揭阳市1460例吸毒者HIV及梅毒监测结果分析

目的了解揭阳市吸毒人员艾滋病病毒（HIV）及梅毒的感染状况及相关危险因素。方法采用统一的调查表．对2006年新进入戒毒所的吸毒人员进行面对面的问卷调查，同时对每一个调查对象采用一次性注射器采集静脉血3～5ml进行HIV和梅毒抗体检测。结果共监测1460名吸毒者，HIV阳性率为0．48％，梅毒感染率为10．55％：有43．84％注射毒品行为，注射毒品的吸毒者中有38．60％承认曾与他人共用注射器或针头：28．22％吸毒者承认曾通过钱或毒品交易与他人发生过性行为，16．26％的吸毒者每次与他人发生性关系时都使用安全套。结论揭阳市吸毒人群的HIV感染率较低，但存在高危行为，应加强干预等工作，阻止艾滋病由高危人群向一般人群传播。     

许昌市2002-2010年吸毒哨点艾滋病性病监测情况

目的了解许昌市吸毒人员的高危行为和艾滋病及性病的感染状况,为制定艾滋病性病的预防控制措施提供依据。方法按照国家艾滋病哨点监测实施方案的要求,对监测期间新入所的吸毒人员进行行为学调查和艾滋病、梅毒、丙肝血清抗体检测。结果口吸毒者及注射吸毒者分别占吸毒人员总数的93.2%和6.80%;该吸毒人群中HIV抗体阳性率为0.41%,梅毒感染率为1.04%。结论许昌市吸毒人员艾滋病、性病感染危险因素广泛存在,应加强针对该人群的高危行为干预。     

广东省2009年高危人群HIV哨点综合监测结果分析

目的通过对吸毒人群（DUs）、暗娼（FCSWs）、男男性行为者（MSMs）和男性性病门诊就诊者（MSTDs）四类艾滋病（AIDS）主要高危人群的综合监测,了解他们的艾滋病病毒（HIV）流行情况及其高危行为。方法按照艾滋病行为和血清学监测方案的操作程序及调查方法对四类人群进行行为及血清学监测。结果 13620例DUs、5309例FCSWs、970例MSMs、4273例MSTDs的HIV阳性率分别为3.7%、0.2%、4.7%、0.3%,梅毒阳性率分别为4.5%、3.1%、12.0%、6.5%,丙肝阳性率分别为34.5%、0.6%、0.5%、0.7%,注射吸毒率分别为68.1%、0.7%、0.3%、3.7%,商业性交率分别为23.3%、100.0%、17.2%、41.4%,艾滋病知识知晓率分别为73.4%、69.4%、82.9%、66.4%,干预覆盖率分别为40.8%、47.0%、74.7%、31.5%。结论四类高危人群中均检出HIV感染者,感染率以MSMs最高,其次为DUs,FCSWs感染率最低,各高危人群均存在感染HIV的诸多危险因素,应加大综合干预力度。     

男性强制戒毒人群的健康危险行为研究

目的了解男性强制戒毒人群人口学特征、注射使用毒品情况及相关的健康危险行为的流行病学情况。方法采用世界卫生组织毒品注射研究第二部分调查问卷(2a版)调查吸毒者社会人口学资料、吸毒的情况、性行为、艾滋病知识与行为改变等内容。结果共调查了200例对象，87.5%的被调查者曾静脉注射毒品，被调查者平均年龄为30.37±5.65岁，在最近六个月中，41.3%的注射毒品者曾合用针头和/或注射器，50.6%的吸毒者将自己使用过的针头和/或注射器给别人使用；大多数吸毒者(85%)与异性性伙伴性交时从不使用安全套；吸毒者了解AIDS知识的主要途径是大众媒体，61.8%的人从未采取任何预防艾滋病病毒(HIV)感染的措施。结论男性强制戒毒人群存在大量健康危险行为，是HIV感染和传播的高危人群。     

