广东省艾滋病防治策略分析

目的 了解广东省当前艾滋病防治策略及措施对防治工作方向的指导作用，为适时、有效的防治策略的制定与调整提供依据。方法 回顾性分析自开展艾滋病防治工作以来的历史文献、监测资料和机构发展情况及其相互关系。结果 全省监测网络基本形成，监测系统趋于完善；截至2002年11月底，广东省累计报告HIV感染者3640例，艾滋病患者139例；传播途径的构成中尽管仍以注射吸毒为主(75．7％)，但经性途径感染的比例已开始增加，2002年达4.2％;吸毒、暗娼等高危人群人数持续增加及其危险行为发生率较高。结论 广东省艾滋病流行日趋严重，HIV已经开始从吸毒人群再次进入性乱人群；尽可能地利用和开发政策支持，及时调整防治策略，动员全社会全面开展大范围宣传教育、行为干预活动，积极推广降低危害项目已刻不容缓。     

沈阳市2006-2012年艾滋病疫情分析

目的了解沈阳市2006-2012年艾滋病流行病学特征,为制定HIV/AIDS预防和控制策略提供科学依据。方法对2006-2012年艾滋病疫情报告和流行病学调查资料进行统计分析。结果沈阳市2006-2012年累计报告HIV/AIDS 1 871例,男女比例为11.1:1,高发年龄为20~49岁青壮年,占79.9%,未婚占53.5%,大专及以上文化程度占38.6%;感染途径以性传播为主,占91.9%,男男同性传播占70.5%。结论沈阳市的艾滋病疫情呈上升趋势,应加大监测力度,加强对男男同性恋等高危人群行为干预措施的力度,以控制沈阳市艾滋病传播与流行。     

中国1995-2009年吸毒者艾滋病毒感染和梅毒流行趋势分析

目的 了解中国不同地区吸毒者艾滋病和梅毒流行特点和变化趋势.方法 收集1995年以来中国艾滋病监测系统病例报告、哨点监测和疫情估计信息,分析吸毒者艾滋病病例报告数量与分布变化情况,吸毒者HIV和梅毒感染率变化趋势以及吸毒行为的变化情况.结果 中国吸毒者规模在过去6年中基本保持稳定,艾滋病病例报告中吸毒者所占比例逐年下降,从2005年之前的44.2%下降到2009年的25.8%.2009年哨点监测数据显示,中国吸毒者HIV和梅毒感染率差异较大,西南地区高东北地区低的态势较为明显.2009年吸毒者哨点HIV抗体平均检出率为6.2%,梅毒为3.7%;注射吸毒者HIV平均感染率为9.2%,梅毒为4.0%.多年监测结果显示,1995-1999年为全国吸毒人群HIV感染的快速增长期,2000年之后注射吸毒者流行进入平台期,最近3年HIV抗体检出率维持在9.0%～10.0%、梅毒检出率在3.5%～4.5%之间波动.结论 在未来一段时期内吸毒行为仍是中国艾滋病流行的重要影响因素;应根据区域流行特点有针对性地制定艾滋病防治措施.     

HIV/AIDS surveillance and prevention: improving the characterization of HIV transmission

By focusing on the most probable mode of exposure, HIV/AIDS surveillance systems have historically been largely effective at describing how HIV is acquired in the United States. However, this analysis demonstrates that the use of the current Centers for Disease Control and Prevention (CDC) risk hierarchy may be inadequate to describe recent trends in HIV acquisition by women, who continue to make up a greater number and proportion of new cases of HIV infection and AIDS both in Michigan and nationally. The authors suggest two changes to the current risk hierarchy to increase the accuracy of describing HIV acquisition: (1). a dual injecting drug users/heterosexual category; and (2). a presumed heterosexual category. They also propose that currently collected information be more thoroughly analyzed to better describe subsequent transmission from HIV infected men to their uninfected female sex partners.     

中国特色的艾滋病防治策略

本文回顾了35年来我国艾滋病防治事业在三个方面的主要发展成就以及陆续出台的重大防治政策、法律、法规及其对艾滋病防治工作的影响。本文介绍了艾滋病防治队伍建立、发展与完善的过程,展示了疫情监测、感染者管理和治疗、高危人群预防干预等主要防治成就,分析了当前防治工作面临的挑战并提出了建议。     

An age- and sex-structured HIV epidemiological model: features and applications.

