河南省2011年报告性途径感染HIV者的流行病学特征分析

目的了解河南省经性途径感染艾滋病病毒（HIV）者的社会人口学特征与行为特征,评估二代传播的危险性。方法采用回顾性横断面调查方法,对河南省2011年报告的经性途径感染HIV的病人进行问卷调查。结果婚内性传播以女性为主,婚外性传播以男性为主。婚外性传播病例中,男性平均年龄显著高于女性。68.0％的婚外性传播病例曾发生过异性商业性行为,平均异性商业性伴数为3个,坚持每次使用安全套的比例为0.7％（4／578）。90.6％（260／287）的同性性传播病例有同性非商业性行为,坚持每次使用全套的比例为5.1％（13／257）。结论河南省经性途径感染HIV的病人普遍存在造成二代传播的高危行为,采取有针对性的防治措施可以有效控制艾滋病的进一步蔓延。     

2000名女性性工作者艾滋病易感性分析

<正>性传播途径现已成为艾滋病的最主要传播方式~([1])。女性性工作者(FSW)是艾滋病病毒(HIV)感染的高危人群~([2]),在艾滋病的传播过程中是重要的中间环节~([3])。为准确掌握FSW的艾滋病相关知识行为情况,掌握该人群艾滋病相关疾病的发病情况,2011-2015年间,对宁波市镇海区FSW开展哨点监测,现将结果分析如下。1对象与方法1.1对象在镇海区从事商业性性交易的女性。1.2方法 1)将发生高危行为的场所依据人均消费水平分为高、中、低三个层次。低等层次场所FSW不得低于监测样本量的10%,中等层次场所的FSW     

西部地区50个县（区）不同活动场所暗娼人群艾滋病行为学监测结果分析

目的了解我国西部地区50个县（区）不同活动场所暗娼（FSW）人群的艾滋病病毒（HIV）抗体阳性检出率和行为学指标情况。方法通过高危人群规模估计,对不同场所内FSW人群进行分层随机抽样和一对一问卷调查,收集高危行为信息,检测血清HIV抗体。结果 15 526名调查对象中,第一类来自宾馆、酒店、桑拿、洗浴中心、夜总会、卡拉OK厅、歌舞厅、酒吧等,占48.04%;第二类来自洗脚屋、发廊、路边店、小饭店和街头站桩,占51.96%。年龄20～29岁者占60.96%;初中以下文化程度占83.77%。第二类FSW人群最近一次性交易时安全套使用率（68.9%）,最近一个月性交易时安全套使用率（37.07%）,艾滋病知识知晓率（17.53%）,最近一年接受预防服务率（67.31%）,均低于第一类。FSW人群HIV阳性率为1.58%。结论 FSW人群中艾滋病知识知晓率较低,存在商业性行为中不使用安全套等高危行为,尤其是在街头等第二类场所中的FSW,是监测和干预工作的重点人群。     

2010-2011年浦东新区高危人群艾滋病和梅毒的监测分析

目的通过对高危人群的监测,了解艾滋病、性病的流行现状及传播途径,为控制艾滋病及梅毒的传播与蔓延提供现实依据。方法对2010-2011年的五类高危人群的血液样本进行抗-HIV、抗-TP的血清学监测,并对不同人群的监测结果进行比较分析。结果 HIV感染率在自愿咨询检测(VCT)人群中最高,暗娼(FSW)人群中最低;梅毒螺旋体(TP)感染率在性病(STD)门诊人群中最高,VCT人群中最低。2010～2011年,HIV及TP感染率在VCT同性性传播人群分别为10.7%、12.7%及4.13%、7.75%;VCT异性性传播人群分别为1.96%、1.85%及1.31%、0.15%。艾滋病在五类高危人群中的感染分布及感染率均无明显变化;VCT同性性传播人群与异性性传播人群两年感染率比较,两人群差异均无统计学意义(P>0.05),但VCT同性性传播人群的HIV感染率显著高于异性性传播人群(P<0.05)。梅毒在五类高危人群中的感染分布及感染率有所变化,其中FSW、STD人群感染率两年比较差异有统计学意义(P<0.05),其余三类人群差异无统计学意义(P>0.05)。VCT同性性传播人群、异性性传播人群两年TP感染率之间比较,同性性传播人群差异无统计学意义(P>0.05),异性性传播人群差异有统计学意义(P<0.05),但VCT同性性传播人群TP感染率两年来均显著高于异性传播人群(P均<0.05)。结论继续做好各类高危人群的监测工作,进一步改进监测策略,提高监测效果并及时对艾滋病性病患者进行心理疏导,提高艾滋病性病的防治工作效果。     

