四川省艾滋病异性性传播表现形式分析

目的分析2015-2017年四川省报告的经异性性接触传播艾滋病病毒(HIV)感染者/艾滋病(AIDS)病例的流行特征及其表现形式,为艾滋病经异性接触传播的防控提供科学依据。方法在"中国疾病预防控制信息系统"中下载历史卡片,筛选出2015-2017年当年新报告的经异性性接触传播的HIV/AIDS病例,利用χ^2检验和Cochran-Armitage趋势检验进行统计分析。结果2015-2017年共报告经异性性接触传播的HIV/AIDS病例50570例,其中商业性性行为传播22973例(45.4%)、非婚非商业性性行为传播20902例(41.3%)、配偶/固定性伴间传播5047例(10.0%)、其他未分类传播1648例(3.3%);男性以商业性传播(62.2%)为主,女性以非婚非商业性传播(61.7%)为主;汉族以商业性传播(50.7%)为主,彝族(63.4%)、藏族(49.9%)以非婚非商业性传播为主;随年龄增加,商业性传播(Z=47.9,P<0.001)和配偶/固定性伴间传播(Z=5.8,P<0.001)比例增加,非婚非商业性传播(Z=-47.4,P<0.001)比例降低;随文化程度增加,商业性传播(Z=8.7,P<0.001)和非婚非商业性传播(Z=5.2,P<0.001)比例增加,配偶/固定性伴间传播(Z=-20.8,P<0.001)比例降低;四川省不同地区异性性接触传播表现形式不同,川东南的内江(61.3%)、泸州(60.5%)、自贡(57.7%)等以商业性传播为主,凉山(60.8%)、阿坝(59.8%)等少数民族聚集的地区以非婚非商业性传播为主;感染时间在3年以内的经异性性接触传播病例以非婚非商业性传播(46.0%)为主。结论四川省异性性接触传播HIV/AIDS病例以商业性性性行为传播为主,不同地区、人群的表现形式不同,应因地施策,把握地区传播特点,采取有针对性的防控策略,同时应关注非婚非商业性传播的防控。

Analysis on the Characteristics of AIDS With Heterosexual Transmission in Sichuan Province

Objective To analyze the epidemiological characteristics of heterosexual HIV/AIDS cases reported in Sichuan Province from 2015 to 2017,so as to provide scientific basis for the prevention and control of HIV/AIDS with heterosexual transmission.Methods The historical cards were downloaded from the China Disease Prevention and Control Information system to screen out the newly reported cases of HIV/AIDS transmitted by heterosexual contact in the year 2015-2017.The chi-square test and Cochran-Armitage trend test were used for statistical analysis.Results A total of 50570 cases of HIV/AIDS transmitted by heterosexual sexual contact was reported from 2015 to 2017,including 22973 cases(45.4%)of commercial heterosexual transmission(CHT),20902 cases(41.3%)of non-marital but non-commercial heterosexual transmission(NMNCHT),5047 cases(10.0%)of spousal or regular partners’transmission(SRPT)and 1648 cases(3.3%)of other non-classified transmission.The CHT(62.2%)was the main way for the male,whereas the NMNCHT(61.7%)was the main way for the female.In Han nationality,the main way was the CHT(50.7%),and the NMNCHT was the main way for Yi nationality(63.4%)and Tibetan nationality(49.9%).The rates of the CHT(Z=47.9,P<0.001)and the SPRT(Z=5.8,P<0.001)increased with age,while the rate of the NMNCHT(Z=-47.4,P<0.001)decreased with age.As the increase of education level,the proportion of the CHT(Z=8.7,P<0.001)and the NMNCHT(Z=5.2,P<0.001)rose,but the proportion of the SPRT(Z=-20.8,P<0.001)decreased.The forms of heterosexual sexual contact transmission showed differences in different regions of Sichuan Province.The CHT mainly occurred in Neijiang(61.3%),Luzhou(60.5%)and Zigong(57.7%)of southeastern Sichuan.In contrast,the NMNCHT was mainly occurred in Liangshan prefecture(60.8%)and Aba Prefecture(59.8%)where ethnic minorities gathered.The cases of heterosexual sexual contact transmission were mainly NMNCT(46.0%)from 2015 to 2017.Conclusion The cases of heterosexual sexual contact transmission of HIV/AIDS are mainly commercial sexual transmission in Sichuan Province,and the characteristics of different regions and groups varies.We need to take measures according to local conditions.Targeted prevention and control strategies should be implemented after getting a full understanding of the characteristics of regional transmission.Attention should also be paid to the prevention and control of non-marital and non-commercial sexual transmission.