社区吸毒人群性行为、吸毒行为及相关因素的聚类分析

目的对社区吸毒人群根据其艾滋病病毒感染相关行为特征进行分类,探索不同类吸毒人群之间的社会人口学、血清学及行为学特征的差异。方法2008年采用同伴推动抽样法（RDS）招募东莞市社区吸毒人群进行面对面的问卷调查,采集血样进行HIV、HCV和梅毒抗体检测;采用SPSS进行两步聚类分析。结果共招募303名社区吸毒人群,聚为4类。根据其特征分别命名为美沙酮组、高危性行为组、高危组、中危组,分别占总人数的12.5%、28.7%、29.4%、29.4%。其中,高危组广西户籍、壮族的比例较高,艾滋病知晓率低,多性伴、商业性行为现象突出,针具共用率较高,HIV、HCV及梅毒抗体阳性率均较高。结论在社区吸毒人群中实施行为干预时,应根据吸毒人群的特点,采取针对性的措施,对那些同时具有高危性行为和针具共用行为的人群应予以更多关注。     

雅安市性传播疾病病人血清学指标调查与艾滋病防治

目的:调查雅安市艾滋病、梅毒、丙肝等性传播疾病患病人群的基本情况,通过血清学指标调查HIV感染情况,提供艾滋病防治的基础依据,寻求艾滋病防治有效措施。方法:在雅安市采用备案整群抽样与滚雪球相结合的方式招募调查对象,采用统一的健康调查问卷进行调查,进行HIV梅毒、丙肝血清抗体检测,用EpiData3.1软件进行数据录入,SPSS17.0软件进行数据分析。结果:被调查的270份样本,高危人群年龄分布以40~69岁为主,艾滋病防治知识总知晓率为68.89%,最近1年与商业性伴发生商业性行为时使用安全套的比例占调查人数的45.92%,最近一次与商业性伴发生商业性行为时安全套使用的比例为41.85%;HIV阳性率为0.05%;梅毒阳性率为2.59%;丙肝阳性率为0.74%。结论:患病人群中文化程度低、重体力劳动、娱乐场所工作人群暴露感染风险较大,要关注异地打工独居人群,加强健康促进和干预工作,重视感染人群配偶的健康保护,加强艾滋病健康教育宣传防治工作。     

某地吸毒人群与HIV感染相关的高危行为调查

目的了解深圳市某地吸毒人群与HIV感染相关的高危行为。方法采用整群抽样的方法对一定时间内全体强制戒毒人员进行血清HIV抗体检测,并对其中76例HIV阳性者进行问卷调查。结果HIV抗体检出率为5．01％,戒毒人群中15～35岁占93．67％;HIV感染者中,15—35岁占96．05％,静脉注射吸毒者高达98．68％,共用注射器者占静脉吸毒者的80．26％。结论某地吸毒人群中存在引起HIV流行的高危行为．需尽快开展有效的干预措施。建议在流动人口中开展艾滋病预防教育活动,同时还应对在校学生开展预防吸毒的教育。     

东莞市男男性行为者艾滋病知识行为调查

目的了解男男性行为者（MSM）艾滋病防治知识掌握情况及高危行为方式,为在该人群中开展艾滋病预防干预工作提供依据。方法在男男性行为者聚集场所进行问卷调查。结果调查对象年龄中位数为29岁,以未婚、高中文化程度、省外流动人口及在东莞居住2年以上者为主;艾滋病知识知晓率为91.75%;74.75%的调查者在过去的6个月中有过同性性行为（其中3.34%的人有过同性商业性行为）,其中51.84%的人每次都使用安全套;39%的人在过去的6个月与女性有过性行为,其中37.82%的人每次都使用安全套;27.25%的人在过去的6个月与男性、女性都有过性行为;7.25%的人在最近一年曾患过性病;10.5%的人HIV抗体筛查结果阳性。结论应采用民间组织宣传干预与VCT检测相结合的模式,加强MSM人群的艾滋病宣传教育工作,推广使用安全套,防止HIV在MSM人群中的传播及经其女性性伴向一般人群传播。     

