云南省德宏州外出务工返乡人员HIV感染及相关卫生服务状况

目的了解云南省德宏州外出务工人群的艾滋病病毒(HIV)感染状况及危险因素,为制订艾滋病防治策略提供依据。方法 2010年以乡镇为单位,随机抽取返乡的外出务工人员进行问卷调查和HIV血清学检测。结果 2260名外出返乡务工人员的HIV感染率为0.9%,过去一年未获得艾滋病防治卫生服务的比例为43.5%。多因素分析显示,景颇族HIV感染风险高于汉族,小学及以下文化程度者HIV感染风险高于初中及以上者,外出务工时间超过半年者感染HIV风险高于未超过半年者,曾经有性病史的研究对象HIV感染风险高于无性病史者。结论云南省德宏州外出返乡务工人员特别是景颇族、文化程度低、外出务工时间长及有性病史者HIV感染率较高;外出务工人员未获得艾滋病防治服务的比例较高。今后要加强对外出务工人员的艾滋病防治工作,并强化对其中感染风险高的亚风险人群的干预力度。     

2008-2014年红河州老年HIV/AIDS流行病学特征分析

目的 分析红河州老年人艾滋病流行病学特征,为制定老年人艾滋病防治措施提供科学依据。 方法 收集红河州2008-2014年≥50岁老年HIV/AIDS病例资料, 分析三间分布特点、传播途径构成、发现途径及相关信息。 结果 2008-2014年报告≥50岁老年HIV/AIDS病例3 138例（AIDS 1 623例,HIV 1 515例）,该年龄组在历年新检出报告病例中的构成比从9.8%上升至28.4%,平均为25.5%。男女比为2.6∶1,在婚的占69.7%,平均年龄（61.7±8.6）岁,小学及以下文化程度占72.0%,农民占55.6%。97.2%老年HIV/AIDS病例通过异性性途径感染HIV,其感染人数和构成比呈逐年上升趋势（χ2趋势＝512.1,P＜0.001）; 92.2%老年男性和50.1%老年女性HIV/AIDS病例通过非婚异性性行为感染HIV,49.2%老年女性HIV/AIDS病例通过配偶/固定性伴性行为感染HIV。老年男性病例中通过非婚异性性行为感染HIV的人数和构成比呈逐年上升趋势（χ2趋势＝337.8,P＜0.001）。 结论 开展艾滋病防治知识宣教活动,帮助老年人群掌握减少高危行为的技能,提高安全套使用率。进一步扩大监测检测覆盖面及覆盖人群,建议全面推行PITC 服务,在各乡镇卫生院、社区卫生服务中心整合公共卫生服务开展HIV筛查,尽早发现HIV感染者。     

张家界市老年艾滋病感染者高危行为因素调查

目的了解老年HIV感染者/AIDS病人的生活质量、婚姻生活情况、家庭及社会关系、可能感染的地点、与感染HIV相关的高危行为因素,为制定相应的防治措施提供依据。方法设计专用调查表,在知情同意的原则下,对湖南张家界地区目标人群进行面对面、一对一的问卷调查。问卷内容包括一般人口学特征、经济及家庭生活状况、高危行为史、健康状况、艾滋病防治知识和相关的态度等,调查数据用Epidata3.02进行双录入。结果共调查张家界地区45名老年艾滋病感染者,平均年龄67.9岁,最小的54岁,最大的82岁。老年HIV感染者的经济状况较好,感染的主要途径是通过低档场所及夫妻间无保护的性行为,调查对象缺乏HIV防治的基本知识。结论艾滋病预防控制工作中应重视老年人这一特殊群体,加强对老年人和暗娼的行为干预,同时,应关注老年HIV感染者/AIDS病人的情感需求,做好治疗与关怀工作。     

重庆市主城区老年人群艾滋病相关知识态度行为调查

目的 了解重庆市主城区老年人群艾滋病相关知识、态度、行为现状、健康知识来源,为制定老年人群艾滋病防治策略提供依据。方法 采用多阶段抽样的方法,抽取重庆市主城区年龄在60岁以上的老年人群599例,用自制问卷进行调查。结果 重庆市主城区老年人群艾滋病相关知识知晓率为68.4%,HIV检测率为8.3%,54.1%的调查对象不会继续和感染艾滋病病毒的朋友交往;不同年龄、性别、文化程度、职业的老年人群某些健康知识来源存在统计学差异。结论 重庆市主城区老年人群艾滋病相关知识知晓率较低,对艾滋病感染者存在歧视,健康知识来源与人口学特征存在关系,可根据人口学特征制定有针对性的宣教措施。     