An important challenge in modelling the human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) epidemic is to use the increasing quantity of disease surveillance data to validate estimates and forecasts. Presented is a novel model for forecasting HIV incidence by age and sex and among sentinel groups for which data are available. This approach permits a closer relationship between forecasting and surveillance activities, and more accurate estimates validated to data. As inputs the model uses an estimate of the HIV prevalence, country demographic data, and a profile of the sexual risk of HIV infection by age, to project HIV incidence, prevalence, number of AIDS cases and population. The following examples of the use of the model are given: forecasting HIV incidence in East Africa, by age, sex, and among pregnant women; 3-5-year forecasts of HIV incidence; modelling mixed risk behaviour HIV epidemics in South-east Asia; demographic indicators; and targeting a preventive vaccine by age group.     

九江市艾滋病流行现状与预防对策探讨

目的分析九江市HIV/AIDS流行现状、特征和趋势,为制定防治策略提供依据。方法对全市历年来流行病学调查和随访资料、监测哨点资料、特殊人群筛查和相关研究资料进行分析。结果自1998年发现首例艾滋病病毒感染者以来,到2006年10月已累计报告47例,其中艾滋病病人14人,死亡7人。以性传播为主要传播途径,并已出现母婴传播病例,HIV/1B亚型是主要流行株。结论近年来,AIDS流行速度明显加快,在外出打工农民工中存在流行危险,应采取有效健康教育和行为干预措施预防HIV在该人群的流行。     

青岛市2010-2014年新报告艾滋病病毒感染者/艾滋病患者病例特征分析

目的 分析青岛市2010-2014年历年新报告艾滋病病毒感染者/艾滋病患者(HIV/AIDS)病例流行病学特征,为青岛市有针对性开展艾滋病防控工作提供科学依据。方法 通过"艾滋病综合防治信息系统"收集青岛市2010-2014年HIV/AIDS报告病例及哨点监测资料,利用SPSS软件进行统计学分析。结果 2010-2014年,青岛市新报告HIV/AIDS病例数呈逐年增长趋势;男女性别比为10.8:1,20~39岁年龄组病例占77.1%;65.6%为未婚者;高中及以上文化程度者占67.6%;同性性传播为主要传播途径;MSM感染率呈逐年上升趋势(P<0.05)。结论 MSM人群为青岛市艾滋病流行的主要高危人群,同时需要加强对女性性乱人群的监测检测,开展有针对性的防控工作,探索适合的防控模式,有效遏制艾滋病在青岛市的传播和流行。     

Surveillance for the HIV infected

This article describes the efforts at early surveillance of HIV infection in India and calls for continued sentinel surveillance. The fact that Asia was the last continent to be affected by the AIDS has granted India an opportunity to contain the epidemic at an early stage. Seizing this opportunity, the Indian Council of Medical Research (ICMR) began an national serosurveillance program for the detection of HIV infection. This surveillance program has given health officials an idea as to the magnitude and major mode to transmission of HIV while the epidemic is still at an early stage. The 1st phase of the program began on October 1985 with the screening of 3027 people from high risk groups; 10 prostitutes were found to be infected with HIV. The 1st AIDS case was detected in May 1986. That same year, ICMR moved on to phase II, a national serosurveillance and clinical surveillance designed to gather information concerning the prevalence and major mode of transmission. The 2nd phase, which ended on October 1987, screened a total of 53,907 persons. 135 HIV and 14 AIDS cases were reported, indicating a low rate of infection even among high risk groups. The 3rd phase began in November 1987 and ended on October 1988. 109,632 individuals were screened, and 387 seropositive and 11 AIDS cases were detected. In 1990, a screening drug users in the state of Manipur showed an extremely high rate of infection. Drug users now compose the 2nd largest high- risk group after promiscuous heterosexuals. The surveillance findings have resulted in intervention measures, but sustained sentinel surveillance will be needed to provide midcourse corrections for ongoing intervention programs.     

山东省2003～2005年艾滋病确认实验室检测指标分析

目的：分析山东省艾滋病实验室检测的有关指标及相关资料，为艾滋病防治提供依据。方法：采用EXECL数据库和SPSS11．5统计软件对山东省21303～21305年艾滋病实验室检测数据和网络直报个案资料进行整理、分析。结果：21303～21305年我省累计报告艾滋病病毒（HIV）感染者703例，其中外来人员376例，占总数的53．5％。结论：应进一步加强艾滋病检测实验室网络建设，积极组织有针对性的HIV抗体专项调查工作，尤其是加强对流动人口、外来妇女的监测，尽快发现HIV感染者，有效遏制艾滋病的传播。     

HIV behavioral surveillance in the U.S.: a conceptual framework

This article describes a conceptual framework for HIV behavioral surveillance in the United States. The framework includes types of behaviors to monitor, such as risk behaviors, HIV testing behaviors, adherence to HIV treatment, and care-seeking for HIV/AIDS. The framework also describes the population groups in which specific behaviors should be monitored. Because the framework is multifaceted in terms of behaviors and populations, behavioral data from multiple surveillance systems are integrated to achieve HIV behavioral surveillance program objectives. Defining surveillance activities more broadly to include behavioral surveillance in multiple populations will provide more comprehensive data for prevention planning, and lead to a more effective response to HIV/AIDS in the United States.     