新疆呼图壁县娱乐场所女性性服务人员安全套使用项目基线调查

目的了解呼图壁县娱乐场所女性性服务人员（FSW）艾滋病（AIDS）/性传播疾病（STD）的危险行为和影响因素,为安全套使用项目的终期评估提供依据。方法对20家呼图壁县城区和312国道天龙水泥厂、88公里处娱乐服务场所共150名FSW开展AIDS知识、行为学问卷调查,并抽取5 mL静脉血进行HIV抗体和梅毒检测。结果 FSW大多数来自外省市,文化程度以初中及以下为主。艾滋病3种传播途径知晓率较高在89.33%-95.33%,但对其他个别知识点仍缺乏理解。与客人发生性关系时,最近一次安全套使用比例为64.58%,过去一个月安全套每次使用比例为56.82%。HIV和梅毒阳性率分别为0和4.67%。结论呼图壁县娱乐场所FSW具有一定的预防意识,但仍存在感染艾滋病病毒（HIV）的风险,为进一步有效阻止经性途径传播AIDS/STD,在FSW中开展行为干预和安全套使用迫在眉睫。     

中国部分HIV高危人群HPV感染现状及影响因素的Meta分析

目的了解我国男男性行为人群（MSM）和女性性工作者（FSW）人乳头瘤病毒（HPV）的感染特征及影响因素。方法通过互联网检索Pubmed、中国知网、万方等数据库,收集在我国MSM和FSW人群中开展的HPV研究,采用Meta分析的方法计算合并HPV感染率。结果分别有6篇关于MSM和FSW人群HPV感染情况的文献纳入分析。1956名MSM的HPV感染率为59.2%[95%可信区间（CI）：46.2%-70.7%],高危型HPV感染率为38.6%（95%CI：22.7%-48.4%）;749名感染HIV的MSM的HPV感染率为65.6%（95%CI：54.4%-92.5%）,高危型HPV感染率为46.6%（95%CI：35.0%-70.0%）。1797名FSW人群的HPV感染率为42.8%（95%CI：30.2%-53.3%）,高危型HPV感染率为33.5%（95%CI：24.6%-42.7%）。结论我国部分HIV感染高危人群的HPV感染率较高,成为严重的公共卫生隐患,亟须在MSM和FSW这两类HIV高危人群中开展艾滋病干预,并在过程中普及HPV知识,以期降低HPV的疾病负担。     

对男男性接触人群社会学因素及相关因素研究

艾滋病病毒（HIV）经性传播是全球艾滋病（AIDS）流行的首要途径，主要包括男女间的性接触和男男间的性接触。男男性接触者（men who have sex with men，MSM）普遍存在容易感染HIV／AIDS的不安全性行为，是HIV／AIDS的高危行为人群之一。自1980年至今，国际间对MSM人群的研究不断增多。为了更好地了解该人群，现对10年来国内外有关这一人群的社会学因素及相关因素的研究综述如下。     

