北京市某区未成年女性从事性服务原因的定性研究

目的探讨未成年女性从事性服务的原因,为在此人群中开展预防艾滋病工作提供参考。方法采用定性研究方法,对22位从事性服务的、15位提供三陪服务的、15位在劳务市场内找工作的未成年女性,以及5位劳务市场负责人、5位公安干警进行个人深入访谈。结果未成年女性从事性服务与贫穷、生存压力大、缺乏社会和家庭的支持、缺乏就业技能、过早的性经历、家庭关系紧张、价值观偏离等有关。结论外来打工妹,特别是三陪小姐应作为性病艾滋病防治的重点人群,应加强劳动就业部门职业技能培训与防治艾滋病培训相结合的力度。     

具有同性性接触的男性调查

目的 了解有同性性接触男性的与可能传播艾滋病、性病有关的性行为。方法 采用自拟的问卷对35例有同性性接触男性进行调查。结果 所有被访者中口交发生率94.3％,肛交68.6％,吻肛28.6％;他们中71.4％有异性性接触。结论 口交和肛交在他们的性接触中占重要位置,应加强防病意识教育。     

Changing trends in human immunodeficiency virus and acquired immunodeficiency syndrome in the population aged 50 and older

OBJECTIVES: To alert persons in the public and private healthcare professions to the increasing trends in higher proportions of persons aged 50 and older who are newly diagnosed with human immunodeficiency virus (HIV) and who are living with HIV and acquired immunodeficiency syndrome (AIDS). DESIGN: Data from the period 1992 through 2004 from the HIV/AIDS Reporting System (HARS) were analyzed. SETTING: New Jersey is the eleventh-most-populous state, with the highest density of persons per square mile. It also has the fifth-highest number of AIDS cases. PARTICIPANTS: All persons residing in New Jersey and reported to HARS with HIV infection or who are considered to have AIDS. MEASUREMENTS: Trends in persons aged 50 and older were compared with those in the population younger than 50 during 1992 through 2004 for the numbers of persons living with HIV/AIDS and the number of persons newly diagnosed with HIV infection. RESULTS: The proportion of all persons aged 50 and older living with HIV/AIDS in 2004 was significantly greater than the comparable proportion of persons in 1992. Proportionally, more persons were newly diagnosed with HIV who were aged 50 and older according to sex and for each of the three major race or ethnicity groups (white non-Hispanic, black non-Hispanic, and Hispanic) than were persons younger than 50. Each of these increases was statistically significant. CONCLUSION: HIV/AIDS social marketing campaigns should include images and issues related to older persons in educational and prevention efforts. New methods that reach older populations should be considered. Physicians and other healthcare providers should be made aware of their role in prevention and education about HIV. Testing of older populations with risk factors should be encouraged.     

河南省上蔡县艾滋病综合防治效果评价

目的评价上蔡县艾滋病综合防治效果。方法采用回顾性方法,收集上蔡县2003-2008年艾滋病基线调查及专题调查、预防艾滋病母婴传播信息、艾滋病疫情网络直报及分析等资料,采用SPSS11.5软件进行统计分析。结果村民、中学生、暗娼(CSW)和艾滋病病毒感染者/病人(PLWHA)的艾滋病知识知晓率,分别由2003年的15.6%、39.8%、21.9%、28.8%,上升到2008年的75.5%、83.6%、88.3%、97.0%。4种人群愿意与感染HIV熟人继续来往的比例分别由2003年的25.4%、51.4%、34.1%、40.7%,上升到2008年的75.6%、83.3%、54.8%、99.6%,差异均有统计学意义(P0.05)。2003年和2008年,CSW人群过去3个月与客人发生性行为时安全套每次使用率,由2003年的58.3%提高到2008年的84.7%。自2001年10月到2008年12月底,对169名不愿终止妊娠的艾滋病孕产妇及所生176名婴儿实施了综合阻断措施,母婴阻断成功率97.6%。结论上蔡县实施综合防治项目以来,以项目带动工作,综合防治工作成效显著,但人群艾滋病知识、态度和行为还有待进一步提高和改善。     

