应用EPP和Spectrum模型估计预测浙江省台州地区艾滋病疫情

目的 探讨运用艾滋病疫情估计和预测软件(EPP)及Spectrum模型估计与预测浙江省台州地区艾滋病疫情以及抗病毒治疗对疫情的影响.方法 以浙江省台州地区为研究现场,收集整理该地人口和社会信息以及艾滋病疫情数据,应用EPP、Spectrum模型拟合以估计和预测该地区艾滋病流行趋势,同时考察抗病毒治疗对疫情的潜在影响.结果 根据EPP和Spectrum模型估计,台州地区处于艾滋病低流行阶段,男男性行为人群和静脉注射毒品人群HIV感染率较高且增幅明显;2010年该地区现存活HIV感染者和艾滋病患者(HIV/AIDS)共计1773例(95％CI:1384 ～ 2449),HⅣ感染率为0.03％(95％CI:0.02％～0.04％);抗病毒治疗可降低HIV新发感染者数和艾滋病死亡数,但不影响人群总HIV感染率、现存HIV/AIDS数以及成年人抗病毒治疗需求数.结论 综合运用EPP和Spectrum模型可以估计预测台州地区艾滋病疫情,并发现抗病毒治疗有助于控制疫情,为其他艾滋病相对低流行地区的疫情评估提供参考.     

Workbook模型在武汉市艾滋病疫情估计中的应用

目的对2017年武汉市艾滋病疫情流行现状进行估计,为艾滋病防控决策提供依据。方法依据武汉市人口学数据、艾滋病流行病学资料,利用Workbook模型,对武汉市2017年艾滋病疫情流行现状进行估计,并用卡方检验比较疫情估计与病例报告数据中性别及传播途径构成差异。结果估计2017年武汉市现存活成年艾滋病病毒感染者(HIV)和艾滋病患者(AIDS)人数为6 008例,HIV总体感染为0.064%,估计检测发现比例为75.02%。现存活者中,同性途径传播4 017(66.86%)例,异性途径传播1 803(30.01%)例,注射毒品传播188(3.13%)例,估计上述不同传播途径病例检测发现比例分别为73.89%、78.81%和48.94%。结论武汉市艾滋病疫情仍处于低流行状态,但仍有近1/4的感染者尚未被发现。传播途径以同性传播为主,异性传播中配偶/固定性伴传播也占有一定比例。在下一步工作中,有必要探索和尝试更有效的艾滋病监测检测实践,特别是高危人群及其性伴的检测覆盖,以最大限度的早发现HIV/AIDS病例,降低二代传播的风险。     

2013-2019年大竹县艾滋病报告疫情特征分析

目的了解2013-2019年大竹县新报告HIV/AIDS病例的疫情特征,估算2019年底艾滋病现存活人数,为制定科学有效的防治措施提供依据。方法从中国艾滋病防治信息系统中下载2013-2019年报告的现住址为大竹县的HIV/AIDS病例的历史卡片,采用描述性流行病学方法综合分析大竹县2013-2019年艾滋病疫情特征。采用SPSS 21.0软件进行卡方检验,应用工作簿方法(Workbook)对5类高危人群及其配偶和非商业性异性性伴现存活HIV/AIDS病例数进行估计。结果 2013-2019年大竹县累计报告HIV/AIDS病例2 015例,其中男性(71.71%),50岁及以上(70.77%),农民占70.92%,文化程度以小学及以下为主(60.65%),已婚有配偶(57.22%),传播途径以异性性接触传播为主(92.95%)。2019年底大竹县估计现存活HIV/AIDS病例3 361例,艾滋病发现率为55.79%。其中吸毒人群(28.47%),嫖客(13.24%),男男性行为者(4.43%),暗娼(1.07%)。结论大竹县艾滋病以性传播为主,疫情得到了一定的控制,但总体艾滋病发现率较低。提示应加强高危人群的行为干预及检测发现力度,阻断艾滋病二代传播。     

福州市2009年艾滋病高危人群规模估计及疫情预测

艾滋病易感高危人群的特殊性、感染人群的隐匿性、社会歧视以及感染人群的健康意识普遍淡薄导致艾滋病病毒抗体检测率较低,使得HIV／AIDS病例报告数不能真实反映HIV／AIDS疫情状况,运用workbook进行HIV／AIDS疫情估计成为了解人群实际感染情况的重要手段。为估计福州市艾滋病各类高危人群规模和艾滋病病毒感染者人数,为艾滋病防治工作提供依据,2009年10月,我们利用现有资料,     

