甘肃省武威市2011-2013年暗娼HIV哨点监测分析

目的 了解2011-2013年甘肃省武威市暗娼（female sex workers，FSWs）人群艾滋病（acquired immunodeficiency syndrome，AIDS）知识知晓率、高危性行为及其影响因素，为武威市暗娼人群艾滋病行为干预提供依据。方法 2011-2013年，对武威市暗娼人群进行分层抽样调查，血清学检测人类免疫缺陷病毒（ human immunodeficiency virus，HIV）、丙型肝炎病毒（hepatitis C virus，HCV）和梅毒抗体。结果 3年共完成1 200人调查，艾滋病知识总体知晓率为89.8%（1 077/1 200）；2011-2013年监测人群的艾滋病知识知晓率分别是97.0%（388/400）、90.8%（363/400）、81.5%（326/400）（χ2=52.88，P<0.001）。2011-2013年，暗娼人群“最近1个月安全套坚持使用率”分别为93.0%（372/400）、83.0%（332/400）和75.0%（300/400）（χ2=47.61，P<0.001）。血清学监测未发现HIV阳性者，梅毒、HCV抗体阳性率分别是2.9%（35/1 200）和2.3%（27/1 200）。多因素Logistic回归分析发现，艾滋病知识的知晓、文化程度、娱乐场所等级、年龄、最近1年被诊断性病是影响暗娼“最近1个月每次商业行为都坚持使用安全套”的因素。结论 2011-2013武威市暗娼人群艾滋病知晓率和安全套坚持使用率有下降的趋势，武威市应将中、低档娱乐场所暗娼作为重点人群，强化艾滋病知识宣教和行为干预。

Sentinel surveillance among female sex workers in Wuwei City Gansu Province from 2011 to 2013

Objective To investigate the awareness of HIV/AIDS related knowledge, high-risk sexual behaviors and influencing factors among female sex workers (FSWs) in Wuwei city and to provide evidence for making intensive intervention policy for FSWs. Methods According to the national acquired immune deficiency syndrome (AIDS) sentinel surveillance protocol, questionnaire survey and serological detection were conducted among FSWs in Wuwei city from 2011 to 2013. Results Total 1 200 FSWs were included in the analysis and the awareness of HIV/AIDS related knowledge among FSWs was 89.8% (1 077/1 200). The awareness of HIV/AIDS related knowledge among FSWs from 2011 to 2013 were 97.0% (388/400),90.8% (363/400),81.5% (326/400) respectively (χ2=52.88,P<0.001). The rate of consistent condom use during the last month among FSWs in 2011-2013 were 93.0% (372/400), 83.0% (332/400) and 75.0% (300/400), respectively (χ2=47.61,P<0.001). No HIV positive cases were detected among FSWs. The positive rates of syphilis and anti-HCV were 2.9%(35/1 200) and 2.3%(27/1 200). Multivariate Logistic regression analysis showed that the awareness of HIV/AIDS related knowledge, education level, grade of sex trade sites, age and diagnosis of sexual transmission disease during last 12 months were associated with persist condom use in the last month among FSWs. Conclusion Compared to 2011, the rates of HIV/AIDS related knowledge awareness and consistent condom use in the last month among FSWs were decreased in 2013. More enhanced propaganda interventions should focus on FSWs in low and middle class sex trade sites in Wuwei city.