Predictors of Continued High-Risk Sexual Behavior in a Community Sample of Persons Living with HIV/AIDS

Most HIV prevention research has focused on persons who are HIV-seronegative. However, some persons aware of their HIV infection may continue to engage in high-risk sexual behavior patterns that place their sexual partners at risk for HIV infection. The present study delineates rates of high-risk sexual behavior in a community sample of persons living with HIV/AIDS and identifies predictors of continued high-risk sex. An anonymous self-report survey assessing social support, access to health care services, health-related quality of life, perceptions of loneliness, life satisfaction, and sexual behavior was completed by 277 persons living with HIV/AIDS in a midwestern state. Predictors of continued high-risk sex included being in an affectionate relationship, greater physical well-being, more barriers to health care services due to geography and distance, and having a greater number of male sexual partners. HIV prevention programs are needed for persons living with HIV disease who have difficulty avoiding high-risk sexual behavior.     

重庆市巴南区“三位一体”艾滋病综合防治模式探讨

目的探索以疾病预防控制中心（CDC）为枢纽,医疗机构和社会组织（NGO）共同参与的三位一体艾滋病综合防治模式,为建立有效、可持续的艾滋病防治机制及政府决策提供依据。方法描述巴南区从2009年探索构建三位一体模式的过程,分析比较模式运行前后干预和随访管理指标、医疗机构检测点和防治队伍的变化。结果从2009-2012年,暗娼（FSW）、男男性行为人群（MSM）和吸毒人群（DU）的月均干预数,CD4淋巴细胞检测率和随访率均有了很大幅度上升;医疗机构艾滋病病毒（HIV）检测点从2个增加到25个,基层艾滋病防治队伍扩大。结论三位一体模式的建立对艾滋病防治工作起到了积极的作用,值得进一步推广。     

河南省基于农村社区的艾滋病综合防治模式探讨

目的探索河南省以社区为依托的艾滋病（AIDS）综合防治（艾防）模式,为制定艾防工作提供科学依据。方法依据并完善现有的县-乡-村医疗卫生体系,科学地开展艾滋病病毒（HIV）感染者管理、患者追踪、实验室检测、母婴阻断、高危干预、健康教育和医疗救治。结果截至2008年底,河南省艾滋病病死率下降至4.57%,母婴传播率降为4.16%,单阳性配偶阳转率为1.13/100人年,病人治疗12个月后仍坚持治疗的比例达到85.2%,大众人群艾滋病防治知识知晓率为82.3%,暗娼中艾滋病预防服务覆盖率为96.98%,娱乐场所暗娼在最近一次商业性性行为时使用安全套的比例为89.54%,暗娼中能够正确识别艾滋病经性传播的途径并摒弃艾滋病传播主要错误观点的比例达81.17%,HIV感染者和AIDS病人（HIV/AIDS病人）安全套坚持使用率达92.57%。结论河南省基于农村社区的艾滋病综合防治模式效果显著,建议在HIV/AIDS病人相对较为集中的地区推广应用。     

AIDS Prevention Research in Low and Middle-Income Countries: Generating the Evidence upon Which Local Decisions are Made

Transgender populations in the United States have been impacted by the HIV/AIDS epidemic. This systematic review estimates the prevalence of HIV infection and risk behaviors of transgender persons. Comprehensive searches of the US-based HIV behavioral prevention literature identified 29 studies focusing on male-to-female (MTF) transgender women; five of these studies also reported data on female-to-male (FTM) transgender men. Using meta-analytic approaches, prevalence rates were estimated by synthesizing weighted means. Meta-analytic findings indicated that 27.7% (95% confidence interval [CI], 24.8–30.6%) of MTFs tested positive for HIV infection (four studies), while 11.8% (95% CI, 10.5–13.2%) of MTFs self-reported being HIV-seropositive (18 studies). Higher HIV infection rates were found among African-American MTFs regardless of assessment method (56.3% test result; 30.8% self-report). Large percentages of MTFs (range, 27–48%) reported engaging in risky behaviors (e.g., unprotected receptive anal intercourse, multiple casual partners, sex work). Prevalence rates of HIV and risk behaviors were low among FTMs. Contextual factors potentially related to increased HIV risk include mental health concerns, physical abuse, social isolation, economic marginalization, and unmet transgender-specific healthcare needs. Additional research is needed to explain the causes of HIV risk behavior of transgender persons. These findings should be considered when developing and adapting prevention interventions for transgender populations.     

