途径感染艾滋病病毒(HIV)的现况,为制定预防与控制HIV性传播的对策提供依据。方法对新疆5个城市15个性病门诊就诊者,静脉采血3ml,进行HIV和RPR的检测,并由首诊医生负责完成行为调查表。结果共调查2 499例就诊者,发现HIV抗体阳性28例,感染率为1.12%;RPR阳性145例,阳性率为5.80%。其中男性HIV感染率0.97%,女性HIV感染率1.37%;汉族HIV阳性8例,感染率0.44%;RPR阳性66例,阳性率3.66%;维吾尔族HIV阳性20例,感染率3.49%;RPP阳性79例,阳性率13.79%。在212例梅毒患者中,HIV阳性4例,感染率为1.89%;420例淋病患者中HIV阳性10例,感染率为2.38%。行为学问卷调查发现,100%使用安全套者没有感染HIV,从未使用过安全套的有付钱性行为者HIV感染率最高为2.77%。结论性传播正在逐步成为新疆艾滋病传播的一种不可忽视的途径,有必要通过对高危人群进行血清学和行为学监测,以掌握流行情况,并采取必要的干预措施控制其进一步传播。     

Rapid HIV testing of clients of a mobile STD/HIV clinic

HIV rapid testing may enhance the effectiveness of a mobile HIV/sexually transmitted disease (STD) screening clinic in at-risk populations who normally do not seek care. Our goal was to determine the usability and post-test counseling rates of rapid HIV testing services for clients tested on a mobile clinic. HIV Oraquick rapid HIV-1 testing (OraSure Technologies, Inc., Bethlehem, PA) (blood) was offered to clients seeking HIV/STI counseling and testing services from the street at predetermined locations in areas of high STD morbidity, drug use, and commercial sex work. Rapid test results were available on the same day at the van within 10 minutes. Disease intervention specialists (DIS) attempted to locate and counsel positive clients who did not stay for results. By comparison, when offered at the same time, 64.5% of clients preferred Oraquick to traditional serologic testing. The post-test counseling rate for clients tested for Oraquick was 89% for infected and 93% for uninfected. By comparison, 11% of infected clients and 40% of uninfected clients tested for traditional test were post-test counseled. Clients who tested for the traditional enzyme immunoassay (EIA) test were told to return to the van in 14 days for results and post-test counseling. In the adjusted model, we also found statistically significant differences comparing clients who choose Oraquick to traditional serologic tests. These data suggest that rapid HIV testing services may enhance the effectiveness of mobile STD/HIV clinics.     

Post-HIV test counselling of clients of a mobile STD/HIV clinic

The objective of the study was to determine the post-test counselling (PTC) rates for HIV-infected and uninfected individuals receiving HIV counselling and testing on a mobile STD/HIV screening clinic and to determine whether individuals at highest risk for transmitting their infection were less likely to receive PTC than those at lower risk for transmitting. Clients presenting for HIV counselling and testing were asked about their demographic characteristics, clinical history, personal risk behaviours, and partner risk factors and told to return after 14 days for results. Disease intervention specialists (DIS) attempted to locate and counsel positive clients. The PTC rate among infected and uninfected clients was 66% and 46%, respectively. There were significant differences in demographics and risk factors for those who were post-test counselled versus those who were not. Among HIV-uninfected clients, there was a positive association between PTC and drug treatment in the past three months and having engaged in sex work within the last three months. Being female was negatively associated with PTC. Among HIV-infected clients, there was a positive association between PTC and current enrollment in drug treatment. These data suggest that mobile STD/HIV screening clinics may be limited in their effectiveness by low rates of PTC.     

STD screening among HIV-infected patients in care, San Francisco

The Centers for Disease Control and Prevention recommends sexually transmitted disease (STD) screening among human immunodeficiency virus (HIV)-infected persons as a means of HIV prevention. HIV-infected persons in care may be an important target group in which to conduct regular STD screening to prevent enhanced transmission of HIV. We conducted STD screening for syphilis and two causes of urethritis, chlamydia, and gonorrhea, among 447 HIV-infected persons at two busy, urban clinics in San Francisco: a general HIV acquired immune deficiency syndrome (AIDS) care clinic and a methadone maintenance clinic. There were no new cases of syphilis identified and only two prevalent cases of chlamydia. While STD screening was feasible and acceptable in this population, the benefits of screening for asymptomatic gonococcal and chlamydial infection remain to be determined. Because these two pathogens only cause about 20% of urethritis, broader screening tests for urethritis, e.g., leukocyte esterase or urine microscopy, may be more useful. Finally, this study reaffirms the notion that local data should be used to evaluate national screening recommendations.     

北京市朝阳区艾滋病自愿咨询检测情况分析

目的调查北京市朝阳区艾滋病自愿咨询检测（VCT）人群的社会人口学特征和艾滋病病毒（HIV）感染状况,有针对性地制定朝阳区艾滋病健康教育和高危干预措施。方法对2007年6月-2008年9月,朝阳区疾病预防控制中心艾滋病VCT门诊求询者的调查结果进行分析。结果868名求询者接受咨询和血清HIV抗体检测,以20～40岁男性青壮年为主,占89.9%;男女比例7.19∶1;未婚占68.9%。求询原因以发生危险性行为为主,占86.3%。HIV抗体阳性41例,感染率为4.7%,以性途径感染为主（75.6%）,22人通过同性性行为感染。结论朝阳区艾滋病的传播以性途径为主,求询者以年轻、未婚和高学历男性为主,HIV感染在男男性行为人群（MSM）中检出率较高。因此,应对男性青壮年、MSM人群进行广泛的艾滋病健康教育,加强针对MSM人群的行为干预措施。