云南省1989～2005年艾滋病流行分析

目的了解云南省不同地区、不同人群艾滋病流行特点和变化趋势。方法采用哨点监测、血清横断面调查和常规资料收集等方法进行血清学流行病学调查。采用Workbook模型对全省现存的艾滋病病毒(HIV)感染者人数进行估计。结果1989年首先在边境注射吸毒人群中发现HIV流行,截止2005年12月,全省共发现HIV感染者40 157例,分布于全省16个地州的128个县(市),其中有4个州(市)进入高度流行期,12个州(市)进入中度流行期,估计实际存活感染者人数为9.2万。近3年注射吸毒人群HIV平均感染率为18.3%~22.6%,5个地区注射吸毒人群HIV感染率≥40%;女性性工作者平均感染率为0~5.2%,嫖客平均感染率分别为0~1.8%,67%的县区发现女性性工作者中存在HIV流行;男性性病患者HIV平均感染率为1.7%~2.6%,孕妇HIV平均感染率2003~2005年分别上升到0.37%、0.38%和0.36%,献血员的HIV感染率持续上升,仅昆明市2005年献血员HIV感染率达到0.127%。结论云南省艾滋病疫情地区范围继续扩大,HIV感染途径正发生明显改变,处于从高危人群向一般人群广泛扩散的关键时期。

An analysis of epidemic of HIV/AIDS in Yunnan Province in 1989 ～2005

Objective To determine HIV prevalence and epidemic trend in different areas and different populations in Yunnan Province and estimate the number of PLWHA Methods Sentinel surveillance,special cross-section survey and case finding were used to determine HIV prevalence and epidemic trend.Workbook was used to calculate the number of PLWHA.Results The HIV prevalence was first found among injecting drug users in border areas in 1989.By the end of 2005,40,157 HIV cases were reported in 128 counties of 16 prefectures in Yunnnan province.By the end of 2005,4 prefectures entered generalized epidemic,and other 12 prefectures entered concentrated epidemic.During the past three years,the average prevalence ranged from 18.3% to 22.6% among IDUs,0% to 5.2% among underground prostitutes,0% to 1.8% among clients of underground prostitutes,67% of the total counties found HIV epidemic among underground prostitutes in 2004.1.7% to 2.6% among male STDs cases;the HIV prevalence among pregnant women,and increased to 0.37% in 2003 and 0.38% in 2004 and 0.36% in 2005,the HIV prevalence among blood donors was increasing to 0.127% in 2005.Conclusion The epidemic has been expanding to wider areas within the province,and is now at a critical stage of spreading from the risk population to the general population.