凉山州彝族与其他民族社区人群艾滋病感染的影响因素分析  

Risk factors of HIV infection among Yi people and other ethnic groups based on the HIV/AIDS sentinel surveillance in the three counties of Liangshan

作　　者：杨淑娟[1] 翟雯雯[1] 吉克春农 王启兴[2] 廖强[2] 余刚[2] 肖琳[2] 姚永娜 龚煜汉[2] 王科[2] 王菊[2] 边仕超[2] 刘茜[2] YANG Shujuan1, ZHAI Wenwen1 , JIKE Chunnong2 ,WANG Qixing2 , LIAO Qiang2 , YU Gang2 , XIAO Lin2 ,YAO Yongna1 , GONG Yuhan2 , WANG Ke2 , WANG Ju2 , BIAN Shichao2 , LIU Qian2(1. Department of Health and Social and Behavioral Sciences, West China School of Public Health, Sichuan University, Chengdu 610041, China; 2. Liangshan Center for Disease Control and Preventio)

机构地区：[1]四川大学华西公共卫生学院健康与社会行为学系,成都610041 [2]凉山州疾病预防控制中心,四川西昌615000

出　　处：《中国艾滋病性病》2018年第3期257-260,共4页Chinese Journal of Aids & STD

基　　金：国家自然科学基金(81703279);四川省卫生和计划生育委员会科研课题(16PJ259);凉山州艾滋病防治项目(H161236);凉山州艾滋病新发感染评估模式探索项目(2014LSCDC002)~~

摘　　要：目的比较分析凉山州2011-2016年彝族与其他民族社区人群艾滋病哨点监测艾滋病病毒（HIV）感染的影响因素。方法采用多阶段分层抽样方法,抽取德昌、宁南、布拖3个县作为社区人群艾滋病监测哨点。采用问卷调查收集调查对象的人口学和行为学特征,并对研究对象进行HIV抗体的血清学检测。多因素非条件Logistic回归,分析彝族和其他民族人群感染HIV的危险因素。结果在2011-2016年凉山州3个哨点县,共监测社区哨点人群共14 198人,其中彝族共4 149人（29.22%）,检出HIV抗体阳性197例,阳性检出率为4.75%;汉族及其他民族共10 049例（70.78%）,检出HIV阳性30例,阳性检出率为0.30%。在彝族人群中,有吸毒史[比值比（OR）=6.69,95%可信区间（CI）：4.23,10.56],高危临时性行为（OR=1.72,95%CI：1.03,2.87）和寡居（OR=2.03,95%CI：1.10,3.75）的个体,感染HIV的风险均较高。而女性与男性相比（OR=0.62,95%CI：0.45,0.85）,小学（OR=0.52,95%CI：0.36,0.74）、初中（OR=0.48,95%CI：0.25,0.94）、高中及以上（OR=0.27,95%CI：0.08,0.85）与文盲相比,感染HIV的风险均较低。在汉族人群中,有吸毒史能增加HIV感染的风险（OR=26.11,95%CI：5.70,119.72）。结论凉山州彝族比汉族及其他民族有更高的HIV感染风险,彝族的性观念和习俗及较低的教育程度,成为导致凉山州HIV传播和流行的重要社会文化因素。Objective To compare the risk factors of HIV infection between Yi group and other ethnic groups based on the HIV/AIDS sentinel surveillance data.Methods Multi-stage stratified sampling method was used for HIV/AIDS sentinel surveillance in the three sites of Dechang,Ningnan and Butuo counties.The demographic and behavior data were collected by questionnaires,and HIV infection was detected by serological testing.Multiple unconditional logistic regression was used to analyze the HIV risk factors of Yi group and other ethnic groups such as Han,Zang and other minorities.Results Between 2011 and 2016,a total of 14 198 cases were collected from the three HIV/AIDS sentinel surveillance sites,including 4149 Yi people and 10049 Han and other peoples.The HIV detection rates for Yi and Han were 4.75%（197/4149）and 0.30%（30/10049）respectively.Among Yi people,drug use（OR=6.69,95%CI=4.23,10.56）,high risk temporary sexual behavior（OR=1.72,95%CI=1.03,2.87）and being widowed（OR=2.03,95%CI=1.10,3.75）increased the risks of HIV infection.Females（OR=0.62,95%CI=0.45,0.85）and higher education（primary school：OR=0.52,95%CI=0.36,0.74;middle high school：OR=0.48,95%CI=0.25,0.94;high school or above：OR=0.27,95%CI=0.08,0.85）reduced the risks of HIV infection.Among Han group,drug use increased the risks of HIV infection（OR=26.11,95%CI=5.70,119.72）.Conclusion Yi group have higher risks of HIV infection compared with Han or other ethnic groups,and the sexual behaviors,local customs and lower educational level contribute to HIV epidemic in this area.

关 键 词：凉山州 彝族 社区哨点监测 艾滋病 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]