Heterosexual anal intercourse: prevalence, cultural factors, and HIV infection and other health risks, Part I

Studies of heterosexual HIV transmission have consistently found anal intercourse to be a highly predictive risk factor for seroconversion. Yet most AIDS prevention messages targeted at heterosexuals, presumably influenced by cultural taboos against acknowledging this sexual practice, continue to emphasize vaginal and, increasingly, oral sex transmission. The health risks of anal sex appear to be severely underestimated by a substantial proportion of sexually active women and men in North and Latin America as well as parts of South Asia, Africa, and other regions. Among heterosexuals reported rates of condom use are nearly universally lower for anal than for vaginal intercourse. This review examines anal sex among the general population, including its prevalence in various world regions, related sociocultural factors, and other associated health problems including anorectal STDs, Hepatitis B infection, and HPV-related anal cancer in women. U.S. survey and other data suggest that, in terms of absolute numbers, approximately seven times more women than homosexual men engage in unprotected receptive anal intercourse. Research among higher risk subpopulations, including bisexual men, injecting drug users, female sex workers, inner-city adolescents, and serodiscordant heterosexual couples, indicates that persons particularly at risk of being infected by or transmitting HIV are also more likely to practice anal sex. Considering this finding, along with the much greater efficiency for HIV infection as well as lower rates of condom usage, a significant proportion of heterosexual transmission in some populations is due to anal intercourse. This typically stigmatized and hidden sexual practice must be given greater emphasis in AIDS/STD prevention, women's care, and other health promotion programs.     

Social Integration,AIDS Knowledge and Factors Related to HIV Prevention Among Migrant Workers in Thailand

Previous research on migrant health indicates that social integration may exert a strong influence on health behavior. However, to our knowledge, this factor has not been integrated into models for HIV prevention. Drawing constructs from the Health Belief Model, the objective of this paper was to determine whether social integration, demographic, relationship and other factors were related to migrants’ ability to prevent HIV infection through AIDS knowledge and condom use. Data for the study were drawn from a survey of 3,405 male and female migrant laborers from Myanmar, Cambodia and Laos who were working in Thailand in 2010. Regression analysis showed that social integration, participation in an AIDS prevention program, self efficacy, demographic and relationship factors increased AIDS knowledge and condom use with regular and nonregular partners. The social integration of migrants into the Thai community strengthened HIV prevention efforts.     

1045例MSM HIV感染状况及影响因素

目的了解男男性行为人群（MSM）的高危行为特征、艾滋病病毒（HIV）感染状况及影响因素。方法采取＂滚雪球＂法进行横断面调查,对选定的贵阳市和遵义市MSM开展面对面问卷调查,内容包括社会人口学特征、艾滋病知识和高危行为并采集血样检测HIV抗体。结果进行χ2检验和Logistic回归分析。结果共招募MSM 1 045人,平均年龄25.6岁,以贵州省的未婚男性为主,文化程度较高。艾滋病知识知晓率为89.7%（936/1 045）。HIV感染率达18.5%（193/1 045）。近6个月与男性发生肛交的占81.2%（829/1 021）,有14.0%（146/1 044）的MSM与女性发生过性行为。多因素回归分析结果提示,HIV的感染与年龄[≥41岁组,比值比（OR）=3.99]、民族（OR=1.91）、文化程度（大专以上文化组,OR=0.48）和近1年有性病相关症状（OR=1.97）等因素有关联。结论调查现场所在城市的MSM人群艾滋病（AIDS）处于高流行水平,该人群普遍存在无保护的多性伴行为,面对该人群艾滋病流行的严峻形势,急需实施具有针对性的预防服务和干预措施。     

With infection rates rising, will the new administration stay focused on AIDS? Activists worry that HIV prevention will be ignored

In a banner year for HIV prevention funding from the federal government, the news from major epidemic cities on both coasts puts a damper on any back-patting. It looks like new HIV infection rates are on the rise again among men who have sex with men. AIDS advocates say this means the Bush administration should renew the previous administration's focus on HIV prevention funding and make sure it remains a priority. Otherwise, middle America may soon see the same increases in HIV infection and a simultaneous increase in unsafe sexual behaviors among the people who are most at risk of infection.     

