云浮市2004～2006年艾滋病流行特点分析

[目的]分析云浮市各监测人群艾滋病病毒/艾滋病(HIV/AIDS)的感染状况及相关行为情况,掌握云浮市HIV/AIDS的流行趋势,为制定预防控制策略提供依据。[方法]分析云浮市2004～2006年的HIV/AIDS常规、哨点、行为监测资料。[结果]自1997年以来云浮市累计发现艾滋病病毒感染者349例,其中HIV 289例,AIDS60例。近3年来艾滋病感染数量分别以60%、53%、41%速度递增;2004～2006年云浮市共报告HIV/AIDS 248例,发现的HIV感染者占总数的71.06%,感染人群以20～39岁组为主,214例,占总发现数的86.29%,2004～2006年HIV感染者中职业不详或其他的占总数7.62%;经静脉吸毒途径感染者占总数的84.91%,性途径占7.11%;并发现两例母婴传播病例。感染者中男性占92.74%,女性占7.26%。[结论]云浮市艾滋病流行速度明显加快,近年来主要在吸毒人群中传播,应对高危人群采取减少危害等干预措施,控制HIV从高危人群向一般人群传播。     

博爱县1995-2006年艾滋病流行趋势分析

目的分析博爱县艾滋病(AIDS)流行趋势,为制定预防控制策略提供依据。方法对博爱县1995-2006年6月的AIDS常规、哨点监测及专题调查资料进行描述性流行病学分析。结果1995-2006年上半年共报告HIV/AIDS病例48例,其中2004-2006年上半年发现的感染者占总数的79.17%(38/48),感染者中农民占77.08%(37/48),年龄在31岁以上的36例,占总数的75.00%(36/48)。感染途径中经献(受)血途径感染的39例,占总数的81.25%(39/48),经性接触途径感染的7例,占总数的14.58%(7/48)。结论近年博爱县HIV流行速度明显加快,主要在献(受)血人群和性乱人群中传播,应针对高危人群采取干预措施,以降低HIV的感染水平。     

208 例艾滋病/HIV 感染者疫情分析

目的探讨济南市艾滋病/HIV感染者流行特征,为制定防制措施及对策提供科学依据。方法对济南市1998-2006年艾滋病/HIV感染者发病资料和防治进行分析。结果济南市艾滋病/HIV感染者发病呈逐年上升趋势,1998-2006年累计报告艾滋病/HIV感染者208例,年龄分布以20～49岁组最高,共178例,占报告发病总数的85.58%,男、女均有发病,男性发病153例,女性发病55例,男、女发病比例为2.78:1,男性发病高于女性。职业报告发病农民最多,共78例,占报告发病数的37.50%;感染途径:经血液感染共计102例,占总感染数的49.04%。结论应大力开展宣传教育,不断提高市民的性安全卫生防病意识,并加强对高危人群的监督和监测。     

云南省德宏州艾滋病传播模式分析

目的 对云南省德宏州当前艾滋病疫情的传播模式做出初步判断.方法 对德宏州1989-2007年艾滋病监测(检测)覆盖人群数量及其构成比、报告的感染者(患者)的流行病学资料应用SAS 8.0软件进行分析.将德宏州1989-2007年的人口规模、高危人群规模及高危行为数据、2000-2007年出生性别比、总和生育率等人口学数据带入模型,对德宏州艾滋病传播模式进行判断.结果 病例报告中经性途径感染的比例2005年为39.1%,2006年为46.9%,2007年1月1 日-9月20日的1636例感染者(患者)中约52%为经性途径传播.对1989-2007年监测(检测)人数的构成比标化后结果显示,吸毒人群中艾滋病病毒(HIV)阳性检出率呈下降趋势,而经性途径感染的HIV感染者呈上升趋势.亚洲艾滋病流行模型(asian epidemic model,AEM)显示,2005-2007年新发感染者中通过性途径感染的比例分别为50.6%、52.3%、52.7%,经吸毒感染人数比例分别为48.9%、47.2%、46.7%.Workbook模型显示,2007年成人现存活的HIV感染者中,经注射吸毒感染的占50.3%,经性途径感染的占48.4%.结论 德宏州艾滋病疫情经吸毒传播快速上升势头得到初步遏制,艾滋病的传播模式已由经静脉注射吸毒为主转换为经性途径和注射吸毒传播两种途径并重的局面.     

