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.

Analysis of the epidemiologic patterns of HIV transmission in Dehong prefecture, Yunnan province

Objective To uncover the transmission patterns of the HIV epidemic in Dehong prefecture.Methods The reviewed case reports,data of sentinel surveillance,testing and special survey were analyzed by SAS 8.0 program.The transmission patterns were modeled by utilizing data including sizes of the whole population and the high risk groups,high risk behavior data from 1989 to 2007,and the population index such as sex ratio and fertility rate.Results In 2005,case reports showed the proportion of people infected with HIV through sexual contact was 39.1%,and 46.9%in 2006.Among 1636 cases reported between January 1 to September 20,2007,the proportion of people infected with HIV through sexual contact was 52%.From 1 989 to 2007,the proportion of HIV infection among drug users was declining,while HIV infection through sexual contact was rising after standardizing the population tested/surveyed.The Asian Epidemic Model has shown that the proportions of incident HIV infections through sexual transmissions were 50.6%,52.3%and 52.7%respectively from 2005 to 2007.Correspondingly,the proportions of incident cases by injecting drug user were 48.9%,47.2%and 46.7%respectively during this period.Moreover,the Workbook method has shown that,among adults living with HIV in 2007,50.3%were infected through injecting drugs and 48.4%through unsafe sexual activity.Conclusion The rapid rise in HIV infections through injecting drug in Dehong prefecture has been initially curbed.HW epidemic has already witnessed a change from predominantly through drug injecting-related activity to an almost equally fuelled epidemic by sexual and drug-related transmission.