2010年昆明市吸毒者梅毒及HIV性传播危险

目的 了解昆明市吸毒者行为学和人口学特征、梅毒、HIV感染情况及相关因素.方法 采用一对一结构问卷调查及血清抗体检测对昆明市戒毒所吸毒者进行横断面研究.结果 共调查吸毒者872人,98.9％使用海洛因,8.9％曾滥用新型毒品,74.1％注射吸毒,27.3％曾共用针具；67.3％有固定性伴,其中仅10.5％最近一年与固定性伴坚持使用安全套；23.7％最近一年有商业性行为,43.7％与商业性伴坚持使用安全套；无论有无固定性伴,吸毒者的商业性行为比例及交易过程中安全套使用比例均无显著性差异(x2均小于1.83,P＞0.4).吸毒者中梅毒感染率为4.5％(39/872),女性吸毒者中为9.9％(12/122).女性(OR:3.8,95％CI:1.8-8.2)、外来吸毒者(OR:2.9,95％CI:1.4-6.1)和低文化程度(OR:2.6,95％CI:1.3-5.5)为梅毒感染影响因素；HIV感染率为14.3％(125/872),共用针具者中达29.5％(52/176),注射吸毒和共用针具为相关影响因素(OR:4.2,95％CI:2.0-9.0;OR:11.1,95％CI:5.1-24.4).结论 昆明市吸毒者中梅毒和HIV感染率较高,高危性行为较普遍,HIV经性途径向固定性伴或其他人群传播的危险不容忽视.积极防治吸毒者的梅毒感染,及时发现管理HIV感染者,加强高危性行为干预,对控制全市梅毒及HIV流行具有重要意义.     

深圳市暗娼、吸毒人群和货柜司机HIV及梅毒感染状况分析

目的了解暗娼、吸毒人群和货柜司机人类免疫缺陷病毒（HIV）及梅毒感染的情况,为制订预防措施提供依据。方法对深圳市2007年和2008年某妇教所收容的暗娼、戒毒所吸毒人员和货柜司机分别抽取静脉血,用酶联免疫吸附实验（ELISA）进行HIV1＋2抗体检测和梅毒甲苯胺红不加热血清试验（TRUST）初筛,梅毒阳性者用梅毒螺旋体明胶颗粒凝集确证试验（TP2PA）进一步确证,HIV-1确证实验用蛋白印迹法。结果 2007年和2008年暗娼人群均未发现HIV感染者,梅毒感染率分别为7.63%和5.14%;吸毒人群的HIV感染率分别为1.63%、2.67%,梅毒感染率分别为9.32%、2.94%;货柜司机的HIV感染率分别为0、0.31%,梅毒感染率分别为1.05%、0.92%。结论暗娼和吸毒人员的梅毒感染率明显高于货柜司机,是感染性病和艾滋病的高危人群,加强对暗娼和吸毒人群的行为干预和监测至关重要。     

清远市娱乐场所女性性工作者艾滋病高危行为干预效果分析

目的了解清远市娱乐场所女性性工作者艾滋病防治知识、态度及行为的改变情况,评价干预措施效果。方法 2009年对清远市部分娱乐场所女性性工作者开展防病知识宣传、安全套推广等综合干预措施,干预前后分别进行艾滋病相关知识和安全性行为问卷调查,对干预前后效果进行分析和评价。结果干预前调查333人,干预后调查216人。接受干预后,调查对象的艾滋病相关知识总知晓率从干预前的68.47%提高到干预后的83.33%（P〈0.01）;最近1个月、最近1次商业性行为时每次使用安全套者所占比例分别从干预前的76.28%、89.79%提高到干预后的93.52%和98.15%（P〈0.01）;出现生殖道不适症状的比例和性病患病率从干预前的63.66%、42.04%下降到干预后的43.06%和31.02%,干预前后比较差异均有统计学意义（P〈0.01）。结论通过综合干预可以有效地提高娱乐场所女性性工作者的艾滋病知识知晓率和安全性行为,应继续加强艾滋病知识的宣传和持续开展100%安全套推广使用工作。     

Sexual behavior among injection drug users in 3 indonesian cities carries a high potential for HIV spread to noninjectors