基于EPP-Spectrum模型的浙江省艾滋病疫情评估

目的应用EPP-Spectrum模型评估浙江省艾滋病疫情,为浙江省预防和控制艾滋病提供依据。方法收集浙江省各类艾滋病高危人群规模、艾滋病感染率监测数据、艾滋病抗病毒治疗和人口学信息等资料,采用EPP-Spectrum模型拟合各类人群艾滋病流行曲线,对浙江省艾滋病感染率、现存活病例数、新发感染和死亡情况等进行综合评估。结果截至2016年底,浙江省全人群艾滋病感染率为0.05%(95%CI:0.04%~0.06%)。现存活艾滋病病毒感染者和艾滋病患者(HIV/AIDS)27 542例(95%CI:24 564~31 187例),以性接触传播为主,同性性接触传播占46.94%,异性商业性行为传播占24.43%,非商业性行为(含配偶间)传播占25.29%。2016年HIV新发感染1 714例(95%CI:1 340~2 194例),新发感染例数2014—2016年基本持平,以性接触传播为主,同性性接触传播占47.55%,异性非商业性行为(含配偶间)传播构成呈上升趋势。2016年HIV/AIDS病例死亡642例(95%CI:476~896例),死亡人数呈缓慢增长后出现平台期。2012—2016年艾滋病检测发现和抗病毒治疗比例逐年上升,估计有57.70%的传染源得到控制。结论浙江省艾滋病感染人数缓慢增长,疫情总体处于低流行态势;以男男性行为、异性商业性行为和异性非商业性行为传播为主。     

Workbook模型在荆州市2019年艾滋病疫情及高危人群规模估计中的应用

目的了解荆州市高危人群规模,估计2019年荆州市存活HIV/AIDS人数,掌握艾滋病疫情的流行状况、变化趋势,为制定艾滋病防治决策、规划、评价防治效果提供重要参考依据。方法依据荆州市人口学数据、收集整理历年艾滋病病例报告、主要高危人群类型及感染率等资料,采用Workbook模型,对荆州市2019年高危人群规模、艾滋病疫情进行估计,并采用卡方检验来比较艾滋病疫情估计与实际病例报告中性别和传播途径构成的差异。结果估计2019年荆州市现存活成年艾滋病病毒感染者(HIV)和艾滋病患者(AIDS)人数为3 054例,HIV感染率为5.41/万,估计检测发现比例为68.50%。高危人群规模估计为76 594~178 036人,其中注射吸毒者1 240~6 776人,男男性行为人群为14 694~22 980人,暗娼数为6 740~13 480人,嫖客人数为53 920~134 800人。现存活者中,有异性途径传播1 766(57.83%)例,同性途径传播1 248(40.86%)例,注射毒品传播40(4.31%)例。结论荆州市艾滋病疫情持续控制在低流行水平,还有将近1/3的感染者没有被发现。传播途径以同性传播为主,异性传播中配偶/固定性伴传播也占有一定比例。在下一步工作中,需要扩大高危人群艾滋病抗体检测覆盖面,提高艾滋病感染者病人的告知和流调质量,有必要探索和尝试更有效方式督促感染者及时将感染状况告知其配偶或有性关系者并主动采取预防措施,降低传播的风险。     

淮安市2000-2009年艾滋病流行病学特征分析

截止2009年底,中国现存活艾滋病病毒感染者和病人约74万,中国艾滋病疫情处于总体低流行,特定人群和局部地区高流行态势。淮安市2000-2009年累计发现HIV/AIDS 135例,为了解淮安市HIV/AIDS流行特征,为开展艾滋病防治工作和制定干预措施提供依据,现对淮安市2000-2009年艾滋病疫情进行分析。     

某市艾滋病流行趋势分析

目的分析某市艾滋病病毒/艾滋病(HIV/AIDS)流行现状、特征、影响因素及趋势,为制定AIDS防治措施提供依据。方法对全市1995~2005年AIDS病人常规监测、高危人群哨点监测、流行病学调查及实验室的资料进行分析。结果自1995年发现首例艾滋病病人至2005年底,累计报告发现HIV抗体阳性者40例,其中现存活艾滋病病人4例,死亡11例。HIV感染者/AIDS病例主要以90年代有偿献血人员和近几年来自艾滋病高发地区的外来HIV阳性妇女为主要高危人群,并已有造成夫妻间和母婴传播病例。结论艾滋病流行速度已明显加快,除在高危人群中发现的人数在增加外,在一般人群中也存在着流行的可能,要加大预防控制措施的落实,防止艾滋病由高危人群向一般人群传播。     