2012年四川省艾滋病高危人群哨点监测结果分析

目的了解四川省艾滋病病毒（HIV）感染高危人群中,艾滋病的流行现状及其相关行为特征,为四川省艾滋病防治策略的制定与干预工作的开展提供科学依据。方法采用连续抽样法调查,对暗娼（FSW）、吸毒人群（DUS）、男男性行为人群（MSM）、性病门诊男性就诊者（Male STD）进行问卷调查和血清学检测。结果2012年4类高危人群共监测40091人,FSW、DUS、MSM、Male STD的HIV阳性检出率分别为0．4％、5．4％、11．1％、0．7％。2009—2012年,DUSHIV阳性检出率呈逐年下降趋势（Х^2=43．26,P〈0．001）,但总体仍在相对较高水平;其余高危人群未见下降趋势,MSM仍维持在较高水平（9．7％～11．5％）,FSW（0．3％～0．6％）、Male STD（0．6％～0．7％）则在较低水平波动。FSW最近1个月商业性行为时坚持使用安全套比例为71．6％,DUS最近1个月共用针具比例为23．6％,MSM最近6个月同性肛交时坚持使用安全套的比例为37．4％。结论MSM与DUS人群的HIV阳性检出率处于较高水平,各人群的HIV感染危险因素广泛存在,四川省艾滋病疫情流行态势依然严峻,预防干预工作不容忽视。     

德宏傣族景颇族自治州新报告85对HIV双阳夫妻感染途径和传播关系分析

目的 分析德宏傣族景颇族自治州（简称德宏州）2015-2019年新报告的85对HIV双阳夫妻感染途径和传播关系。方法 收集HIV双阳夫妻的一般人口学特征信息、流行病学个案调查资料等,描述双阳夫妻特征;结合pol基因序列检测分析,判断夫妻间传播关系。结果 纳入分析的85对HIV双阳夫妻共170人中,97.1%为异性性行为感染,主要HIV亚型有C型（33.5%）、BC重组型（18.2%）、CRF01＿AE(14.1%)。判断27对双阳夫妻（31.8%）存在夫妻间传播关系,其中家庭内先证感染者男性17人,女性10人,夫妻对间基因亚型均一致,以C型（12对）和BC重组型（6对）为主,先证者高危行为史以非商业非婚异性性接触史为主。结论 德宏州HIV双阳夫妻感染途径主要为异性性传播,且存在一定比例的夫妻间传播关系,提示有必要进一步加强HIV阳性配偶的早期发现和针对性预防干预。     

新疆喀什地区特殊人群艾滋病感染调查

目的了解喀什地区特殊人群艾滋病病毒（HIV）感染状况及影响因素,为制定控制策略和措施提供科学依据。方法运用描述性研究方法对全地区7409名羁押、收教人员及戒毒学员的HIV感染的血清流行病学调查资料进行综合分析。结果共发现HIV感染者131人,感染率1．77％。经血液传播合并性传播为主要传播途径。结论该地区特殊人群HIV感染形势严峻,应尽快采取健康教育,行为干预和相应监管措施。     

Sexual behavior and HIV risk across the life course in rural South Africa: trends and comparisons

There is limited information about sexual behavior among older Africans, which is problematic given high HIV rates among older adults. We use a population-based survey among people aged 15–80+ to examine the prevalence of sexual risk and protective behaviors in the context of a severe HIV epidemic. We focus on variation across the life course, gender and HIV serostatus to compare the similarities and differences of young, middle aged, and older adults. Younger adults continue to be at risk of HIV, with potential partners being more likely to have been diagnosed with an STI and more likely to have HIV, partner change is high, and condom use is low. Middle aged and older adults engage in sexual behavior that makes them vulnerable at older ages, including extramarital sex, low condom use, and cross-generational sex with people in age groups with the highest rates of HIV. We find insignificant differences between HIV positive and negative adults’ reports of recent sexual activity. This study provides new information on sexual behavior and HIV risk across the life course in rural South Africa to inform HIV prevention and treatment programing.     

Motherhood and HIV Risk Among Female Sex Workers in Andhra Pradesh, India: The Need to Consider Women’s Life Contexts

This study examines whether the challenges of motherhood among female sex workers (FSW) are linked with vulnerability to sexual risk factors for HIV. FSW at least 18 years of age (n = 850) were recruited through respondent driven sampling for a survey on HIV risk in the Rajahmundry area of Andhra Pradesh, India. Logistic regression models adjusted for demographic characteristics were used to assess the relation between reported caretaking challenges and sexual risk indicators for HIV. In adjusted logistic regression models, FSW who reported three or more children in their household or current child health concerns were significantly less likely to report consistent condom use (adjusted odds ratios (AORs) range: 0.5–0.6) and more likely to take more money for sex without a condom (both AORs: 2.5). Women who reported current child health concerns were also more likely to report an STI symptom in the past 6 months (AOR = 1.6; 95 % confidence interval: 1.1–2.3). Findings suggest that challenging responsibilities related to caretaking of children are associated with heightened vulnerability to HIV risk among FSW. Such findings add to the cumulating evidence urging for the implementation of HIV prevention interventions that consider the multiple challenges across various domains of women’s lives.     