Using the theory of planned behaviour to understand the motivation to learn about HIV/AIDS prevention among adolescents in Tigray, Ethiopia

Various studies indicate that school- or university-based HIV prevention curricula can reduce the prevalence of sexual risk behaviour among adolescent youth in Sub-Saharan Africa. However, effective HIV/AIDS prevention education may be problematic, if the needs of youth are not served adequately. To date, little attention has been given to the motivation of youth to learn about HIV/AIDS and about their preferences for HIV/AIDS curriculum design options. The aim of this study was to get insight into the determinants of the motivation of youth to learn about HIV/AIDS prevention and to assess their curriculum design preferences. Students from a university in Tigray, Ethiopia, filled out a structured questionnaire, which assessed demographics, variables that according to the Theory of Planned Behaviour are related to the motivation to learn, and their preferences for independent, carrier and integrated HIV/AIDS curriculum designs. On average, participants were highly motivated to learn about HIV/AIDS. Motivation to learn was primarily related to social norms and was not related to self-efficacy to discuss HIV/AIDS in class. The often discussed reluctance to discuss sexuality and condom use in curricula in Sub-Saharan Africa, seems to be more related to existing negative social norms, than to lack of self-efficacy. Participants revealed a high preference for the independent, carrier and integrated curriculum design options. However, students with a higher motivation to learn about HIV/AIDS were more attracted to the independent course design.     

Anal sex, vaginal practices, and HIV incidence in female sex workers in urban Kenya: implications for the development of intravaginal HIV prevention methods

Multiple intravaginal HIV prevention methods, including microbicide gels, barriers, and intravaginal rings, are in clinical development in Africa. Development of intravaginal HIV prevention products requires an understanding of sexual behavior, sexually transmitted infection (STI), and vaginitis prevalences, and sexual and vaginal practices in potential target populations. We assessed these factors in a cohort of Kenyan female sex workers (FSW). Women who reported exchanging sex for money/gifts at least three times in the past month and who were HIV uninfected were enrolled and followed for 6 months. STI prevalence and HIV incidence were analyzed by multivariate logistic regression analysis, controlling for demographic and behavioral factors. Thirty-seven percent (74/200) reported having had anal sex. Frequency of anal sex was higher with regular and casual partners than with primary partners. Women were less likely to use condoms for anal sex than for vaginal sex with regular or casual partners. Vaginal washing was universal (100%). HIV incidence was 5.6 per 100 person-years (95% CI 1.62, 11.67). HIV incidence was not associated with any demographic or risk behavior. The relatively high rate of anal sex and universal vaginal washing may complicate both safety and efficacy evaluation of intravaginal products and should be taken into account in trial design. This FSW population had significant HIV incidence and needs continued HIV prevention interventions.     

某地区农村基层医务人员艾滋病知识、态度及相关行为研究

目的 了解基层医务人员艾滋病基本知识、态度和个人性行为。方法 对某地五个县(市)的县、乡两级医疗卫生单位医务人员进行分层随机抽样,用匿名调查表收集有关个人背景、艾滋病知识、态度和个人性行为资料。计算县、乡两级医务人员各项艾滋病知识正确率和不同态度的分布情况及危险性行为。结果 共调查296名医务人员。三条传播途径知识为44.44％～97.24％,非传播途径知识为62.28％～86.85％,两条预防方法知识为59.3％～63.76％,非预防方法知识为68.51％～85.07％。24.41％的人知道“普遍性防护原则”。65.52％的人认为开展艾滋病抗体检查有助于预防艾滋病传播。认为应该公开感染者身份和允许感染者继续工作的人分别占33.79％和42.76％。多数知识和态度问题县、乡两级间无明显差别。未婚者与至少2个人发生过性行为者占14.29％,已婚者过去6个月发生婚外性行为者为3.88％。结论 基层医务人员艾滋病基本知识比较低,要加强艾滋病预防专项培训工作,特别是“普遍性防护原则”的培训及具体实施,以减少艾滋病医源性传播。     