Reporting of newly diagnosed HIV infections in Catalonia, Barcelona, Spain. Implementation and results

OBJECTIVES: To describe newly diagnosed HIV infections from the HIV Reporting System in Catalonia (2001-2003), and to compare the characteristics of the epidemic based on the use of the HIV Reporting System and the Catalonian AIDS Registry versus those based on the Catalonian AIDS Registry alone. METHODS: Data were collected from newly diagnosed HIV infections and AIDS cases between 2001 and 2003 in Catalonia. RESULTS: Among the newly diagnosed HIV infections (1,765) the most frequent route of HIV infection was heterosexual transmission (46.8%), followed by men who had sex with men (26.7%), and injecting drug use (19.9%). Out of the 1,210 AIDS cases, the most common route of HIV transmission was injecting drug used (42.2%), followed by (heterosexual transmission 34.5%) and MSM (18.0%). Comparison of routes of HIV transmission in the two reporting systems (HIV/AIDS versus AIDS) revealed statistically significant differences. CONCLUSIONS: The HIV/AIDS Reporting System based on reporting of newly diagnosed HIV infections is feasible, since it has been useful in achieving the objectives of epidemiological HIV infection surveillance. It also provides more accurate information than does the AIDS Registry, which can be used to describe recent patterns of HIV transmission. The completeness of the new reporting system may be enhanced by including the diagnosis of HIV infection among the diseases of mandatory notification.     

河北省某市艾滋病流行特征分析

目的分析某市艾滋病病毒／艾滋病（HIV/AIDS）流行现状、特征及趋势。方法依据该市1989—2006年AIDS常规监测、高危人群哨点监测，流行病学调查及实验室资料，建立数据库并进行综合分析。结果自1989年发现首例HIV感染者至2006年底，累计发现HIV抗体阳性者240例，其中AIDS病人60例，死亡82例。HIV感染者／AIDS病例主要分布在沙河市。从市外既往有偿供血者传人为主转向境内蔓延扩散，经可疑受血感染是该市HIV传播的主要途径，青壮年女性感染率较高。HIV～1型B’亚型、CRF—BC重组株是该市主要流行株。结论该市艾滋病呈低流行状态，局部地区呈聚集性升高，经可疑受血传播HIV已被阻断。     

1996年～2006年连云港市艾滋病流行特征分析及控制策略

目的:了解连云港市艾滋病流行特征与规律,探讨防治对策与措施。方法:收集1996年~2006年连云港市艾滋病毒感染者/艾滋病(HIV/AIDS)流行病学资料进行统计分析。结果:连云港市的HIV/AIDS的流行时间晚于全国平均水平,但快速增长的势头日趋明显;三种传播途径并存,82.14%的AIDS感染者年龄集中在20~39岁之间人群,以农民(28.57%)和流动人口(32.14%)为主。结论:应加大农村和流动人口的艾滋病宣传教育工作,同时对高危人群采取有针对性的干预措施,防止疫情从高危人群向一般人群传播。     

Epidemiological environment and response to the HIV epidemic in Bolivia]

With AIDS/HIV, early detection is of key importance to public health, as well as disseminating prevention information and providing timely and appropriate treatment. In Bolivia, at the end of 2006 approximately 50% had AIDS at the time of diagnosis, detection having occurred late in the illness. The HIV/AIDS epidemic in Bolivia is concentrated, with prevalence rates over 5% among the at-risk population, primarily men who have sex with men. From January 1984 through October 2006, the total number of HIV/AIDS cases reported in Bolivia rose to 2 190, with 1 239 HIV and 951 AIDS cases, and underreporting estimated to be over 70% country-wide. The United National Joint Program on AIDS (UNAIDS) estimated that by the end of 2006 there would be 6 700 people living with HIV/AIDS in Bolivia. In the context of this scenario, the article describes the challenges facing the HIV/AIDS program and the strategies developed to address the epidemic in Bolivia. In addition, the UNAIDS/PAHO strategies are stressed and must get underway for HIV/AIDS prevention and control activities in the country.     