Applying the pre-intentional phase of the Health Action Process Approach (HAPA) Model to investigate factors associated with intention on consistent condom use with various types of female sex partners among males who inject drugs in China

Both drug injection and sexual transmission are the primary drivers of the HIV epidemic in China. This study investigated the prevalence and associated factors of intention of consistent condom use during sexual intercourse with female regular partners (RP), non-regular partners (NRP) and sex workers (FSW) among male people who inject drugs (PWID)in China. A total of 529 male non-institutionalized PWID aged 18–45 years with negative/unknown HIV status were recruited by multiple methods in Dazhou and Hengyang, China. The constructs of the pre-intention phase of the Health Action Process Approach (HAPA) Model, including partner-specific HIV risk perception, condom use positive outcome expectancies, condom use negative outcome expectancies, and self-efficacy of condom use, were assessed. The prevalence of behavioral intention of consistent condom use with RP, NRP, and FSW was 32.1%, 49.1%, and 63.6%, respectively. In multivariate stepwise analysis, conditional risk perception of HIV transmission via unprotected sex with RP/NRP/FSW was associated with intention of consistent condom use with these types of female sex partners (multivariate odds ratio (ORm)?=?3.25–7.06). Condom use negative outcome expectancies were associated with intention of consistent condom use with RP and NRP (ORm?=?0.30–0.46), while condom use self-efficacy was associated with intention of consistent condom use with RP and FSW in the next six months (ORm?=?2.24–3.81). Male PWID are at high risk of HIV transmission through sexual behaviors. The pre-intention phase of the HAPA model may be applied to plan interventions to increase behavioral intention of consistent condom use with various types of female partners. Such interventions are warranted.     

Behavioral and Psychosocial Correlates of HIV Testing Among Male Clients of Female Sex Workers in Tijuana,Mexico

We use data collected from a sample of 400 male clients of female sex workers (FSW) to examine their HIV testing behavior. We present frequencies of HIV testing and used bivariate and multivariable analyses to assess its socio-demographic, behavioral, and psychosocial correlates. We found that the majority (55 %) of male clients of FSW in Tijuana, Mexico had never had an HIV test and the prevalence of HIV testing within the past year was low (9 %). In multivariable analyses, significant correlates of having ever tested for HIV were higher age, higher HIV knowledge score, lower sexual compulsiveness score, lower misogynistic attitudes score, having a condom break during sex with a FSW, and higher frequency of sex with a FSW while she was high. Our findings represent an important starting point for developing effective interventions to address the need to promote HIV testing among this population.     

Moderate Levels of Depression Predict Sexual Transmission Risk in HIV-Infected MSM: A Longitudinal Analysis of Data From Six Sites Involved in a “Prevention for Positives” Study

Depression is highly comorbid with HIV and may contribute to increased sexual transmission risk behavior (TRB) amongst HIV-infected MSM, the largest risk group for HIV in the U.S. However, examinations of this effect are inconsistent. The present longitudinal analyses of 746 HIV-infected MSM is from a multi-site “prevention for positives” study. A non-linear association between depression and TRB emerged. Moderate levels of depression (compared to either low or high levels) were associated with a more modest decline in the odds of sexual risk behavior over 12-month follow-up. Assessing depression in HIV primary care settings may help to identify those at risk and integrating the treatment of depression into secondary prevention and treatment initiatives may decrease the likelihood of sexual risk and help to contain the epidemic among MSM.     