邹城市人群艾滋病感染分布及传播危险因素分析

目的：了解邹城市艾滋病病毒（HIV）在人群中的感染情况,评估艾滋病流行传播的高危人群,分析其传播危险性,为防治艾滋病（AIDS）提供科学依据。方法：2005—2009年对普通人群艾滋病感染情况筛查和高危人群多项次艾滋病感染情况的专题调查。结果：普通人群中未检出HIV感染者,外来妇女、羁押人员和供血员HIV感染率分别为0．43％、0．12％、0．44％．外来妇女、羁押人员、供血员、性服务人员、MSM人群、性病病人梅毒抗体阳性率分别为1．42％、0．92％、0．33％、3．88％、4．76％、8．22％。结论：HIV感染者主要集中在外来妇女和羁押人员中,外来妇女成为本地人感染HIV主要因素;HIV感染者流窜盗窃犯罪,吸毒与性乱行为同时存在,将成为传播艾滋病性病最危险的人群;性服务人员、男性同性恋者、性病病人有较高的梅毒感染率,将会成为艾滋病向一般人群传播的中介人群。     

衡阳市控制艾滋病综合干预措施效果评价

目的探讨适合我国的艾滋病综合干预措施,为开展艾滋病综合防治提供经验和资料。方法调查分析衡阳市采取控制艾滋病综合干预措施前后,HIV感染者发现数、社会各阶层人群对艾滋病知晓率、对待HIV感染者及病人的态度、高危行为发生率、接受自愿HIV检测人数,综合评价干预效果。结果采取控制艾滋病综合干预措施3年(2004年、2005年、2006年)发现的HIV感染者总数是1992-2003年12年的513.90%;社会各阶层人群艾滋病知晓率、对艾滋认知程度、政府对艾防工作的重视程度显著提高;吸毒人员最近一次的吸毒共针率由2003年的52.26%下降至18.57%,女性性服务工作者最近一次性服务的安全套使用率由2003年39.46%上升至94.67%;2006年接受自愿HIV检测人数是2003年的40.5倍,检测对象中接受咨询的比例达到77.81%。结论衡阳市采取的控制艾滋病综合干预措施效果明显,值得推广。     

辽源市FSW人群艾滋病知识行为调查

《中国疾病预防控制信息系统数据》显示,经性途径传播的艾滋病感染者比例逐年上升,女性商业性性服务工作者（FSW）是经性途径传播艾滋病高危人群之一。因此对FSW人群艾滋病防治知识、行为及HIV感染状况进行调查,获取FSW人群预防艾滋病知识、行为及其危险因素资料,可有效预防艾滋病经性途径传播,并为制定艾滋病性病防治规划和开展有效干预提供依据。2011年辽源市开展了FSW人群艾滋病知识行为调查工作,现将结果报告如下。     

社区吸毒人群艾滋病性病感染风险研究

目的:观察社区吸毒人群艾滋病性病感染风险。方法:综合利用2011~2014年中山市人口学、哨点监测,自愿咨询监测门诊(VCT)、羁押场所检测、医院就诊者HIV检测及CD4+T淋巴细胞计数检测数据,采用多种方法对中山市男男性行为人群和吸毒人群艾滋病新发感染率进行估计,比较不同方法在男男性行为人群和吸毒人群中引用的有效性,获得中山市近5年不同人群艾滋病流行趋势,并且结合人群规模估计数据,评估中山市艾滋病新发感染状况。结果:一共400名调查对象参与调查,其中HIV初筛试验阳性病例50例,经过HIV确证试验,结果显示HIV感染者45人,感染率为11.25%。TPPA阳性80例,阳性率为20%。梅毒感染病例40例,感染率为10%。中山市2011年HIV抗体阳性病例8例,2012年为8例,2013年为12例,2014年为10例,2015年为12例。2011~2015年调查中山市社区吸毒人员艾滋病知识总知晓率分别为78%、85%、88%、90%。结论:中山市社区吸毒人员艾滋病知晓水平较高,但艾滋病感染风险意识低。建议在今后的社区吸毒人员干预工作中,应重点加强HIV等疾病传染力和传染风险等知识培训,加强社区吸毒人员对艾滋病感染风险的防治意识。     

