广州市1995-2007年吸毒人群艾滋病哨点监测结果分析

目的掌握广州市吸毒人群中艾滋病的流行趋势及其行为变化,为政府制定防制策略和措施提供循证参考。方法广州市1995-2001年设立了1个吸毒者艾滋病监测哨点（A）,2002年增加到2个哨点（A、B）,2004年开始增至8个（A～H）,对哨点的目标人群采用连续抽样的方法进行问卷调查,调查其注射毒品、商业性行为及安全套的使用等高危行为,并检测其HIV抗体。结果1995-2001年,哨点A的HIV感染率在1995-1999年快速上升,至1999年达到18.47%,1999-2001年下降至7.72%;1998-2000年注射吸毒比例高于1997年和2001年,1998年共用针具比例高于其他年份。2003-2007年广州市吸毒人群HIV感染率（中位数范围为2.95%～5.36%）、注射吸毒比例（中位数范围为47.56%～65.72%）、共用针具比例（中位数范围为22.91%～51.11%）、发生商业性行为比例（中位数范围为14.87%～35.25%）及发生商业性行为时每次使用安全套比例（中位数范围为12.69%～27.59%）总体上年度间的差异无统计学意义,而各哨点的各项指标的年度变化不一,其中除哨点D的注射吸毒比例无明显变化,其余各哨点的注射吸毒比例呈下降趋势。结论近年来广州市吸毒人群中HIV感染的流行趋势进入平稳持续阶段,该人群中传播HIV的危险因素仍广泛存在。应继续大力开展美沙酮维持治疗、清洁针具交换和推广使用安全套等干预工作。

HIV sentinel surveillance for drug users in Guangzhou from 1995 to 2007

Objective To understand the trend of HIV prevalence and behavior change among drug users in Guangzhou, and to provide evidence for government to make strategic decisions. Methods A sentinel site （ site A） for drug users was established in Guangzhou from 1995 to 2001. The site number was added to two in 2002 （sites A and B） and finally up to eight in 2004 （sites A to H）. The questionnaire survey about the risk factors including drug use, commercial sex behavior and condom use was conducted among the drug users in the sites by consecutive samples and HIV antibody was tested simultaneously. Results From 1995 to 2001, HIV prevalent rate of sentinel site A rapidly increased from 1995 to 1999 and up to 18.47% in 1999. The rate decreased to 7.72% from 1999 to 2001. In site A, the proportion of injection drug use form 1998 to 2000 significantly higher than in 1997 and 2001, while the proportion of sharing needle in 1998 significantly higher than that in other years. From 2003 to 2007, there were no significant changes as a whole in HIV prevalent rate （median range 2.95% -5.36% ）, the proportion of injection drug use （ median range 47.56% - 65.72% ） , the proportion of sharing needle （ median range 22. 91% -51.11% ）, the proportion of commercial sex （median range 14. 87% -35. 25% ） and the proportion of insistent condom （ median range 12. 69% - 27.59% ） among drug users in Guangzhou. The change of the rate or proportions was different in each site from 2002 to 2007. The proportion of injection drug use showed a downtrend in most sites while there were no significant changes in site D. Conclusion In recent years, the prevalent trend of HIV infection among drug users in Guangzhou City entered steady continuous phase and the risk factors of HIV spread were still widespread in such group. It should be continued to conduct the interventions such as vigorously carrying out methadone maintenance treatment, clean needle exchange and promotion of condom use.