Risk for Heterosexual HIV Transmission Among Non-Injecting Female Partners of Injection Drug Users in Estonia

The HIV epidemic in Estonia, as with other eastern European countries, is currently concentrated among injection drug users (IDUs). Non-IDUs who have IDU sex partners could serve as a potential bridge in an expanding epidemic. We applied HIV transmission modelling to data collected from non-IDU/IDU heterosexual couples in Kohtla-Järve, Estonia to estimate HIV risk from IDUs to their sex partners based on self-reported sexual behaviors shared by the couple. IDUs and their current main non-injecting sex partners were recruited for an interviewer-administered survey and HIV testing. Bernoulli modelling techniques were applied to estimate the risk of HIV transmission (incidence) among HIV negative non-injecting female partners of male IDUs. The estimated HIV incidence in this population of non-injecting women with only main sexual partners in the last 6 months ranged from 3.24 to 4.94 HIV seroconversions per 100 person years depending on the value used in the models for the per act transmission rate during acute stage infection. Non-IDUs who have IDU sex partners are at high risk for HIV and could serve as a potential bridge to a more generalized epidemic. Whether this might lead to an expansion of the HIV epidemic beyond core groups in Estonia or other Eastern European countries warrants closer study.     

Circuit parties: sexual behaviors and HIV disclosure practices among men who have sex with men at the White Party, Palm Springs, California, 2003

The syphilis epidemic among men who have sex with men (MSM) in major US cities and concomitant increases in high-risk sexual behavior, have raised concerns of increased HIV transmission in this population. Therefore, to provide information for health promotion and disease awareness efforts, we investigated sexual behaviors, partner selection preferences and HIV serostatus disclosure practices of MSM at the White Party in Palm Springs, California. Circuit party attendees reported engaging in unprotected anal sex, however, a high proportion reported disclosing their HIV status. These findings suggest that some gay men are serosorting as a risk reduction strategy or implementing sexual risk reduction strategies to protect themselves and their partners. In our study, HIV-negative men were nine times more likely to report a preference for a seroconcordant sexual partner. The self-protecting attitudes of HIV-negative men in our sample outweighed the partner-protecting attitudes of HIV-positive men. This suggests that prevention interventions focusing on HIV-positive persons are warranted.     

HIV Testing Behaviors Among Female Sex Workers in Southwest China

Despite the recognized importance of HIV testing in prevention, care and treatment, HIV testing remains low in China. Millions of female sex workers (FSW) play a critical role in China’s escalating HIV epidemic. Limited data are available regarding HIV testing behavior among this at-risk population. This study, based on a cross-sectional survey of 1,022 FSW recruited from communities in Southwest China, attempted to address the literature gap. Our data revealed that 48% of FSW ever took HIV testing; older age, less education, working in higher-income commercial sex venues and better HIV knowledge were associated with HIV testing. Those who never took HIV testing were more likely to engage in high-risk behaviors including inconsistent condom use with clients and stable partners. A number of psychological and structural barriers to testing were also reported. We call for culturally appropriate interventions to reduce HIV risks and promote HIV testing for vulnerable FSW in China.     

Sexual networks of pregnant women with and without HIV infection

OBJECTIVES: To determine the relationship of HIV infection in pregnant women to sexual network size and other risk factors. DESIGN: Case-control study of women attending the public maternity hospital in Lima, Peru. METHODS: We interviewed 75 HIV-seropositive women, 41 of their most recent male partners, and two control groups totaling 137 uninfected pregnant women and 70 of their most recent male partners. Each woman's sexual network size was estimated through second and third-generation partnerships over the past year, 5 years and lifetime. RESULTS: Few HIV-seropositive women reported behavioral risk factors for HIV infection, but 79% of male partners were HIV seropositive. Risk factors in male partners included sex with a female sex worker (FSW) or with another man (MSM). The mean 5-year sexual network sizes through the second generation (8.4 persons for HIV-seropositive women, and 2.5 and 1.9 for women in the two control groups) predicted HIV in the women, independently of her own number of partners. These differences were largely attributable to the number of partners reported by male partners. Using data from concurrent studies of FSW and MSM, estimates of 5-year sexual network sizes through the third-generation, excluding contacts with FSW which were protected by consistent condom use, were 672 persons for HIV-seropositive women, and 160 and 224 for women in the two control groups. CONCLUSIONS: HIV infection risk among pregnant women in Lima depends largely on their male partners' risk behaviors. Even monogamous women had very large sexual networks.