多部门合作人员AIDS防治相关情况调查

目的 了解多部门与艾滋病(AIDS)防治相关工作人员对《中国预防与控制艾滋病中长期规划(1998—2010年)》(简称《中长期规划》)及AIDS知识知晓情况,掌握我国AIDS防治工作存在的问题及需求,为制定AIDS防治策略及多部门人员培训计划提供建议与依据。方法 采用分层整群抽样方法。选择8个AIDS流行率及高危因素各具不同特点的省份的各1个地区(市)和1个县,随机抽样政府多部门与AIDS防治工作政策的制定或实施人员共800人,调查了解他们对《中长期规划》及AIDS知识知晓情况。结果 (1)72．35％的调查对象了解国家制定了《中长期规划》,但只有13．38％的调查对象阅读过《中长期规划》;(2)90％以上的调查对象对握手、游泳、共用办公用品不会传播艾滋病病毒(HIV)及通过性接触途径、接受输血及血制品、共用注射器和母婴途径可传播HIV的回答正确率较高;但对蚊虫叮咬、共用餐具、轻吻不传播HIV等回答的正确率不高。(3)对公开推广安全套态度不同。84．94％的调查对象认为安全套不仅可以避孕,同时也具有预防性病、AIDS的作用;有65．78％的调查对象赞成在宾馆、旅馆等公共场所放置安全套;48．23％的调查对象赞成在大学校园中公开销售安全套。(4)对防治工作的总体评价不同。84．17％的调查对象认为我国有AIDS流行;52．28％的调查对象认为当地有AIDS流行;分别有41．01％及29．53％的调查对象认为近2年来全国及当地的AIDS防治工作比较好;90％以上的调查对象认为AIDS的流行会影响当地经济和社会的发展;近70％的调查对象认为近年来当地打击卖淫嫖娼及禁毒工作取得了一定的成效,在预防与控制AIDS的工作中发挥了积极作用。(5)97．23％的调查对象认为中国需要制定有关AIDS防治的法律或法规;96．47％的调查对象认为AIDS防治有必要采取“多部门合作”的策略;67．83％的调查对象赞成“政府领导、多部门合作、全社会参与”AIDS综合防治对策;75．97％的调查对象认为健康教育是目前预防AIDS最重要和有效的措施。结论 在多部门合作领域,有针对性地开展《中长期规划》宣传和AIDS防治政策与策略的需求调研与评估工作,宣传普及AIDS防治相关知识,可以提高政府多部门间AIDS防治合作应对与决策能力,有效地达到预防和控制AIDS传播目的。     

Condom use by men with non-stable partners in Mexico City]

OBJECTIVE: To analyze the association between sociodemographic variables and condom use during vaginal sexual relationships with non-stable partners. MATERIAL AND METHODS: Data were taken from a household probability survey on sexual behavior in 1992-1993 in the Mexico City Metropolitan Area. Of the completed survey were obtained 8,068 men of 15 to 60 years of age. 1,535 were selected because they reported that their last sexual relationship with vaginal intercourse had been with a non-stable partner. Principal component analyses were conducted to groups of variables with common underlying structures, these components and other variables were included in a logistic regressions. Condom use during last intercourse was the dependent variable. RESULTS: Feeling that sex with condoms or sex without penetration could be pleasurable, a high ranking in a scale on self-efficacy for condom use, compulsion for using a condom because of being afraid of contracting HIV/AIDS were positively associated with using a condom in the last sexual intercourse. Marital status, schooling, and the number of episodes of sexually transmitted diseases were significantly associated with condom use. Perception of inevitability of becoming infected due to lack of trust in condoms was negatively associated with its use. None of the variables regarding knowledge on HIV/AIDS, including means of transmission and ways to prevent its infection, showed any significant association with condom use. CONCLUSIONS: Even when information is considered important in educational strategies, it might be more important to promote a positive perception on condoms and safe sex as pleasurable (at the individual and social level), as well as the promotion of self-efficacy on being able to use a condom or enforce preventive behaviors against HIV infection.     