大学生艾滋病知识和态度现况调查

截至2009年底,估计中国现存活艾滋病病毒感染者和艾滋病患者(HIV/AIDS)74万人,其中艾滋病患者10.5万人,中国艾滋病流行态势复杂疫情从高危人群向一般人群扩散[1]。性生理已成     

南昌市2007—2011年艾滋病疫情及流行趋势分析

目的 分析南昌市艾滋病流行趋势,为制定针对性艾滋病防治措施提供科学依据.方法 采用描述流行病学方法对南昌市HIV/AIDS病例进行分析.结果 自1994年以来南昌市累计发现艾滋病病毒感染者866例,其中AIDS病人442例,报告死亡312例,累计现存活554例;男女发病比为4.25∶1;以20～59岁青壮年为主;≥60岁的感染人数逐年上升,累计到2011年底,占22.63％;感染途径多样,主要为性接触传播,占71.83％.结论 南昌市HIV/AIDS流行呈快速增长趋势,从高危人群向一般人群蔓延趋势明显,性接触传播成为主要传播方式,老年人感染艾滋病的比例逐年增高,必须采取有效的综合防治措施,提高其安全性意识.     

Role of the priority national health project in implementing HIV epidemic control strategy in the Russian Federation

According to the data of the UN AIDS control program, the estimated number of persons living with HIV infection worldwide is close to 36 million. There is only one way to reduce HIV infection treatment and care costs; this is to develop large-scale HIV prevention programs. The geography of the HIV infection epidemic is inhomogeneous; about 70% of the absolute number of all notified HIV cases are concentrated in 15 subjects of Russia; bulk of them are industrially developed high-income areas. The laboratory base of AIDS prevention and control centers has been drastically renewed; about 400 units of up-to-date laboratory equipment have been purchased. The problem of preventing the prevalence of HIV infection is being primarily solved within the framework of the priority national project. The programs to prevent HIV infection among particularly vulnerable population groups have been elaborated with regard to the realities and specific features of development of the epidemic of HIV infection.     

Risk and vulnerability reduction in the HIV / AIDS pandemic

An estimated 13.2 million men, 10 million women, and 2.7 million children worldwide have been infected with HIV since the beginning of the pandemic, and more than 10,000 people daily acquire HIV infection. 67% and 19% of these infections have occurred in sub-Saharan Africa and Southeast Asia, respectively. Even though the annual number of new HIV infections appears to have reached a plateau in Western Europe and the Caribbean and may be approaching one in sub-Saharan Africa, and the rise of new infection seems to be on the decline in North America, Oceania, and the southeastern Mediterranean, the HIV/AIDS pandemic has not been controlled anywhere in the world and its major impact has yet to come. Prevention activities undertaken by individuals, communities, nations, and international bodies have shown that the spread of HIV can be effectively reduced. Public health interventions against HIV/AIDS emphasize risk reduction strategies through the provision of HIV/AIDS-related information about safe behavior and the promotion of prevention methods. Exclusive reliance upon risk reduction strategies, however, fails to address the contextual issues in which the pandemic is rooted. In order to significantly affect the pandemic, short-term risk reduction interventions must be expanded considerably, adapted to local needs, and replicated worldwide. An expanded response to the pandemic also calls for medium- and long-term risk reduction interventions, including the linking of HIV/AIDS prevention, care, and support work with other actions in the health and social sector, and the remodeling of services to respond more effectively to growing needs. Until recently, such interventions have been neglected or misconstrued as the process of spreading thinly and irresponsibly HIV/AIDS actions within health and social programs. The sustainability and eventual success of HIV prevention will depend upon the capacity of health systems to integrate HIV/AIDS-related activities with other initiatives, while retaining the ability to track the epidemic and account for what is done about it. The influence of contextual factors on vulnerability to HIV/AIDS is discussed.     

山东省艾滋病高危人群规模估计及疫情预测

[目的]估计山东省艾滋病各类高危人群的规模，预测艾滋病病毒（HIV）感染者人数，为艾滋病防治工作提供依据。[方法]依据山东省艾滋病病例报告、哨点监测、艾滋病专题调查等获得的数据，参考有关资料，运用Workbook估计法，估计山东省各市艾滋病高危人群基数，预测艾滋病疫情。[结果]估计山东省现有HIV高危险人群1023770～1864181人；预测山东省现有艾滋病感染者7077人。[结论]山东省目前仍处于艾滋病低流行状态，但流行形势并不乐观。     

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.     

