云南省艾滋病病毒感染者和艾滋病患者的高危行为影响因素分析

目的调查云南省HIV感染者／AIDS患者确证为HIV阳性后的高危行为等情况，探讨高危行为的影响因素。方法采用整群抽样方法，抽取云南省艾滋病疫情较为严重的德宏州芒市，瑞丽市和陇川县部分乡镇卫生院在2012年5月15日～6月14日期间接受随访的〉18岁的艾滋病病毒感染者／艾滋病病人（people who living with HIV／AIDS，PLWHA），共调查303人，有效问卷300份。结果25．7％的调查对象在确证HIV阳性后发生过无保护的高危行为，其高危行为发生的影响因素为重度耻辱和在婚，重度耻辱感（OR=1．89，95％CI：1．09～3．27），在婚（OR=2．99，95％CI：1．43—6．26）均为危险因素，另外在访谈中还发现高危行为的发生与静脉注射吸毒人员缺乏清洁针具，部分女性PLWHA患者因生活困难而从事商业性行为等因素有关。结论PLWHA患者的高危行为的影响因素为重度耻辱感和在婚，同时还与缺乏清洁针具和生活困难等因素有关。建议进一步加强PL—WHA患者的管理，有针对性的进行PLWHA患者的干预，降低其耻辱感，减少其高危行为的发生，预防艾滋病的二代传播。

Analysis on the influencing factors of high-risk behavior among people with HIV/AIDS in Yunnan Province

Objective To detect HIV-related stigma and discrimination among people with HIV/AIDS （PLWHA）, and to analyze its influencing factors of high-risk behaviors in Yunnan Province. Methods By clustering sampling, 303 PLWHA who were over 18 years old and received followed up during May 15, 2012 to June 14 were selected for investigation, finally 300 effective questionnaires were collected. Results After being confirmed with positive HIV, 25.7% of PL- WHA had high-risk behaviors, and the severe HIV-related stigma（ OR = 1.89,95% CI： 1.09-3.27） and marriage （OR = 2. 99,95% CI： 1.43-6. 26） were its influencing factors. Meanwhile,by interview,it was found that the high-risk behaviors also had relationship with intravenous drug user without clean needles and some female PLWHA engaged in commercial sex service because of poverty. Conclusions The influencing factors of the high-risk behaviors included the severe HIV-related stigma and marriage, and also had relationship with contamminated needles and low economic income. In order to decrease the stigma, reduce the occurrence of high-risk behaviors and prevent the second generation spread of HIV, the targeted intervention and management of PLWHA should been strengthened.