广东省中山市2010-2012年艾滋病自愿咨询检测数据分析

目的探索广东省中山市艾滋病自愿咨询检测（VCT）HIV抗体阳性率及影响因素。方法从《中国疾病预防控制信息系统》下载2010--2012年广东省中山市艾滋病VCT数据；对参加VCT的人员进行HIV、梅毒血清学检测；在描述性分析基础上，对影响HIV阳性率的因素进行单因素分析和多因素非条件logistic回归分析。结果广东省中山市设置3个VCT点，2010--2012年对3613人次提供服务，其中3601人次（99．7％）接受HIV抗体检测，阳性率5．9％（212／3601），其中男性、女性HIV抗体阳性率分别为：5．8％（173／2972）、6．2％（39／629）；2759人次接受梅毒抗体检测，梅毒阳性率4．4％（121／2759），其中男性、女性梅毒阳性率分别为4．9％（117／2389）、1．1％（4／370）。梅毒阳性者的HIV阳性率为25．6％（31／121）。不同求询原因人群HIV阳性率分别为：既往检测怀疑阳性66．7％（8／12），既往输血卖血史17．6％（3／17），固定性伴阳性13．1％（29／221），注射吸毒12．7％（8／63），男男性行为人群（MSM）10．4％（114／1096），性病史6．3％（3／48），固定性伴高危行为人群5．9％（4／68），母亲阳性3．0％（1／33），非婚异性性行为2．5％（22／896），商业异性性行为人群2．4％（20／825）；职业暴露、母亲之外其他家庭成员阳性、拔牙、针刺等不安全行为、健康检查和恐艾人群均未发现阳性者。多因素logistic回归结果表明：文化程度越低（AOR=1．39），HIV阳性的风险越高；相对于梅毒阴性者，梅毒阳性者HIV阳性的风险更高（AOR=4．14）；MSM、固定性伴阳性人群HIV阳性的风险分别高于非婚异性性行为人群（AOR=4．78、4．71，均P〈0．01）。结论中山市接受VCT服务的人群中，文化程度低、梅毒抗体阳性、MSM及固定性伴阳性人群有着更高的HIV感染率，需要在这些人群中开展更加有效的综合防治工作。

Analysis of HIV voluntary counseling and testing data in Zhongshan City, 2010 - 2012

Objective To understand HIV positive rate and its correlation among voluntary counseling and testing （VCT） in Zhongshan City, Guangdong Province. Methods The VCT data during 2010 to 2012 in Zhongshan City were downloaded from China information system for disease control and prevention. HIV and syphilis serological detection were performed for all VCT participants. The HIV positive rates were analyzed using the single factor and muhifactor unconditioned logistic regression. Results Three VCT sites received 3 613 clients during 2010 to 2012. Of the 3 601 （99. 7% ） clients having HIV test, 212 （5.9%） were positive. The HIV positive rates were 5.8% （173/2 972 ） for male and 6. 2% （39/629） for female. Of the 2 759 clients having syphilis test, 121 （4.4 % ） were positive. The syphilis seropositive rate was 4. 9% （ 117/2 389） for male and 1.1% （4/370） for female. The HIV positive rate for syphilis seropositive clients was 25.6% （31/121）. The HIV positive rates were 66. 7% （8/12） for those suspected positive in history test, 17.6% （3/17） for those with blood transfusion or sale history, 13.1% （29/221） for those having a positive regular sexual partner, 12.7% （8/63） for those injecting drug use, 10.4% （114/1096） for those men who had sex with men （MSM）, 6. 3% （3/48） for those with sex transmitted disease history, 5.9% （4/68） for those having a regular sexual partner with high risk behaviors, 3.0% （1/33） for those whose mothers were HIV positive, 2. 5% （22/896） for those with un- married heterosexual behaviors, and 2.4% （ 20/825 ） for those with commercial heterosexual behaviors. Clients with occupation exposure, positive family members except for the mother, unsafe behaviors such as exelcymosis and needling, health examination, or fear of AIDS were all screened to be HIV negative. The multifactor logistic regression model showed that, the lower level of education （AOR = 1.39 ）, had a higher risk to be HIV positive ; clients with syphilis seropositive tests were 4. 14 times the risk to be HIV positive compared to those with syphilis seronegative tests ; MSM were 4.78 times the risk to be HIV positive com- pared to those with unmarried heterosexual behaviors, and those with a positive regular sexual partner were 4. 71 times the risk to be HIV positive compared to those with unmarried heterosexual behaviors （ all P 〈 0. 01 ）. Conclusion Clients of the low level of education, the syphilis seropositive, MSM, and those with a positive regular sexual partner have a relative high HIV infection rate. It is necessary to take more comprehensive and effective prevention measures and intervention.