广西 50 岁及以上嫖客 HIV 感染现况及影响因素研究

目的了解广西50岁及以上嫖客人类免疫缺陷病毒（human immunodeficiency virus，HIV）感染现况，并探讨该人群HIV感染的影响因素。方法2012年10～12月，在广西贵港市和平南县针对50岁及以上嫖客开展横断面调查，调查内容包括一般人口学特征、性行为特征、艾滋病相关知识和血清学HIV及梅毒检测。结果共调查676人，HIV和梅毒感染率分别为2．8％和4．O％。在单因素分析中，嫖娼史、商业性行为时是否使用安全套、每次商业性行为平均价格、是否知道艾滋病自愿咨询检测门诊、是否做过艾滋病检测与HIV感染差异均有统计学意义（均有P〈0．10）。在多因素Logistic回归模型中，商业性行为时从未使用安全套（OR=4．756，95％C／：1．138—19．879）和做过艾滋病检测（OR=5．670，95％C／：1．981—16．223）是HW感染的危险因素。结论在艾滋病重点省份要加强开展面向普通人群的艾防宣传和面向低档女性性服务者（femalesexworkers，FSWs）的干预，以促进50岁及以上嫖客安全性行为，减少H1V传播。

HIV infection and associated factors among clients aged 50 years or older of female sex workers in Guangxi,China

Objective To assess the HIV prevalence and risk factors among clients aged 50 years or older of female sex workers （FSWs） in Guangxi. Methods A cross-sectional study was conducted from October to December, 2012 in Guigang City and Pingnan County. A questionnaire was used to collect demographic and commercial sexual behaviors in- formation and 5 ml blood specimen was collected for screening of HIV and syphilis among male clients aged 50 years or ol- der of FSWs. Results A total of 676 clients were recruited. Prevalence of HIV and syphilis was 2. 8% and 4.0% , re- spectively. Univariate analysis indicated that prostitution history, condom use in commercial sex, average cost per commer- cial sex, aware of voluntary counseling and testing and ever receiving HIV testing were significantly associated with HIV in- fection （ all P 〈 0. 10）. Multivariate logistic analysis identified that no use of condom in commercial sexual behaviors （ OR = 4. 756,95% CI：I. 138-19. 879）, and experienced HIV testing （OR =5. 670,95% CI：I. 981-16. 223） were risk factors of HIV infection . Conclusions Enhancing the dissemination of HIV/AIDS related knowledge to general population, and the prevention and control strategies towards low class female sex workers （FSWs）, is more likely to promote safe commercial sexual behaviors and lessen HIV infection among clients aged 50 years or older of FSWs.