广州市艾滋病流行状况与控制策略分析

目的 分析广州市艾滋病流行和防治现状,探讨对策。方法 对１９８６~２０００年广州市艾滋病监测结果和防治情况进行分析。结果１９８６年广州市报告首例国外输入的ＨＩＶ感染者,１９９１年报告首例ＡＩＤＳ病人,至２０００年底累计报告ＨＩＶ感染者４０６例,在广州死亡２９例,其中ＡＩＤＳ病人６８例,在广州死亡２５例。流行经历了传入期(１９８６~１９８９年)、扩散期(１９９０~１９９４年)和快速增长期(１９９５~２０００年),分别发现ＨＩＶ感染者４例、２４例和３７８例。流行特征是ＨＩＶ感染者主要以男性(８６．９５%)、２０~４９岁中青年(９１．８７%)为主;传播途径主要以静脉吸毒为主,占５７．６４%,性传播途径占２３．１５%,尚未发现母婴传播。结论 广州市ＨＩＶ广泛流行,形势严峻。今后防治对策应加强领导,多部门合作,全社会参与,继续加强艾滋病监测和预防控制网络建设,加紧实施以宣传教育为主的艾滋病综合性预防策略。     

Epidemiology of HIV and sexually transmitted infections in Thailand

There are very few developing countries in the world where public policy has been effective in preventing the spread of HIV/AIDS on a national scale. Thailand is an exception, a massive program to control HIV has reduced visits to commercial sex workers by half, raised condom usage, decreased sexually transmitted infections dramatically, and achieved substantial reductions in new HIV infections. However, unless past efforts are sustained and new sources of infection are addressed, the striking achievements made in controlling the epidemic could be put at risk. There is a need in Thailand to continue strong HIV/AIDS prevention and education efforts in the future, as well as to provide treatment and care for those living with HIV/AIDS.     

流动人口艾滋病流行及其危险因素

随着我国经济的高速发展,流动人口的数量和规模的日益增长,估计约有1.2～1.3亿人由农村流向城市务工,流动人口在艾滋病的传播与流行中所起的作用越来越受到重视。目前,流动人口已被视为艾滋病感染和传播的脆弱人群和桥梁人群,促进艾滋病从高危人群像一般人群扩散。作者主要对流动人口艾滋病流行情况,以及影响艾滋病流行的危险因素进行综述,为开展有针对性的预防控制措施提供依据,从而控制艾滋病在流动人口中的传播。     

Modelling HIV/AIDS epidemics in sub-Saharan Africa using seroprevalence data from antenatal clinics

OBJECTIVE: To improve the methodological basis for modelling the HIV/AIDS epidemics in adults in sub-Saharan Africa, with examples from Botswana, Central African Republic, Ethiopia, and Zimbabwe. Understanding the magnitude and trajectory of the HIV/AIDS epidemic is essential for planning and evaluating control strategies. METHODS: Previous mathematical models were developed to estimate epidemic trends based on sentinel surveillance data from pregnant women. In this project, we have extended these models in order to take full advantage of the available data. We developed a maximum likelihood approach for the estimation of model parameters and used numerical simulation methods to compute uncertainty intervals around the estimates. FINDINGS: In the four countries analysed, there were an estimated half a million new adult HIV infections in 1999 (range: 260 to 960 thousand), 4.7 million prevalent infections (range: 3.0 to 6.6 million), and 370 thousand adult deaths from AIDS (range: 266 to 492 thousand). CONCLUSION: While this project addresses some of the limitations of previous modelling efforts, an important research agenda remains, including the need to clarify the relationship between sentinel data from pregnant women and the epidemiology of HIV and AIDS in the general population.     

Going beyond "ABC" to include "GEM": critical reflections on progress in the HIV/AIDS epidemic

A considerable number of studies have sought to identify what factors accounted for substantial reductions in HIV seroprevalence after several countries deployed "ABC" (abstinence, be faithful, condom use) strategies. After much public discourse and research on ABC success stories, the Joint United Nations Programme on HIV/AIDS 2004 epidemic report indicated that nearly 50% of infected people worldwide were women, up from 35% in 1985. In light of the feminization of HIV/AIDS, we critically assess the limitations of ABC strategies. We provide 3 additional prevention strategies that focus on gender relations, economics, and migration (GEM) and can speak to the new face of the epidemic. Pressing beyond ABC, GEM strategies provide the basis for a stronger central platform from which national efforts against HIV/AIDS can proceed to reduce transmission risks.