祁阳县2003-2008年艾滋病综合防治模式及效果评价

目的 探索切实可行的艾滋病综合防治工作模式,控制艾滋病疫情的蔓延扩散. 方法政府主导,各部门协作,全社会参与,开展健康教育与促进、自愿咨询检测、针具交换、美沙酮维持治疗、100%安全套推广使用、医疗救治、生活救助和生产自救等干预活动,实施艾滋病综合防治. 结果不同人群艾滋病防治知识水平普遍提高,高危人群的高危行为明显改变,艾滋病病毒(HIV)感染者和病人得到及时救治和救助,生活水平和生活质量有明显上升;吸毒人员违法犯罪行为明显下降. 结论开展健康教育与促进,对高危人群实施行为干预,积极救治和救助HIV感染者和病人,开展艾滋病综合防治工作是遏制艾滋病扩散传播的有效途径.     

某院性病门诊艾滋病自愿咨询检测结果分析

艾滋病自愿咨询检测(VCT)是艾滋病防治与关怀工作的切入点和枢纽[1]。它可以及早发现艾滋病病毒(HIV)感染者和艾滋病病人,及时预防艾滋病的传播,减少艾滋病对个人、家庭以及社会的不良影响。为了解来我院性病门诊接受VCT服务人群的HIV抗体检测情况我们对2010年艾滋病咨询检测资料进行整理分析。     

Epidemiologische Entwicklung bei ausgewählten sexuell übertragbaren Infektionen (STI) in Deutschland

The number of people living with HIV infection has been increasing since the mid 1990s and is expected to rise further in the coming years. The HIV epidemic in Germany is still most affected by developments in the group of men who have sex with men (MSM). In this group, the number of newly diagnosed HIV infections has increased in recent years especially in large cities. Despite increased efforts to motivate HIV-infected people, who were not previously diagnosed, to be tested as early as possible and to seek medical treatment, the number of undiagnosed HIV-infected persons has increased. There are more people infected with HIV than those who have been tested positive for HIV and subsequently receive antiretroviral treatment. However, early testing and treatment alone are not sufficient to effectively contain the infection. Increased efforts are required to more effectively prevent new HIV infections by combining all the available options. In Germany as in all other developed countries, a stronger increase in the number of syphilis infections among MSM is reported, which is primarily due to a higher willingness to risk unprotected contacts, whereby the risk of HIV infection is also increased. The public prevention messages available for HIV are only partially effective against syphilis. More frequent examinations and optimized therapy management are necessary in addition to the use of condoms to prevent the spread of syphilis, gonorrhea, and Chlamydia trachomatis. Sustainable containment of new HIV infections must, therefore, be accompanied by both containment of sexually transmitted infections (STI) and use of public prevention messages for HIV/STI.     

黔东南州2010-2012年性病门诊男性就诊者艾滋病哨点监测结果分析

目的针对调查对象艾滋病防治知识、感染率、相关危险行为因素进行分析,为制定该类人群艾滋病防治策略和干预措施提供依据。方法收集凯里市2010-2012年国家级性病门诊男性就诊者哨点监测数据,利用spss 18统计软件进行分析。结果有效样本1 202份,艾滋病知识题回答正确率与年龄分组有统计学差异;最近三个月与暗娼、临时性伴均发生性关系的占7.2%,其最近一年患过性病比例为34.5%;2010-2012年HIV抗体阳性检出率为1.6%;不同年份及同性性行为HIV抗体阳性检出率有统计学差异。结论性病门诊男性就诊者知晓率较低,应采取措施提高知晓率;高危行为频发,性病患病比例较高,艾滋病传播风险大,采取有效干预措施刻不容缓。接受高干及咨询服务比例低,采取措施规范性病门诊诊疗服务。HIV检出率较暗娼人群高,应作为高危人群干预重点。     

Sexual risk behaviours and barriers to HIV testing among clients of female sex workers in Guatemala: a qualitative study

Few interventions have targeted clients of female sex workers in Central America, despite their potential role in HIV/STI prevention. Semi-structured interviews were conducted with 30 clients of female sex workers on attitudes towards prevention of HIV/STIs, barriers to condom use and behaviour towards HIV/STI testing and treatment in Escuintla, Guatemala. Despite high knowledge of condoms as an HIV/STI preventive measure, the decision to use them was often based on the client's social judgment of the woman's sexual conduct. Regular clients reported lower condom use. Clients' risk perception diminished with the awareness of the public HIV/STI clinic addressed to female sex workers. Most preferred private clinics to increase confidentiality and were reluctant to take the HIV test for fear of a positive result. Outreach programmes offering HIV/STI counselling and testing to clients of female sex workers could increase their test uptake and health-seeking behaviour and reduce potential transmission to the general population.     