会泽县HIV感染者/AIDS患者流行病学分析

目的了解会泽县HIV感染者/AIDS患者的流行特征。方法分析1997-2007年会泽县HIV感染者/AIDS患者的流行病学调查资料,采用描述性流行病学方法进行分析。结果1997-2007年会泽县共报告HIV感染者/AIDS患者173例,其中HIV感染者128例,AIDS患者13例,报告死亡32例;男性107例,女性66例,男女性别比为1.62∶1。感染途径以性接触传播为主,占39.3%(68例),其次为静脉吸毒占26.6%(46例),母婴传播占1.7%(3例),传播途径不详占32.4%(56例)。结论会泽县艾滋病流行形势严峻,多种传播途径并存,并呈由高危人群向一般人群蔓延趋势。     

深圳市1992～2003年艾滋病流行现状分析

目的 分析深圳市艾滋病(AIDS)流行现状,为制定预防控制策略提供依据。方法 分析深圳市1992～2003年的AIDS常规、哨点监测资料。结果 1992～2003年深圳市共报告HIV／AIDS病例540例,2002～2003年发现的感染者占总数的67．2％(363／540),省外流动人员占53．9％(291／540),省内流动人员占34．3％(185／540)。感染者中无业人员占57．4％(310／540),年龄在21～40岁之间的446例,占总数的82．5％。感染途径中,经静脉吸毒途径感染的311例,占总数的57．6％,经性接触途径感染的183例,占33．9％。结论 深圳市HIV流行速率明显加快,主要在吸毒人群和性乱人群中传播,应对高危人群采取针对性干预措施,以降低HIV的感染水平。     

HIV/AIDS门诊患者381例流行病学分析

目的分析沈阳市及周边城市人免疫缺陷病毒(HIV)感染者/艾滋病(AIDS)患者流行病学特征,为艾滋病防治提供科学依据。方法以中国医科大学附属第一医院红丝带门诊收治的1993年1月-2009年7月确诊HIV/AIDS患者为调查对象,回顾性分析HIV/AIDS患者人口学特征、HIV传播途径等流行病学资料。结果门诊累计收治HIV/AIDS患者381例,男性333例,占87.4%,19~40岁年龄组228例,占59.8%;2006-2009年确诊HIV感染者是1993-1997年确诊HIV感染者的46倍;男男性接触者(MSM)占所有感染者的比例从1998-2001年的3.3%(1/30)上升至2006-2009年的73.2%(202/276),已成为HIV感染主要人群。结论沈阳地区以男男性接触为主要传播途径的HIV感染者数量增长迅速。     

自贡市吸毒人群HIV、HCV感染情况及危险因素分析

目的了解自贡市吸毒人群HIV、HCV感染状况及其危险因素,为制定艾滋病及相应传染病的防控措施提供依据。方法对2006-2008年在自贡市疾病预防控制中心美沙酮门诊接受美沙酮替代疗法的吸毒人员进行社会人口学及吸毒行为调查,并采集血样检测HIV、HCV抗体。结果共调查727名吸毒人员,检出HIV抗体阳性158例,阳性率为21.73%;检出HCV抗体阳性584例,阳性率为83.67%(584/698);在158例HIV感染者中合并感染HCV134例,占HIV感染者的84.81%(134/158)。多因素logistic回归分析结果显示,吸毒时间、是否共用注射器是HIV感染的影响因素;吸毒方式、是否共用注射器、婚姻状况和职业情况是HCV感染的影响因素。结论自贡市吸毒人群HIV、HCV感染率较高,而且HIV合并感染HCV比例也较高,提示吸毒人群中存在许多加速艾滋病和丙型肝炎流行的危险因素,应采取有效措施控制HIV、HCV的传播和流行。     

