云南省德宏傣族景颇族自治州2015年新报告缅甸籍HIV感染者高危行为调查

目的 了解云南省德宏傣族景颇族自治州（德宏州）缅甸籍HIV感染者相关人口统计学与高危行为特征。方法 以德宏州2015年新报告的缅甸籍感染者为研究对象，开展横断面调查，收集其入境德宏地区的目的、住宿地点、停留时间等社会人口统计学信息以及艾滋病高危行为发生情况。结果 共调查489例缅甸籍感染者，其中男性367例（75.1%）；初中以下文化程度者407例（83.2%）；371例（75.9%）来自与德宏州相邻的克钦邦和掸邦； 339例（69.3%）为务工/经商进入德宏州。23.3%（113/485）的感染者存在无保护性行为，多因素logistic回归分析显示，感染者发生无保护性行为的危险因素包括有配偶/固定性伴（OR=12.98，95%CI：6.53～25.83，P<0.001），居住在打工场所（OR=2.88，95%CI：1.09～7.61，P=0.033）、出租屋（OR=5.36，95%CI：1.94～14.84，P=0.001）和自己家（OR=5.14，95%CI：1.36～19.35，P=0.016）。32.0%（156/487）的感染者有吸毒行为，多因素logistic回归分析结果显示，感染者发生吸毒行为的危险因素包括男性（OR=15.61，95%CI：6.47～37.69，P<0.001），文盲（OR=2.89，95%CI：1.44～5.84，P=0.003），来自克钦邦（OR=3.01，95%CI：1.50～6.04，P=0.002）、掸邦（OR=5.30，95%CI：2.66～10.58，P<0.001），经便道/其他方式入境（OR=1.93，95%CI：1.18～3.14，P=0.009），居住在亲友家（OR=5.78，95%CI：2.01～16.61，P=0.001）、打工场所（OR=6.67，95%CI：3.06～14.53，P<0.001）、出租屋（OR=11.84，95%CI：4.76～29.47，P<0.001）、自己家（OR=6.77，95%CI：1.84～24.85，P=0.004）。结论 德宏州内缅甸籍HIV感染者流动性大，感染状态知晓比例低而艾滋病相关高危行为发生率较高，给德宏州艾滋病防治工作带来巨大挑战，相关机构需积极探索有效的随访管理办法。

Risk behaviors among newly reported Burmese HIV infection in Dehong, Dai and Jingpo Autonomous Prefectures of Yunnan province, 2015

Objective To study the AIDS-related socio-demographic characteristics and high risk behaviors of Burmese HIV-infected individuals, in Dehong prefecture, Yunnan province. Methods A cross-sectional study with questionnaire interview, was conducted. Results Features of the 489 HIV-infected individuals appearfed as:367(75.1%) males, 407(83.2%) illiterate or with primary education, 371(75.9%) from Kachin State or Shan State, 306(62.6%) visited Dehong twice or more per year, 238(48.7%) entered Dehong illegally, 339(69.3%) came to the city looking for jobs or working on cargo transportation, 309(63.2%) of them living in working place/rented house/own house, and 313(64.0%) with the length of stay shorter than six months. Only 36(7.4%) of the interviewees were aware of their HIV sero-positive status, with 23.3% of them (113/485) reported having had unprotected sex experiences in Dehong. Results from the multivariate logistic regression model analysis showed that HIV-infected individuals with the following characteristics:having spouses/regular sexual partners (OR=12.98, 95%CI:6.53-25.83, P<0.001), living in working place (OR=2.88, 95%CI:1.09-7.61, P=0.033), living in rented houses (OR=5.36, 95%CI:1.94-14.84, P=0.001). Those living in their own houses (OR=5.14, 95%CI:1.36-19.35, P=0.016) were more likely to engage in unprotected sex. 32.0% (156/487) of the interviewees clained that they ever used drugs in Dehong, with 9.7% (47/487) of them sharing syringe. Data also showed that HIV-infected individuals who had the following feartures as:being male (OR=15.61, 95%CI:6.47-37.69, P<0.001), illiterate (OR=2.89, 95%CI:1.44-5.84, P=0.003), coming from Kachin State (OR=3.01, 95%CI:1.50-6.04, P=0.002) or Shan State (OR=5.30, 95%CI:2.66-10.58, P<0.001), illegal visiters (OR=1.93, 95%CI:1.18-3.14, P=0.009), living with friends/relatives (OR=5.78, 95%CI:2.01-16.61, P=0.001), living in working place (OR=6.67, 95%CI:3.06-14.53, P<0.001), or in rented houses (OR=11.84, 95%CI:4.76-29.47, P<0.001). The ones who were living in their own houses (OR=6.77, 95%CI:1.84-24.85, P=0.004) were more likely to engage in drug use in Dehong. Conclusion Results from our study showed that the Burmese HIV-infected citizens in Dehong prefecture had the following characteristics:high mobility, low awareness of HIV positive status and high prevalence of AIDS-related risky behaviors. These findings called for greater efforts on HIV/AIDS prevention and management in Dehong city.