某地HIV/AIDS者确诊后一年内高危性行为的改变及影响因素研究

目的 了解艾滋病病毒感染者/艾滋病患者（HIV/AIDS）确诊后一年内高危性行为变化情况及其影响因素。方法 从国家艾滋病综合防治数据信息管理系统下载2010年1月1日—2019年12月31日的相关资料，描述性行为发生率的变化趋势，采用广义估计方程（GEE）模型分析HIV/AIDS确诊后一年内高危性行为的相关因素。 结果 2 528例HIV/AIDS中，确诊前性行为发生率60.48%而确诊后一年内在57.09%～60.11%之间，女性（趋势χ2 = 5.417，P = 0.020）和未婚者（趋势χ2 = 6.684，P = 0.010）确诊后一年内的性行为发生率呈下降趋势，男性（趋势χ2 = 4.301，P = 0.038）、已婚（趋势χ2 = 4.061，P = 0.044）和ART者（趋势χ2 = 4.783，P = 0.029）的性行为发生率呈上升趋势。高危性行为发生率由61.61%下降至3.98%（趋势χ2 = 1 606.933，P＜0.001），多因素结果显示:已婚（OR = 2.374，95%CI:1.478～3.811）和未ART者（OR = 1.837，95%CI:1.431～2.358）更易发生高危性行为。性别和年龄亚组分析显示，已婚和未接受ART治疗与高危性行为的关联方向保持一致。 结论 HIV/AIDS确诊后一年内仍保持性活跃且存在高危性行为，仍具备二代传播、感染其他性传播疾病和不同HIV型别毒株或耐药毒株风险，应提供精准干预，促进HIV/AIDS坚持使用安全套。

Changes of the unprotected sexual behavior and its influencing factors among HIV/AIDS patients within one year after diagnosis

Objective To understand the changes of unprotected sexual behavior and its influencing factors among HIV/AIDS patients within one year after HIV/AIDS diagnosis. Methods All data were obtained from the National Comprehensive HIV/AIDS Prevention and Care Information System, between January 1, 2010 and December 31, 2019. The changing trends of patients with sexual behavior were described, and the generalized estimating equation (GEE) models were used to analysis influencing factors of unprotected sexual behavior among HIV/AIDS patients within one year after HIV/AIDS diagnosis. Results Among 2 528 HIV/AIDS cases, the prevalence of sexual behavior before diagnosis was 60.48% and within one year after diagnosis ranged from 57.09% to 60.11%, with a decreasing trend in the prevalence of sexual behavior within one year after diagnosis among females (trend χ2=5.417, P=0.020) and unmarried (trend χ2=6.684, P=0.010). Males (trend χ2= 4.301, P=0.038), married (trend χ2=4.061, P=0.044), and those who received antiretroviral therapy (ART) (trend χ2=4.783, P=0.029) showed an increasing trend in the incidence of sexual behavior. The incidence of high-risk sexual behavior decreased from 61.61% to 3.98% (trend χ2=1 606.933, P<0.001), and the multifactorial results showed that married (OR=2.374, 95%CI: 1.478-3.811) and those without ART(OR=1.837, 95%CI: 1.431-2.358) were more likely to have high-risk sexual behavior. Gender and age subgroup analyses showed that the direction of association between married and those without ART and high-risk sexual behaviors remained consistent. Conclusion People who remain sexually active and have high-risk sexual behavior within one year after HIV/AIDS diagnosis are still at risk for second-generation transmission, infection with other sexually transmitted diseases and different HIV type strains or drug-resistant strains, and should be provided with precise interventions to promote condom use adherence in HIV/AIDS.