2018年成都市某艾滋病自愿咨询检测门诊求询者HIV感染状况及原因分析

目的 分析我院2018年艾滋病自愿咨询检测（VCT）门诊求询者的流行病学资料及人类免疫缺陷病毒（HIV）感染情况,为艾滋病防治工作提供参考依据。方法 对2018年我院VCT门诊求询者的性别、年龄、文化程度、婚姻状况、男男性行为、使用安全套等流行病学情况以及HIV抗体检测结果进行回顾性分析。结果 2018年VCT门诊求询者有858人,其中男822人（占95.8%）,女36人（占4.2%）,年龄以20～39岁为主（740人,占86.25%）。HIV抗体检测阳性者71例,阳性率为8.28%（71/858）,其中男70例,女1例,年龄仍以20～39岁为主（51例,占71.83%）。多因素logistic回归分析显示,年龄大于50岁、男男性行为、未使用安全套及文化程度低是本组求询者发生HIV感染的易感因素。年龄为20～39岁的人群发生HIV感染的风险较年龄大于50岁人群者更低（OR=0.419）,有男男性行为者（MSM）发生HIV感染的风险是没有男男性行为者的20.606倍,未使用安全套者发生HIV感染的风险是使用安全套者的7.058倍,而文化程度初中及以下者发生HIV感染的风险是大专及以上者的2.547倍。结论 艾滋病VCT门诊是控制艾滋病传播的重要途径之一,门诊医师需重视对低文化程度者、发生男男性行为者、中老年男性进行健康教育和行为干预。     

Sustaining sexual safety in relationships: Hiv positive people and their sexual partners

This paper presents findings on how sexual safety is sustained in relationships. A qualitative study was undertaken to gather data on the social relations of sexual negotiation and safety among HIV positive people and their sexual partners. HIV positive people were found to avoid close relationships because of the difficulties of sustaining safer sex with regular partners. In response, many sought HIV positive concordant partners, and unprotected sex in these relationships was considered 'acceptable'. Action that suspended protected sex helped define relationships as intimate and important. As the emotional content of relationships developed, the acceptability of risk increased. Relationship risk management in the time of AIDS is as much an effort to protect relationships as intimate, loving and secure, as it is an effort to ensure viral safety. This was particularly the case in antibody discordant relationships. Here, 'love relationships' were presented as important as life itself. It was HIV negative partners in discordant relationships who most often negotiated for unprotected sex. Gay men were better able than heterosexuals to sustain safer sex in long term, love relationships. These differences in capacity to sustain safer sex between gay and straight people and between HIV positive and negative people may reflect differences in exposure to sexual safety and relationship norms. We discuss HIV prevention initiatives in light of these findings.     

Impact of Improved Treatments on Perceptions About HIV and Safer Sex Among Inner-City HIV-Infected Men and Women

Protease inhibitor combination therapies have significantly improved the health of many people with HIV/AIDS. Prior studies, consisting mainly of gay men, have indicated that these treatments have prompted reduced concern about HIV and an increase in high-risk behavior. This study assessed the impact of HIV treatment advances on HIV-infected individuals living in inner-city areas. A convenience sample was used (n = 196), consisting largely of heterosexual African-Americans and Hispanics. Almost the entire sample had heard of the latest HIV treatments, and 75% were currently on protease inhibitor regimens. One-third of the sample reported that AIDS was a less serious threat nowadays and that being HIV-positive was not a big deal. Fifteen percent of respondents believed that protease inhibitor combination therapies reduced the risk of HIV transmission, and 10% believed that these treatments reduced need for safer sex practices. As in previous studies of other populations, a significant percentage (23%) of respondents practiced safer sex less often since new HIV treatments arrived. HIV prevention programs need to focus more attention on HIV-infected individuals in inner city areas. Interventions for these individuals need to address changing attitudes and behaviors stemming from HIV treatment advances.     

