广西北海市2004—2018年146对HIV抗体阳性夫妻的流行特征

目的 了解北海市HIV感染者/AIDS患者配偶间HIV的传播状况,分析北海市艾滋病抗体阳性夫妻的流行特征,为开展夫妻间HIV传播的预防控制工作提供依据。 方法 对广西北海市2004—2018年艾滋病综合防治信息系统中夫妻双方均为HIV抗体阳性的病例收集流行病学调查信息和随访信息建立数据库,采用χ²检验或Fisher确切概率法分析双阳夫妻的信息差异。 结果 北海市2004—2018年共报告配偶双方均为HIV抗体阳性146对,男性平均年龄（50.64±14.24）岁,女性平均年龄为（45.73±14.95）岁。通过咨询检测发现占35.27%,检测发现方式男女差异无统计学意义（P>0.05）。夫妻只有一方有危险行为的占71.23%,双方均有危险行为占28.77%; 292例HIV病例中,晚发现率为55.48%,存活率为90.07%;首次CD4⁺T淋巴细胞计数均值（429.40±251.81）个/μL,接受抗病毒治疗占90.41%,男女治疗情况差异无统计学意义（P>0.05）。 结论 北海市HIV抗体阳性夫妻家庭中男方存在多性伴及商业性性行为等高危行为,夫妻间二次传播率较高,艾滋病晚发现率较高,主动检测意识低,建议加强随访,提高检测咨询,提高安全套使用率,避免夫妻间家庭内传播。

Epidemiological characteristics among 146 HIV positive couples in Beihai,Guangxi, 2004-2018

Objective To investigate the transmission of HIV, and epidemiological characteristics of HIV positive/AIDS couples in Beihai city, so as to provide scientific basis for HIV prevention and intervention among the HIV positive couples. Methods It’s based on Beihai HIV/AIDS information system from 2004 to 2018, database was established through collecting the epidemiological investigation and follow-up information of cases that both partners were HIV positive. It was analyzed by using χ² test or Fisher's exact probability among the information difference of HIV positive couples. Results A total of 146 pairs of HIV positive couples were reported from 2004 to 2018, the male average age was (50.64±14.24) years, the female average age was (45.73±14.95) years. Cases were mainly found from voluntary counseling & testing (VCT) (35.27％), there was no significant difference in detection methods between male and female (P>0.05). Only one of the couple had dangerous behavior accounted for 71.23%, both of the couple had dangerous behavior accounted for 28.77%. The late discovery rate was 55.48% of the 292 cases,the survival rate was 90.07%;The mean value of first CD4⁺ T lymphocyte count was (429.40±251.81) cells/μL , the proportion of cases receiving antiviral treatment were 90.41%,there was no significant difference in antiviral treatment between male and female (P>0.05). Conclusion The husbands had higher proportion of risk behaviors such as multiple partners and commercial sex, higher rate of secondary transmission and higher rate of late detection between husband and wife, the couples had low awareness of active detection among the HIV positive couples in Beihai. It was recommended to strengthen follow-up, to improve testing and counseling, to increase condom use, and to avoid transmission within the family.