成都市HIV/AIDS疫情监测分析

目的 了解流行现状,明确防制工作重点,为防控提供依据.方法 收集成都市1992-2006年HIV/AIDS病例报告、流行病学个案调查表,以及哨点监测、专题调查等资料进行统计分析.结果 成都市1992-2006年累计报告HIV/AIDS 1 319例,年平均报告增长速度为46.92%.近2年共监测各类人群399 318人次,检出率为0.23%.以静脉注射吸毒传播为主(43.97%),性接触感染逐年上升.流动人口是潜在的危险因素.结论 成都市艾滋病流行快速增长,存在多种潜在危险因素.应采取强有力的防制措施,不断完善监测系统,加大开展高危行为干预,加强流动人口防治,控制进一步流行.     

对国境口岸艾滋病监测应有策略的商榷

目的对口岸艾滋病监测的现状进行分析,探索切实可行的口岸艾滋病监测策略。方法借鉴国内外艾滋病监测的先进经验,结合国境口岸艾滋病监测工作的实际,建立适合国境口岸的艾滋病综合监测系统。结果在现有口岸艾滋病监测的基础上,将生物学和行为学监测相结合,将艾滋病监测和其它相关疾病的监测相结合,调整监测策略,整合有效资源,将有利于改变长期以来口岸艾滋病监测工作的被动局面。结论口岸艾滋病监测工作任重而道远,出入境检验检疫部门要认识到目前口岸艾滋病监测工作的问题和不足,及时调整监测策略,确保口岸艾滋病监测工作顺利进行。     

Availability of indicators of migration in the surveillance of HIV, tuberculosis and hepatitis B in the European Union – a short note

Background and aim

Data regarding infectious diseases in migrant populations in Europe are scarce. We aimed to assess whether information on migration status is collected in countries of the European Union (EU) as part of their national surveillance systems for major infectious diseases (HIV/AIDS, tuberculosis (TB) and hepatitis B infection).

Methods

Using different electronic sources we collected information about whether indicators of migration status were collected in national infectious diseases surveillance systems in European countries.

Results

Of 27 EU countries, migration status was recorded in all 27 countries for TB surveillance (100%), in 22 countries for HIV (~82%) and in 23 countries for AIDS (~85%). Eight of 20 countries (40%) recorded migration status in hepatitis B surveillance systems. The most commonly recorded indicator of migration status was country of birth. Among countries which conducted migrant specific surveillance, country of birth was collected in ~82% of TB, ~86% of HIV, and ~83% of AIDS surveillance systems. Other indicators of the migration status were ethnicity (used in HIV and AIDS surveillance) and citizenship (TB surveillance).

Conclusion

We showed differences in how migration status is recorded in surveillance systems from European countries. This was especially true for tuberculoses and hepatitis B, whereas data collection as part of HIV/AIDS surveillance was nearly uniform. These results suggest the need for a more uniform reporting of migration status as part of infectious disease surveillance in EU countries.     

中国2006--2010年男男性行为者艾滋病疫情分析

目的 分析2006-2010年中国男男性行为者(MSM)的艾滋病疫情特征.方法 分析2006-2010年中国艾滋病病例报告系统中男男性传播病例的三间分布(时间、人群、地区)及哨点监测系统中MSM的HIV抗体检出率及安全套使用率.结果 艾滋病病例报告系统显示,2006-2010年男男性传播病例构成比从1.5％增长到10.8％,是增长最快的传播途径.与其他传播途径相比,男男性传播HIV/AIDS病例具有以下明显的特征:15～29岁为主(54.6％)、文化程度较高(具有高中及以上学历者占69.8％)、未婚为主(64.8％)、干部/教师/医生离退休人员(14.3％)及学生(7.9％)等职业占相当高的比例、流动性强(流动人口占36.2％)、城市为主(城市人口占72.6％)、专题调查(26.7％)及无偿献血(6.4％)检出比例较高.地区分布差异大,主要分布在北京、四川、广东、重庆、江苏、辽宁、上海和浙江等经济发达地区的大中城市.哨点监测系统显示,2006-2010年中国MSM的HIV抗体阳性检出率(中位数)为3.4％,最近一次安全套使用率(中位数)为73.2％.结论2006-2010年中国男男性传播艾滋病报告病例构成比增长快速,哨点监测发现MSM感染率较高,安全套使用率较低,表明MSM艾滋病流行严重且呈明显上升趋势,其中以15～29岁青年学生及无偿献血人员感染为主.     

The potential contribution of small-scale intervention projects in the field to the national health information system for HIV and sexually transmitted infections: a case study of a multilevel intervention in Guatemala

Objective  

Guatemala’s efforts to fight sexually transmitted infections and HIV/AIDS are compromised by the lack of timely and accurate data. The strengthening of the national Monitoring and Evaluation system is key for a better understanding of the epidemics and the formulation of effective public health responses. This study assessed how health service providers in resource-poor countries can contribute indicators to national health authorities.