浙江省农村外来婚嫁女HIV感染的流行病学特征分析

目的 调查浙江省农村外来婚嫁女HIV感染的流行病学特征.方法 于2009年对全省既往主动和被动监测发现的118例感染HIV或AIDS患者的外来婚嫁女进行回顾性调查,收集调查对象的社会人口学特征、感染危险行为及夫妻间安全套使用、配偶及子女HIV感染状况等信息,利用EpiData 3.0和SPSS 13.0进行数据库建立及单因素和多因素分析.结果 118例调查对象嫁人浙江省以前原户籍主要在云南省53.4%(63/118)],少数民族占33.1%(39/118),HIV抗体检测发现阳性时配偶同时检测阳性的比例为30.6%(33/108),女性单方HIV抗体阳性夫妻随访中配偶HIV抗体阳转率为2.09/100人年(3/143.5人年).调查对象中有非婚异性性行为的占83.9%(99/118),69.5%(82/118)的人在原籍有前男友或配偶;调查对象检测发现HIV抗体阳性时配偶同时检测阳性的有36对夫妻,检出前夫妻间性行为从来不用安全套的占63.9%(23/36).单因素分析显示,外来婚嫁女嫁入浙江省与检测发现HIV抗体阳性时间间隔为2年以下12(20.7%)]、2～5年9(31.0%)]、5年以上11(57.9%)]的夫妻双方均为阳性的检出率的差异有统计学意义(x2=8.708,P=0.003);多元非条件logistic回归分析显示,嫁入浙江省与检测发现阳性时间间隔长是配偶感染的危险因素(OR=2.223;95%CI:1.288～3.836).结论 浙江省农村外来婚嫁女婚前有不安全性行为、婚内性行为不使用安全套、嫁入本省后检测发现迟是HIV感染和传播的主要危险因素.

Analysis of epidemiological characteristics of HIV infections among immigrant marriage women in rural areas in Zhejiang province

Objective To analyze the epidemiological characteristics of HIV infected immigrant marriage women in rural areas in Zhejiang province. Methods A retrospective investigation was conducted among 118 HIV infected immigrant marriage women,who were detected in active or passive surveillance in rural areas in Zhejiang provinve. The investigation information included the basic demographic characteristics, risky behavior, the status of HIV infection among their spouses and children. EpiData 3.0 and SPSS 13.0 software were used for database set up and bivariate and multiple logistic regression analysis. Results By the end of 2009, a total of 118 HIV/AIDS were reported among immigrant marriage women. Of which,53.4% (63/118) of the subjects were from Yunnan province and 33. 1% (39/118) were minority nationality,and 30. 6% (39/108)of their spouses were diagnosed HIV infection when these targeted women were detected. In discordant couples follow up with female partner being HIV positive, the spouse seroincidence rate was 2.09 per 100 person years (3/143.5 person years). Subjects who had sexual behavior beyond marriage accounted for 83.9% (99/118 ) of total, and 69.5 % ( 82/118 ) subjects had former boyfriend or former husband in former inhabited places. In the 36 concordant-positive couples,63.9% (23/36)reported never using condom in in-marriage sexual behavior before being detected HIV positive. Bivariate analysis results revealed that the significant difference for the HIV positive testing rate for a couple among different time duration that an immigrated woman moved to Zhejiang province due to marriage was observed (x2 =8. 708,P=0. 003). While the number and proportion of HIV positive couples for those immigrated women who lived in Zhejiang province for less than 2 years,2 - 5 years, more than 5 years were 12 (20. 7% ),9 (31.0% ), 11 (57.9%) ,respectively. Multiple logistic regression analysis showed that the long time length when an immigrated woman was detected positivity after she moved to Zhejiang province was the risk predictor of their husband being infected ( OR = 2. 223 ;95% CI: 1. 288 - 3. 836 ). Conclusion It is showed that premarital unsafely sexual behavior, in-marriage sexual behavior without condom, delayed detection of HIV are risk factors for HIV infection and transmission.