2002—2011年重庆市铜梁县HIV/AIDS疫情分析

目的了解重庆市铜梁县2002—2011年艾滋病病毒(感染者)/艾滋病(患者)(HIV/AIDS)流行特征和发展趋势,为制定艾滋病防制措施提供科学依据。方法对铜梁县2002—2011年HIV/AIDS疫情报告资料进行流行病学分析。结果铜梁县2002—2011年累计报告HIV/AIDS病例259例,感染途径前期以静脉注射吸毒和性传播为主,后期以性传播为主;病例以中青年为主,占71.43%;男性占总数的70.27%,女性占总数的29.73%;文化程度以中低文化程度为主;职业以待业和民工、农民为主。结论铜梁县HIV/AIDS病例呈逐年增长的趋势;感染者以中青年为主,感染途径已发生变化,健康的性观念和使用安全套是针对高危人群的主要干预措施,在普通人群中开展艾滋病防治知识的健康教育十分重要。     

昭通市1997-2007年艾滋病流行分析

目的了解昭通市艾滋病传播途径及不同人群流行特点和变化趋势。方法采用1997-2007年昭通市本地监测检出的艾滋病病毒（human immunodeficiency virus,HIV）感染者统计表和艾滋病疫情专网报告的数据进行统计分析。结果1997-2007年该市HIV累计报告感染者914例,2002年前报告144例,2003-2007年累积报告HIV感染者770例,其中本地检出524例,占报告数的68.05%,外地报告246例,占报告数的31.95%。静脉吸毒260例,占33.8%,异性性接触155例,占20.1%,母婴传播20例,占2.6%,不详335例,占43.5%。报告感染率从1997年的0.19/10万上升到2007年的3.51/10万,外出务工人员感染率为23.43/10万。结论1997-2007年昭通市HIV感染和传播途径发生较大变化,感染率不断上升,感染人群从吸毒等高危人群快速向一般人群扩散,流动人口感染率快速上升。     

Counselling anomie: clashing governmentalities of HIV criminalisation and prevention

HIV criminalisation is a term that describes the criminal prosecution of persons in instances of HIV transmission, exposure and so-called non-disclosure of their HIV serostatus. In the United States (US), there have been over 500 reported instances of HIV criminalisation. Over the past decade, several negative consequences of HIV criminalisation have been identified, including its capacity to increase stigma and social injustice. In addition, scholars have built an evidence base demonstrating that HIV criminalisation has the potential to undermine HIV prevention and that it is thus harmful to public health. This article contributes to that evidence base by (1) combining Foucaultian studies of ‘governmentality’ with the sociology of ‘anomie’ to theorise the larger implications of HIV criminalisation for the institution of public health, and (2) presenting interviews with public health service providers working in Tennessee, USA. This state is an important site for studying the public health implications of HIV criminalisation because, between 2008 and 2012, it was reported to have led all American jurisdictions in prosecutions of HIV-specific criminal offences. Concentrating on discussions of post-test counselling, this article argues that a major system-level effect of HIV criminalisation is the propagation of an anomic affective climate, which makes it difficult to establish norms of HIV prevention.     

HIV prevention in sub-Saharan Africa: a multilevel analysis of message frames and their social determinants

In light of the great threat that HIV/AIDS poses in sub-Saharan Africa, the current study assesses HIV/AIDS posters from this region with specific reference to health message frames, including HIV sources, consequences, self-efficacy, preventive means, and barriers and benefits to employing such means of prevention. There is a two-step methodology. First, the content of HIV/AIDS posters from 15 sub-Saharan African countries was coded for the six health message frames. Second, relationships between the health message frames and four social determinants (HIV rate, HIV awareness, condom use and uncertainty avoidance (UAI)) were assessed with hierarchical linear modeling (HLM). Analysis indicates that self-efficacy is the most common frame, but that almost one-quarter of the posters has none of the six health message frames. HLM indicates some favorable findings, including that health message frames are used most often in countries with the most troubling levels of HIV awareness and condom use. Less favorably, health message frames are used least common in countries that have high levels of UAI and high HIV rates. Improvements for related media practices and policy are articulated.     

