中国1995-2009年吸毒者艾滋病毒感染和梅毒流行趋势分析

目的 了解中国不同地区吸毒者艾滋病和梅毒流行特点和变化趋势.方法 收集1995年以来中国艾滋病监测系统病例报告、哨点监测和疫情估计信息,分析吸毒者艾滋病病例报告数量与分布变化情况,吸毒者HIV和梅毒感染率变化趋势以及吸毒行为的变化情况.结果 中国吸毒者规模在过去6年中基本保持稳定,艾滋病病例报告中吸毒者所占比例逐年下降,从2005年之前的44.2%下降到2009年的25.8%.2009年哨点监测数据显示,中国吸毒者HIV和梅毒感染率差异较大,西南地区高东北地区低的态势较为明显.2009年吸毒者哨点HIV抗体平均检出率为6.2%,梅毒为3.7%;注射吸毒者HIV平均感染率为9.2%,梅毒为4.0%.多年监测结果显示,1995-1999年为全国吸毒人群HIV感染的快速增长期,2000年之后注射吸毒者流行进入平台期,最近3年HIV抗体检出率维持在9.0%～10.0%、梅毒检出率在3.5%～4.5%之间波动.结论 在未来一段时期内吸毒行为仍是中国艾滋病流行的重要影响因素;应根据区域流行特点有针对性地制定艾滋病防治措施.

Situations and trends of HIV and syphilis infections among drug users in China, 1995-2009

Objective To understand the characteristics and trends of HIV and syphilis infections among drug users. Methods Information was collected regarding HIV and syphilis epidemics, as well as on high risk behaviors from the HIV/AIDS surveillance system. Source of information was from HIV/AIDS case- reporting, sentinel surveillance and trend estimation, related to the changes of distribution among HIV positive drug users prevalence rates on HIV and syphilis together with their high risk behaviors. Results Scale number on drug users remained stable in the past six year (from 2003-2009), while the proportion of drug users decreased from 44.2% in 2005 to 25.8% in 2009. Based on the information from HIV/AIDS case reporting system, HIV sentinel surveillance data showed that the HIV prevalence of drug users was quite different from those of Southwestern to Northeastern parts of China. The HIV prevalence in Southwestern China was much higher than that of the Northeastern areas. Sentinel surveillance data showed that the average positive rates were 6.2% and 3.7% on HIV and syphilis , among the drug users. As for injecting drug users (IDU), the average rates on HIV antibody syphilis and HCV were 9.2% and 4.0% respectively. Series surveillance data indicated that the HIV epidemic expanded quickly among drug users from 1995-1999 but became plateaued after 2000 among the IDUs. HIV antibody positive rate remained at 9.0%-10.0% in the past three years while syphilis fluctuated between 3.5%-4.5% in the past three years. Conclusion Drug users and IDUs still remained an important driven factor for HIV/AIDS epidemic in China, suggesting more specific strategies and methods should be developed, based on the characteristics and trends of HIV epidemic, to optimize the allocation HIV prevention and control resources.