第四轮中国全球基金艾滋病项目基线调查分析

目的 为评价第四轮全球基金艾滋病（AIDS）项目执行情况提供本底资料，并为项目计划修订和活动调整提供依据。方法 通过现有资料收集和现场调查获得项目县艾滋病疫情、高危人群规模及其危险行为特征以及防治工作现状。结果 7省76个项目县共累计报告艾滋病病毒（HIV）感染者／AIDS病人24316人，经注射吸毒传播的占74．0％，感染率高达85．1％。31个项目县发现暗娼HIV感染者，感染率最高达13．6％。结论 76个项目县HIV流行态势严峻，针对吸毒人群开展降低危害工作，对暗娼的预防干预以及对病人的治疗与目标差距很大，是项目的核心工作，需要加大工作力度。     

秦皇岛市MSM的HIV、TP、HCV感染状况及影响因素

目的了解秦皇岛市男男性行为人群（MSM）的艾滋病病毒（HIV）、梅毒螺旋体（TP）、丙型肝炎病毒（HCV）感染状况和相关影响因素,提出有针对性的防控性病艾滋病的干预建议。方法 2009-2012年连续4年采用自愿招募和滚雪球的方法,通过自愿咨询检测（VCT）门诊和开展外展干预活动,对第一次接受艾滋病咨询检测的MSM进行问卷调查和血清学检测。结果 4年共招募MSM 1043人。70.76%（738/1043）的人通过网络寻找性伴,4年间,艾滋病知识知晓率、接受艾滋病干预服务和接受HIV检测人数均逐年上升（P〈0.01）。近6个月,898人（86.10%）有过同性肛交行为,其中坚持使用安全套率为42.76%;34.63%（311/898）有过异性性行为,安全套坚持使用率为36.98%;9.02%（81/898）有过商业性性行为,安全套坚持使用率为53.09%。HIV、TP、HCV平均感染率分别为5.75%（60/1043）、7.19%（75/1043）、0.19%（2/1043）,HIV、TP感染率呈逐年上升趋势（P〈0.05）。多因素分析结果显示：文化程度相对低、在当地居住时间短、曾感染过性病是HIV、TP感染率的危险因素;年龄较大的MSM,TP感染的风险更大。结论秦皇岛市MSM HIV、TP感染率较高,应重点加强对年轻MSM的宣传干预力度,切实提高安全意识和安全行为,同时推广网络宣传干预;而在年龄大、已婚的MSM,则应加强TP筛查并提供方便、可及的诊疗服务。在开展性病艾滋病防治宣传的同时不应忽视丙型肝炎防治知识的宣传。     

HIV/AIDS stigma among a sample of primarily African-American and Latino men who have sex with men social media users

The recent increase in social media use allows these technologies to rapidly reach communities with higher HIV prevalence, such as African-American and Latino men who have sex with men (MSM). However, no studies have looked at HIV/AIDS stigma among social media users from African-American and Latino MSM communities, or the association between stigma and social media use among these groups. This study sought to assess the level of HIV/AIDS stigma among a sample of social media-using African-American and Latino MSM from Los Angeles. A total of 112 (primarily African-American and Latino, n?=?98, 88%) MSM Facebook users completed a survey on demographics, online social network use, and HIV/AIDS stigma. A composite stigma score was created by taking the cumulative score from a 15-item stigma questionnaire. Cumulative logistic models were used to assess the association between HIV/AIDS stigma and online social network use. In general, participants reported a low level of HIV/AIDS stigma (mean?=?22.2/75, SD?=?5.74). HIV/AIDS stigma composite score was significantly associated with increased time spent on online social networks each day (Adjusted odds ratios (AOR): 1.07, 95% CI: 1.00, 1.15). Among this diverse sample of MSM online social network users, findings suggest that HIV/AIDS stigma is associated with usage of social media. We discuss the implications of this work for future HIV prevention.