2017-2019年南宁市女性性服务者HIV感染率及相关行为变化趋势分析  

The Trend of HIV Infection Rate and Related Behaviors Among Women in Sexual Service in Nanning City from 2017 to 2019

作　　者：农丽萍[1] 何波[1] 汤洪洋[1] 黎火佳 林倩[1] 姚敏[1] 李斯斯[1] 吴敬兰 农梦妮 许秀东[1] 覃威翱 NONG Liping;HE Bo;TANG Hongyang;LI Huojia;LIN Qian;YAO Min;LI Sisi;WU Jinglan;NONG Mengni;XU Xiudong;QIN Wei'ao(Nanning City Center for Disease Control and Prevention in Guangxi,Nanning 530023,China;The Health Supervision Institute of Guangxi Zhuang Autonomous Region,Nanning 530021,China)

机构地区：[1]广西南宁市疾病预防控制中心,广西南宁530023 [2]广西壮族自治区卫生监督所,广西南宁530021

出　　处：《中国皮肤性病学杂志》2021年第8期886-896,共11页The Chinese Journal of Dermatovenereology

基　　金：广西卫生健康委员会科研课题(Z20190631,Z20200419)。

摘　　要：目的了解2017-2019年南宁市基层艾滋病综合防控(以下简称"艾防")工作模式推广实施的不同时期,女性性服务者艾滋病病毒(HIV)感染率及相关行为的变化趋势。方法 2017-2019年,每年4~7月,采用横断面研究设计,整群抽样方法,在南宁市城区及艾滋病疫情较严重的H县、BY县的性服务场所对女性性服务者开展问卷调查和血清学检测,分析其中HIV感染率及相关行为变化趋势。结果女性性服务者答对≥6道艾滋病知识知晓率、最近1次和最近1个月商业性行为,安全套坚持使用率分别由2017年推广前的94.71%、95.62%和90.11%提升到2019年推广后的98.01%、98.01%和92.88%,均呈现逐期逐年上升的趋势(P<0.05),差异均有统计学意义(P<0.05)。从未使用安全套的比例,由2017年推广前的0.53%下降到2019年推广后的0.10%,但差异无统计学意义(P>0.05);HIV感染率由2017年推广前的2.04%下降到2019年推广后的1.42%,但差异无统计学意义(P>0.05)。多因素分析结果表明,年龄、婚姻状况、性服务场所档次、宣传干预、艾滋病知识是女性性服务者商业性行为坚持使用安全套的影响因素。年龄、性服务场所档次、坚持使用安全套、艾滋病知识、梅毒感染是女性性服务者感染HIV的影响因素。结论南宁市推广实施基层艾防工作模式后,女性性服务者艾滋病知识知晓率和商业性行为安全套坚持使用率均呈现逐期逐年上升的趋势,且达到了较高水平。HIV感染率有所下降,但总体水平仍然较高,相关部门仍需加强女性性服务者的综合干预工作。Objective To analyze the trend of HIV infection rate and related behaviors of women in sexual service in different periods of the implementation of comprehensive prevention and control of AIDS(hereinafter referred to as“AIDS prevention”)in Nanning.Methods From April to July in 2017-2019,a cross-sectional study design and cluster sampling method were used to carry out questionnaire survey and serological testing on women in sexual service places in Nanning,H county and BY county.Results The awareness rate of AIDS knowledge,the last commercial sex,the last month's commercial sex,and the rate of condom continuous use of women in sexual service increased from 94.71%,95.62%and 90.11%before promotion in 2017 to 98.01%,98.01%and 92.88%after promotion in 2019(P<0.05).The proportion of never using condom decreased from 0.53%before promotion in 2017 to 0.10%after promotion in 2019,but the difference was no statistically difference(P>0.05).The HIV infection rate decreased from 2.04%before promotion in 2017 to 1.42%after promotion in 2019,but the difference was no statistically difference(P>0.05).Multivariate analysis showed that age,marital status,grade of sexual service places,publicity and intervention,and AIDS knowledge were the influencing factors of condom use.Age,grade of sexual service place,continuous condom use,AIDS knowledge and syphilis infection were the influencing factors of HIV infection.Conclusion After the implementation and promotion of basic level AIDS prevention mode in Nanning,the awareness rate of AIDS knowledge and the proportion of commercial sexual behavior continued to use condoms showed an upward trend year by year,and reached a higher level.The HIV infection rate was decreased,but the overall level was still high.The relevant departments still need to strengthen the comprehensive intervention of women in sexual services.

关 键 词：女性性服务者 高危行为 艾滋病病毒 

分 类 号：R512.91[医药卫生—内科学]