萍乡市男男同性恋性病艾滋病哨点监测结果分析

目的了解男同人群的性相关危险因素特点,找出有效的途径或策略,进一步有效控制艾滋病的流行。方法问卷调查与实验室检测。结果总共监测310名男同,其中酒吧会所监测占30.97%,网络监测占69.03%;90%被监测男同是高中以上文化程度;最近一年患性病的占14.19%;310人当中HIV感染者8例,感染率为2.58%;网络招募人中HIV感染为3.27%。艾滋病知识知晓率为98.71%;有将近15%的感染者有过商业性行为(包括3名感染者);有商业性行为的男男同性恋艾滋病感染率与没有商业性行为的男男同性恋的艾滋病感染率两者比较有明显差异;与女性发生性关系的时候有三分之一不使用安全套,每次都会使用的不到一半,最近一次与女性发生性关系有三分之一没有使用安全套。结论男同容易将艾滋病性病进行婚内、外传播;男同存在掌握相关HIV防治知识与实际防范结果背离现象;网络加大了男同交往的频率和范围,也加大了艾滋病传播风险;同性商业性行为风险性更高;男同的双性性关系及无保护性性交在艾滋病传播中起到一个非常重要的桥梁作用;今后要把宣传干预重点放在双性恋、男性性商业服务人群、男同配偶或性伴、甚至青年妇女、青年学生身上。     

校外青少年艾滋病高危行为及其影响因素调查

目的了解校外青少年与艾滋病相关的高危行为及其社会影响因素,为在校外青少年中开展艾滋病预防提供参考依据。方法采用＂朋友找朋友＂的方法抽样,运用自编结构式问卷调查605名校外青少年,所得资料采用Excel录入,Spss11.8统计分析。结果校外青少年性行为发生率男性为60.3%,高于女性的34.5%,差异有统计学意义（χ2=35.9,P=0.000）。其中61.0%的人很少或从不使用安全套,最近1次性行为中50.0%的人未使用安全套;5.0%的调查对象曾发生过性交易。18.2%的人曾经使用过毒品,其中静脉注射占15.6%,共用针具占2.4%。使用过毒品者性行为、性交易发生率高于未使用过毒品者。结论校外青少年存在不安全性行为、毒品使用等艾滋病高危行为,增加其对艾滋病的认识和了解,有助于改善其不安全性行为。     

HIV-positive people, risk and sexual behaviour

For a long time, the sexual behaviour of HIV-infected persons did not receive any serious attention for a variety of reasons. Initially, diagnosis of HIV-infection appeared to imply a death sentence. In this context, the sex life of those infected seemed a secondary issue making prevention focused on sexual behaviour hard to imagine. Furthermore, the conviction that stigmatisation should be avoided also precluded an interest in the sexual behaviour of HIV-infected persons. From an epidemiological perspective and in the context of the developments in the medical treatment of AIDS it is important to address the sexuality of HIV-infected people. The scarce research done until now shows that there are various ways in which an HIV-infection affects people's sexuality. It seems that the sexuality of HIV-infected people can be compromised by their infection, inducing various sexual problems. Research also shows that there are HIV-infected people who do engage in unprotected sex, just as there are HIV-negative people or people with unknown serostatus who do so. Studies into the determinants of unsafe sex in HIV-infected people suggest that to some extent the same determinants are operative as among people in general. These include intention and self-efficacy regarding safe sex. Recreational drug use also affects safe sex regardless of serostatus. However, safe sex as well as sex in general is different for seropositive persons than for people who are seronegative or have an unknown serostatus. Among seropositive people, sex is also related to dilemma's involving disclosing their serostatus to potential sex partners, and their motivation to protect their partners as well as themselves against surinfection and STD. Furthermore, having to cope with a serious disease induces negative mood states (particularly depression) and may compromise sexual functioning. Comprehensive prevention aimed at HIV infected persons should address these various issues and should be an integrated part of general HIV-prevention.     

2011年北京市昌平区4类人群艾滋病监测结果分析

目的了解北京市昌平区4类人群艾滋病知识及相关高危行为,为艾滋病综合防治、制定干预策略提供科学依据。方法根据北京市哨点监测方案要求,对4类人群进行问卷调查和HIV及梅毒抗体检测。结果男男性接触者（MSM）、暗娼（FSW）、性病门诊就诊者（STD）3类人群艾滋病知识知晓率较高,流产妇女（ABR）艾滋病知识知晓率较低,差异具有统计学意义（P〈0.01）。HIV抗体阳性检出率：MSM为9.50%,其他人群未检出;梅毒抗体阳性检出率最高的是MSM人群为6.90%,其次是STD人群为1.9%。结论应加强对流产妇女艾滋病知识的宣传,提高其艾滋病知识知晓率。各类人群高危行为存在多样性,应进一步加强健康教育和干预工作力度,控制艾滋病性病的传播流行。