OBJECTIVE: To establish the prevalence of injecting practices that carry a risk of HIV infection among injection drug users (IDUs) in Indonesia and to examine the risk of sexual transmission of HIV from IDUs to noninjecting populations. DESIGN: A first round of behavioral surveillance among community-recruited male IDUs in 3 cities. METHODS: In late 2002, IDU gathering places were mapped in 3 cities, and 650 IDUs were recruited using multiple wave sampling originating from sites systematically selected for diversity. Trained interviewers, mostly former IDUs, administered a questionnaire focusing on injecting practices, sexual behavior, and HIV-related knowledge. RESULTS: Almost all IDUs knew that HIV is transmissible through shared needles, but 85% of injectors reported using a syringe previously used by another IDU in the previous week. Over two thirds of IDUs were sexually active, 48% reported multiple partners, and 40% had bought sex from a female sex worker in the preceding 12 months. Consistent condom use was reported by 10%. CONCLUSIONS: The potential for the sexual spread of HIV from IDUs to noninjectors is extremely high in Indonesia. Interventions are urgently needed to reduce high levels of needle sharing, but a focus on needle cleaning and increasing condom use among IDUs is also essential.     

Séroprévalence VIH chez les consultants IST à Nouakchott et à Nouadhibou (Mauritanie)

This work presents the results of the behavioural and serologic survey on HIV/AIDS conducted from December 2007 to December 2008 among the group of STD (sexually transmitted disease) patients, supposed to be at HIV infection risk. In Mauritania, the last survey of HIV seroprevalence among the STD patients goes up to the year 1995 (the prevalence was estimated then to be 0.9%). The goal was to determine the seroprevalence of HIV and syphilis and to gather information on the knowledge, the sexual behaviours on a risk concerning the HIV/AIDS, and the sexually transmitted disease among these patients. The census has been made on over 224 STD patients during the period of the study, without predominance of sex and with a majority of young adults. The prevalence for HIV is 9% and for the syphilis it is 10%. Actually, the condom is widely underused by this group, even in occasional intercourse. The STD patients are a group of risk towards HIV, because of their risk behaviours and low level of knowledge.     

HIV infection and sexually transmitted diseases in female commercial sex workers in China

A cross-sectional survey was conducted among female commercial sex workers (FSWs) in Zhengzhou, China, to estimate rates of HIV infection and sexually transmitted diseases (STDs) and to document their sexual behavior patterns from October 2000 to January 2001. FSWs were recruited by the snowball sampling technique and were interviewed at their working environments anonymously. This strategy resulted in high rates of response (92%) and concordance (98%) to sensitive questions. A total of 621 FSWs were enrolled. One direct FSW and 1 indirect FSW were positive for antibodies to HIV in oral fluids (prevalence of HIV infection, 1.4% and 0.2%, respectively). A history of STDs was reported by 49% of the FSWs. Most FSWs (87%) reported inconsistent condom use. Ten percent of FSWs recognized their clients as drug users. A few FSWs (2.2%) were injecting drug users, of whom 2 reported incidents of sharing needles/syringes with other injecting drug users. Direct FSWs had more risk characteristics and were more vulnerable to HIV infection and STDs than indirect FSWs. Inconsistent use of condoms and a high level of STDs underscore the urgent need to implement intervention strategies and condom promotion, particularly among direct sex workers in China.     

HIV prevention among sex workers in India

To test the efficacy of a sustainable community-level HIV intervention among sex workers, the Sonagachi Project was replicated, including community organizing and advocacy, peer education, condom social marketing, and establishment of a health clinic. Sex workers were randomly selected in 2 small urban communities in northeastern India (n = 100 each) and assessed every 5-6 months over 15 months (85% retention). Overall condom use increased significantly in the intervention community (39%) compared with the control community (11%), and the proportion of consistent condom users increased 25% in the intervention community compared with a 16% decrease in the control community. This study supports the efficacy of the Sonagachi model intervention in increasing condom use and maintaining low HIV prevalence among sex workers.     