江西省结核病人中HIV感染现状调查

[目地]通过对结核病人进行HIV感染状况筛查,分析江西省结核病人人群中HIV的流行特征,为制定TB/HIV双重防治感染措施提供科学依据.[方法]2007年9～12月在调查县(区)新登记的结核病患者病例,填写<新登记结核病人HIV感染现状调查表>,对同意接受HIV筛查的病人进行抽血、检测,初筛阳性的患者进行确证实验.[结果]97%的登记病人接受了筛查,筛查出5例TB/HIV阳性患者,感染率为0.36%,项目地区与非项目地区TB/HIV双重感染有统计学差异(u=4.45,P＜0.001).[结论]重点加强HIV感染高疫情流行地区中重点人群HIV感染监测,建立有效的部门合作机制,强化治疗管理,为控制TB/HIV疫情的主要手段.     

An Epidemic in Evolution: The Need for New Models of HIV Care in the Chronic Disease Era

Since the beginning of the AIDS epidemic, models of HIV care have needed to be invented or modified as the needs of patients and communities evolved. Early in the epidemic, primary care and palliative care predominated; subsequently, the emergence of effective therapy for HIV infection led to further specialization and a focus on increasingly complex antiretroviral therapy as the cornerstone of effective HIV care. Over the past decade, factors including (1) an aging, long-surviving population; (2) multiple co-morbidities; (3) polypharmacy; and (4) the need for chronic disease management have led to a need for further evolution of HIV care models. Moreover, geographic diffusion; persistent disparities in timely HIV diagnosis, treatment access, and outcomes; and the aging of the HIV provider workforce also suggest the importance of reincorporating primary care providers into the spectrum of HIV care in the current era. Although some HIV-dedicated treatment centers offer comprehensive medical services, other models of HIV care potentially exist and should be developed and evaluated. In particular, primary care- and community-based collaborative practices—where HIV experts or specialists are incorporated into existing health centers—are one approach that combines the benefits of HIV-specific expertise and comprehensive primary care using an integrated, patient-centered approach.     

枞阳县2005～2011年不同人群HIV抗体检测结果分析

目的了解不同人群HIV感染状况,为艾滋病监测和防治工作提供依据。方法收集枞阳县2005-2011年不同人群艾滋病病毒（HIV）抗体检测数据并进行分析。结果 2005-2011年共检测不同人群HIV-抗体31470人,确认HIV-抗体阳性29例。其中男性19例,女性10例,年龄最大的65岁,最小的2岁;感染途径主要是异性性传播20例（占68.97%）,其次男男同性性传播7例（占24.14%）。结论枞阳县不同相关人群发现HIV感染者,且有增多趋势,加强特定目标人群筛查,最大限度地发现HIV感染者及AIDS病人,控制艾滋病的流行。     

Trends in human immunodeficiency virus diagnoses among men who have sex with men in North America,Western Europe,and Australia, 2000–2014

PurposeThe aim of the article was to investigate recent trends in human immunodeficiency virus (HIV) diagnosis rates among men who have sex with men (MSM) in high-income countries in North America, Western Europe, and Australia.MethodsData on annual rates of HIV diagnoses among MSM aged 15 to 65 years from 2000 to 2014 were collected from 13 high-income countries. Joinpoint regression software was used to empirically determine country-specific trend periods. Trends in HIV diagnosis rates and in the proportion of diagnoses occurring in young MSM aged 15 to 24 years were analyzed using Poisson regression and log-binomial regression, respectively.ResultsSix countries experienced an increasing trend from 2000 to 2007-08 followed by either a stable or declining trend through 2014. Five countries had recently increasing trends, and two countries had one stable trend from 2000 to 2014. All 13 countries experienced increases in the proportion of diagnoses occurring in young MSM.ConclusionsSince 2008, half of the 13 high-income countries examined experienced stable or decreasing trends. Still, some countries continue to experience increasing HIV trends, and young MSM are increasingly represented among new diagnoses. Efforts to support early sexual health promotion, reduce barriers to pre-exposure prophylaxis, and improve care engagement for young MSM are critical to addressing current HIV trends.     

