重庆市部分地区新报告异性性传播HIV/AIDS感染方式分析

目的 了解重庆市部分地区新报告异性性传播HIV/AIDS的感染方式，为有效开展艾滋病经异性性传播的防控提供依据。方法 对重庆市部分地区2019年7月1日至10月1日新报告的异性性传播HIV/AIDS展开面对面问卷调查，收集社会人口学特征、异性性行为情况等相关数据。结果 共完成312例异性性传播HIV/AIDS的问卷调查，主要以男性（207，66.3%）、≥50岁（210，67.3%）、初中及以下文化程度（252，80.8%）、已婚或同居者（200，64.1%）为主。经商业性行为感染占48.7%（152/312），经配偶/固定性伴感染占40.4%（126/312），经非商业临时性行为感染占10.9%（34/312）。不同性别、年龄、职业的HIV/AIDS，感染方式差异有统计学意义（P<0.05）。多因素logistic回归分析结果显示，相比于经配偶/固定性伴感染，男性（OR=822.34，95% CI：103.99～6 503.10）、初中及以下文化程度者（OR=3.02，95% CI：1.05～8.66）的商业性行为感染HIV风险更大；而家务/待业者（OR=0.23，95% CI：0.07～0.76）的商业性行为感染HIV的风险更小；男性（OR=29.20，95% CI：9.40～90.75）、初中及以下文化程度者（OR=4.28，95% CI：1.24～14.81）的非商业临时性行为感染HIV的风险更大。除了在线下场所结识非婚异性性伴，有一定比例（6.2%）HIV/AIDS通过线上交友发展性伴关系，且性伴交往场所以低档为主。结论 重庆市部分地区新报告异性性传播HIV/AIDS的感染方式以线下低档场所结识性伴，并经商业性行为感染为主，应深入了解异性性传播HIV/AIDS的感染方式，制定有针对性的干预策略。

Characteristics of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city

Objective To understand the routes of newly reported HIV/AIDS cases with heterosexual mode of transmission in six districts of Chongqing city, and to provide evidence for HIV/AIDS prevention and control programs regarding heterosexual mode of transmission on HIV. Methods HIV/AIDS cases that were newly reported as with heterosexual mode of transmission in six districts of Chongqing from July 1st to October 1st in 2019, were recruited in the study. Information related to their sociodemographic characteristics and heterosexual behaviors was collected. A self-designed questionnaire was used in this face-to-face survey. Results A total of 312 HIV/AIDS cases with heterosexual mode of transmission were recruited. Most of them were males (207, 66.3%), aged 50 years or over (210, 67.3%), having junior high school or lower education (252, 80.8%), married or cohabitating (200, 64.1%). 48.7% (152/312) of them were infected through commercial sexual contact while 40.4% (126/312) of them were infected by spouses or stabled partners. 10.9% (34/312) of them were infected by non-marital and non-commercial sexual contacts. Significant differences were noticed on the infection mode of heterosexual transmission in gender, age and occupation (P<0.05). Results from the multivariate logistic regression analysis revealed that: male (OR=822.34, 95%CI: 103.99-6 503.10), junior high school and lower education level (OR=3.02, 95%CI: 1.05-8.66), household chores and underemployed (OR=0.23, 95%CI: 0.07-0.76) were influencing factors on HIV infection that were through commercial sexual contacts. Male (OR=29.20, 95%CI: 9.40-90.75), junior high school and lower education level (OR=4.28, 95%CI: 1.24-14.81) were influencing factors on HIV infection, through non-marital and non-commercial sexual contacts. In addition to meeting sexual partners in offline places, some HIV/AIDS patients with heterosexual mode of transmission had developed sexual partnerships through online dating and with low-grade venue as the main place for sex engagement. Conclusions Newly reported HIV/AIDS cases under heterosexual mode of transmission in Chongqing were mainly infected from offline low-grade venues, and caused by commercial sexual engagement. The routes of HIV infections that caused by heterosexual contact should be deeply understood in order to develop targeted intervention programs.