云南省艾滋病高流行区农村留守妇女HIV感染状况及影响因素分析

目的 了解云南省艾滋病高流行区农村留守妇女HIV感染现况及其影响因素。方法 于2015年3-5月,对云南省艾滋病疫情较为严重的德宏州、临沧市的留守妇女进行横断面调查。采用概率比例规模抽样法抽取500名留守妇女,进行问卷调查和HIV抗体检测。结果 500名留守妇女HIV感染率为8.2%(41/500)。丈夫吸毒的留守妇女HIV感染率为22.7%(30/132),多因素logistic回归分析显示其HIV感染主要危险因素为:少数民族、初中以下文化水平、丧偶、现居临沧市、夫妻间未坚持使用安全套、丈夫为HIV感染者。本人和配偶均无吸毒行为的留守妇女HIV感染率为2.8%(10/363),多因素logistic回归分析显示其HIV感染主要危险因素为:年龄在30~40岁之间、少数民族、初中以下文水平、离异、现居住在德宏州、有多性伴行为、丈夫半年以上回家一次。本人吸毒但配偶未吸毒的留守妇女HIV感染率为20.0%(1/5)。结论 云南省艾滋病高流行区农村留守妇女HIV感染率较高,主要与丈夫吸毒感染HIV造成配偶间传播有关。此外,应关注留守妇女的多性伴行为,进一步加强禁毒和预防配偶间传播,特别加强对文化程度较低、少数民族和有多性伴行为留守妇女及其家庭的综合干预。

HIV prevalence and risk factors among left-behind women in high HIV epidemic rural areas of Yunnan province

Objective To understand the status of HIV infection and risk factors among those left-behind women(LBW) in high HIV epidemic rural areas.Methods A cross-sectional investigation was conducted between March and May, 2015 in Dehong and Lincang prefectures, Yunnan province, where HIV appeared highly epidemic.Probability Proportion to Size(PPS) sampling method was used, and 500 cases were involved and tested for HIV antibody.Results The total rate of HIV infection among LBW was 8.2%(41/500).The rate of HIV infection among LBWs whose husbands were on medication was 22.7%(30/132).Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection were:being minorities, education background lower than junior high school, widowed, living in Lincang prefecture, husband infected with HIV but did not consistently use condoms, etc.The rate of HIV infection among other LBWs was 2.8%(10/363).Data from Multi-factor logistic regression analysis showed that the risk factors of HIV infection would include:aged between 30-40 years, being minorities, education background lower than junior high school, divorced, living in Dehong prefecture, having had multiple-sex partners, husband coming home less than once a year, etc.The rate of HIV infection among drug users whose husbands did not take HIV medication was 20.0%(1/5).Conclusion HIV prevalence among LBWs in highly HIV epidemic areas was high, and the major risk factors related to their husbands were:being drug users or with HIV infected.Further effort should be made on consistently use of anti-HIV drugs and prevention of inter-marital sexual transmission.Comprehensive intervention should be carried out for LBWs who were having lower education background, being minority and having multiple-sex partners.