Shifting the Paradigm: Using HIV Surveillance Data as a Foundation for Improving HIV Care and Preventing HIV Infection

Context

Reducing HIV incidence in the United States and improving health outcomes for people living with HIV hinge on improving access to highly effective treatment and overcoming barriers to continuous treatment. Using laboratory tests routinely reported for HIV surveillance to monitor individuals’ receipt of HIV care and contacting them to facilitate optimal care could help achieve these objectives. Historically, surveillance-based public health intervention with individuals for HIV control has been controversial because of concerns that risks to privacy and autonomy could outweigh benefits. But with the availability of lifesaving, transmission-interrupting treatment for HIV infection, some health departments have begun surveillance-based outreach to facilitate HIV medical care.

Methods

Guided by ethics frameworks, we explored the ethical arguments for changing the uses of HIV surveillance data. To identify ethical, procedural, and strategic considerations, we reviewed the activities of health departments that are using HIV surveillance data to contact persons identified as needing assistance with initiating or returning to care.

Findings

Although privacy concerns surrounding the uses of HIV surveillance data still exist, there are ethical concerns associated with not using HIV surveillance to maximize the benefits from HIV medical care and treatment. Early efforts to use surveillance data to facilitate optimal HIV medical care illustrate how the ethical burdens may vary depending on the local context and the specifics of implementation. Health departments laid the foundation for these activities by engaging stakeholders to gain their trust in sharing sensitive information; establishing or strengthening legal, policy and governance infrastructure; and developing communication and follow-up protocols that protect privacy.

Conclusions

We describe a shift toward using HIV surveillance to facilitate optimal HIV care. Health departments should review the considerations outlined before implementing new uses of HIV surveillance data, and they should commit to an ongoing review of activities with the objective of balancing beneficence, respect for persons, and justice.     

高危人群HIV感染状况的流行病学分析

为了解高危环境人群的 HIV感染状况 ,于 1992～ 1995年对卖淫妇女 ( 55人 )、归国劳务人员 ( 159人 )、职业献血员 ( 88人 )、性病 ( STD)患者 ( 88人 )、HIV感染者的配偶 ( 3人 )和子女 ( 3人 )共计 396人进行了抗 - HIV检测和流行病学调查。抗 - HIV采用 Western blot法 ,阳性结果送山东省艾滋病检测中心复核确诊。4年共发现 6名 HIV感染者 ,其中男、女献血员各 1名 ,归国劳务人员 4名 (均为男性 ) ,其他人群未检出抗 - HIV阳性者。     

HIV/AIDS Prevention in New York City: Identifying Sociocultural Needs of the Community

This article is a call for those who design social work courses to recognize the complexity and richness of aged care social work in health care and to social workers to shake off ageist attitudes and consider working with older people as a positive option in this rapidly expanding area of social work practice. A mixture of practice experience together with findings from the literature, this article explores social work practice with older people in hospital settings. Social work with older people has both therapeutic and practical components. The importance of integrating a therapeutic approach into all aspects of social work practice with this population cannot be overestimated.     

东莞口岸从三资企业从业人员中检出3例HIV感染者的报告

〔目的〕了解东莞口岸三资企业从业人员中HIV感染者的流行病学特点,以便采取有效的控制措施。〔方法〕对2000～2001年从东莞口岸入境的三资企业境外人员进行了艾滋病血清学检验。〔结果〕检出3例HIV感染者,分别为台湾籍1人;缅甸籍1人;巴西籍1人。经流行病学调查,3例HIV感染者的艾滋病传播途径为性传播。〔结论〕随着我国对外开放,到我国三资企业从业的外籍人员日益增多,有些是来自艾滋病高发国家,出入境检验检疫机关应加强对这一重点人群的艾滋病监测工作,有效地控制艾滋病从国外传入国内。