吸毒严重地区的暗娼HIV和梅毒新发感染及队列保持研究

目的 了解吸毒严重地区暗娼HIV和梅毒新发感染及队列保持情况。方法 2004年12月至2005年1月，在四川省西昌市以社区为基础招募343名暗娼开展前瞻性队列研究，在6个月随访时进行HIV和梅毒血清抗体检测，估算HIV和梅毒血清抗体阳转率，以及分析队列本底的社会人口学和高危行为特征与队列6个月保持率的关系。结果 暗娼队列6个月的HIV和梅毒血清抗体阳转率分别为1．00／100人年和6，23／100人年。队列6个月保持率为53．6％（184／343），在队列保持率影响因素的多因素logistic回归模型分析中，少数民族（OR=0．36，95％CI：0．18～0．74）、参加过艾滋病防治项目（OR：1，83，95％CI：1．17～2．86）、近6个月嫖客人数≥50人（OR=1．75，95％CI：1．11～2．77）和住所或工作场所变化（OR=0．56，95％CI：0．33～0．94）与6个月仍旧能随访的关系有统计学意义。结论 该地区有高的暗娼梅毒新发感染率和高危性行为，汉族、参加过艾滋病防治项目及住所或工作场所稳定的暗娼队列保持率高。

Incidence rates of human immunodeficiency virus and syphilis as well as the rate of retention in a 6-month follow-up study of female sex workers in areas with heavy drug use in Xichang of Sichuan province,China

OBJECTIVE: To investigate the human immunodeficiency virus (HIV) and syphilis incidence rates as well as the retention rate in a cohort with 6-month follow-up study among female sex workers (FSWs). METHODS: From December, 2004, to January, 2005, a community-based baseline survey was conducted to recruit 343 FSWs for a prospective cohort study in Xichang county of Sichuan province, China. Follow-up visits were conducted at 6 months to analyze risk factors associated with cohort retention for subjects' baseline sociodemographic and sexual behavioral characteristics. Blood specimens were also collected to test antibodies against HIV and syphilis. RESULTS: During the 6-month follow-up period, HIV and syphilis incidence appeared to be 1.00 per 100 person-years and 6.23 per 100 person-years, respectively. The rate of retention in the cohort was 53.6% (184/343). Results from multivariate logistic regression model showed that factors were significantly associated with cohort retention including people with minority ethnic background (OR = 0.36; 95% CI: 0.18-0.74), people having participated in AIDS prevention program (OR = 1.83; 95% CI: 1.17-2.86) or being clients in the last 6 months > or = 50 (OR = 1.75; 95% CI: 1.11-2.77) and having changed living/working place (OR = 0.56; 95% CI: 0.33-0.94). CONCLUSION: The results of this study showed that the syphilis incidence and unprotected sex behavior were high among local FSWs. People belonged to Han nationality, having participated in AIDS prevention program and having a steady living/working place were associated with cohort retention at 6-month follow-up study among FSWs, respectively.