德宏州社区流动人群租住行为与艾滋病传播的多水平模型分析  

A multi-level model analysis of housing behavior and AIDS transmission of community migrant population

作　　者：叶润华[1] 俞秋嫣 王雪贤 杨跃诚[1] 姚仕堂[1] 王继宝[1] 濮永成[3] 杜本丽 杨盈波 聂永英 李维美[7] 吕繁[8] 何纳[9] 段松[1] YE Runhua;YU Qiuyan;WANG Xuexian;YANG Yuecheng;YAO Shitang;WANG Jibao;PU Yongcheng;DU Benli;YANG Yingbo;NIE Yongying;LI Weimei;LYU Fan;HE Na;DUAN Song(Dehong Center for Disease Control and Prevention,Mangshi,Yunnan 678400,China;School of Public Health and Management,Wenzhou Medical University,Wenzhou,Zhejiang 325035,China;Longchuan Center for Disease Control and Prevention,Longchuan,Yunnan 678700,China;Mangshi Center for Disease Control and Prevention,Mangshi,Yunnan 678400,China;Ruili Center for Disease Control and Prevention,Ruili,Yunnan 678600,China;Yingjiang Center for Disease Control and Prevention,Yingjiang,Yunnan 679300,China;Lianghe Center for Disease Control and Prevention,Lianghe,Yunnan 679200,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;School of Public Health/Key Laboratory of Public Health Safety of the Ministry of Education,Fudan University,Shanghai 200032,China)

机构地区：[1]云南省德宏州疾病预防控制中心,云南芒市678400 [2]温州医科大学公共卫生与管理学院,浙江温州325035 [3]云南省陇川县疾病预防控制中心,云南陇川678700 [4]云南省芒市疾病预防控制中心,云南芒市678400 [5]云南省瑞丽市疾病预防控制中心,云南瑞丽678600 [6]云南省盈江县疾病预控制中心,云南盈江679300 [7]云南省梁河县疾病预防控制中心,云南梁河679200 [8]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [9]复旦大学公共卫生学院流行病学教研室/公共卫生安全教育部重点实验室,上海200032

出　　处：《中国农村卫生事业管理》2019年第10期754-760,共7页Chinese Rural Health Service Administration

基　　金：国家重点地区艾滋病防治项目;国家科技重大专项(2018ZX10715006)

摘　　要：了解德宏州社区出租屋人群合租行为与艾滋病传播之间的关系。2016年1月至12月对德宏州所辖5县市流动人口集中社区的7 579名租住人员进行了HIV和梅毒检测及流行病学调查,收集研究对象人口学特征、租住时长、租住状态(独居或合租)、合租人数、免费接受安全套、行为干预等信息。用SAS 9.2软件拟合两水平Logistic回归模型分析租住人群合租行为的影响因素。7 579名租住人员,合租占59.56%(4 514/7 579),HIV感染率为0.395%(30/7 579),梅毒感染率为0.356%(27/7 579)。不同房东(出租屋)间租住人员合租率不同(t=10.26,P<0.000 1)。拟合两水平Logistic回归零模型分析得到方差分配系数(VPC)=0.505 6,约50.56%的变异是由出租屋不同引起的。引入解释变量后的结果显示租住人群外省户籍的合租行为高于本地户籍(OR=1.449, 95%CI:1.094~1.804),缅籍租住人群的合租行为也高于本地户籍(OR=1.368, 95%CI:1.033~1.703);租住人群45~64岁组的独居行为高于15~24岁组(OR=0.638, 95%CI:0.456~0.820)。不同出租屋间租住人群合租行为分布存在差异,外省户籍或缅籍是租住人群合租行为的促进因素,年龄组(45~64岁)是合租行为的抑制因素。To explore the relationship of housing behavior and AIDS transmission among community migrant population in Dehong Prefecture of Yunnan Province.An HIV/syphilis test and epidemiological questionnaire survey was conducted from January 2016 to December 2016 among 7579 migrant rental population selected from communities of five counties(cities)of Dehong Prefecture to collect such information as demographic characteristics,rental duration,rental status(living alone or sharing),number of flatmates,receiving condoms free of charge,and behavior intervention.Statistical software packages SAS 9.2 was used for fitting a two-level logistic regression model to identify the influence factors for flat sharing behavior.Among 7579 migrants,the rate of flat sharing was 59.56%(4514/7579),the positive rate of HIV was 0.395%(30/7579),and the positive rate of syphilis was 0.356%(27/7579).The rates of flat sharing varied with landlords and rentals(t=10.26,P<0.0001).The empty two-level logistic regression model showed that the variance partition coefficient(VPC)was 0.5056,which was resulted from various rentals.After the introduction of explanatory variables to the model,the results showed that there was a higher rate of flat sharing among migrants from other provinces(OR=1.449,95%CI:1.094~1.804)or Burma(OR=1.368,95%CI:1.033~1.703).And the rate of flat sharing in age group of 45~64 years was lower than that in age group of 15~24 years(OR=0.638,95%CI:0.456~0.820).The flat sharing behaviors were different among migrants in different rentals.Migrants from other provinces or Burma were positive factors while age group of 45~64 years was a negative factor for flat sharing.

关 键 词：社区出租屋 合租行为 获得性免疫缺陷综合征 多水平模型 

分 类 号：R183.9[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]