2009年深圳市暗娼综合监测调查报告

目的了解深圳市娱乐场所暗娼AIDS知识和相关危险行为,为AIDS行为干预措施提供依据。方法按国家综合监测点方案的抽样方法抽取4个区娱乐场所暗娼426名,采用一对一匿名的问卷方式进行调查和采血。结果调查对象平均年龄为（23.5±4.9）岁,暗娼AIDS知识较缺乏。其中,蚊虫钉咬会感染艾滋病全对率为35.2%、同桌吃饭会感染艾滋病全对率为67.6%、不共用注射器能预防艾滋病全对率为89.4%、AIDS传播途径全对率为77.6%。安全套使用率低,最近一次与客人发生性关系时只有68.0%的暗娼使用安全套。426名暗娼中未发现HIV感染者,感染梅毒的有19例,占4.5%。结论多数暗娼对艾滋病的严重性认识不足,在卖淫活动中未能100%地使用安全套进行安全的性行为,存在着感染与传播艾滋病的高危险性,应加强综合监测与科学防控。     

High HIV sexual risk behaviors and sexually transmitted disease prevalence among injection drug users in Northern Vietnam: implications for a generalized HIV epidemic

BACKGROUND: HIV prevalence in Vietnam is currently concentrated among injection drug users (IDUs). The extent to which this core risk group represents a potential for broader HIV transmission to the general population is currently unknown. METHODS: A community-based cross-sectional study among IDUs in Vietnam assessed sexually transmitted disease (STD) prevalence and behavioral risk factors. Qualitative interview data enhanced quantitative findings. RESULTS: The prevalence of any STDs among 272 IDUs was 30% (chlamydia, 9%; herpes simplex virus type 2 [HSV-2], 22%; gonorrhea, 0%; and syphilis, 1%). Part-time work or unemployment (odds ratio [OR] = 2.74, 95% confidence interval [CI]: 1.1 to 6.9), sex with > or =2 sex workers in the past year (OR = 4.9, 95% CI: 1.91 to 12.6), having ever smoked heroin (OR = 4.5, 95% CI: 1.1 to 18.3), and injecting less frequently than daily (OR = 3.9, 95% CI: 1.43 to 10.6) were independently associated with chlamydial infection. Urban residency (OR = 4.0, 95% CI: 1.4 to 11.0) and daily injecting (OR = 2.2, 95% CI: 1.1 to 4.4) were independently associated with HSV-2. Odds of HSV-2 among older (> or =28 years of age) IDUs who had sex with <2 sex workers in the past year was higher than among younger IDUs who had sex with more sex workers (OR = 6.4, 95% CI: 2.1 to 18.4). CONCLUSIONS: High STD prevalence and high-risk sexual and parenteral behaviors among IDUs indicate the potential for HIV/STD transmission to the general Vietnamese population.     

Correlates and trend of HIV prevalence among female sex workers attending sexually transmitted disease clinics in Pune, India (1993-2002)

In India, substantial efforts have been made to increase awareness about HIV/AIDS among female sex workers (FSWs). We assessed the impact of awareness regarding safe sex in a cohort of FSWs by studying trends in HIV prevalence, sexually transmitted diseases (STDs), and risk behaviors measured from 1993 to 2002 in Pune, India. A total of 1359 FSWs attending 3 STD clinics were screened for HIV infection, and data on demographics, sexual behaviors, and past and current STDs were obtained. The overall HIV prevalence among FSWs was 54%. Not being married (adjusted odds ratio [AOR] = 1.74, 95% confidence interval [CI]: 1.17 to 2.59), being widowed (AOR = 2.10, 95% CI: 1.16 to 3.80), inconsistent condom use (AOR = 1.60, 95% CI: 1.02 to 2.50), clinical presence of genital ulcer disease (GUD; AOR = 1.66, 95% CI: 1.07 to 2.56), and genital warts (AOR = 4.70, 95% CI: 1.57 to 14.08) were independently associated with HIV infection among FSWs. The prevalence of HIV remained stable over 10 years (46% in 1993 and 50% in 2002; P = 0.80). The prevalence of GUD decreased over time (P < 0.001), whereas that of observed genital discharge remained stable. Reported consistent condom use as well as the proportion of FSWs who refused sexual contact without condoms increased over time (P < 0.001). These data collectively suggest that safe sex interventions have had a positive impact on FSWs in Pune, India.