某地HIV/AIDS者确诊后一年内高危性行为的改变及影响因素研究  

Changes of the unprotected sexual behavior and its influencing factors among HIV/AIDS patients within one year after diagnosis

作　　者：董文斌[1] 李世福[1] 赵金仙[1] 何子倩 李泽 陈黎跃[1] 王晓雯[3] 蔡英[1] 朱永芬 管艳 刘小春[1] 鲁建波[1] 许杰[1] 李顺祥[1,4,5] 冯婉君 DONG Wen-bin;LI Shi-fu;ZHAO Jin-xian;HE Zi-qian;LI Ze;CHEN Li-yue;WANG Xiao-wen;CAI Ying;ZHU Yongfen;GUAN Yan;LIU Xiao-chun;LU Jian-bo;XU Jie;LI Shun-xiang;FENG Wan-jun(Division of STDs&AIDS control,Yuxi Centre for Disease Control and Prevention,Yuxi,Yunnan 653100,China)

机构地区：[1]玉溪市疾病预防控制中心性病艾滋病控制科,云南玉溪653100 [2]玉溪市人民医院检验科 [3]云南省疾病预防控制中心性病艾滋病防制所 [4]玉溪市急救中心,云南玉溪653100 [5]大理大学公共卫生学院流行病学和预防医学系,云南大理671000

出　　处：《现代预防医学》2022年第14期2661-2665,共5页Modern Preventive Medicine

基　　金：云南省卫生和计划生育委员会医学学科带头人培养项目(D-201651)。

摘　　要：目的 了解艾滋病病毒感染者/艾滋病患者(HIV/AIDS)确诊后一年内高危性行为变化情况及其影响因素。方法从国家艾滋病综合防治数据信息管理系统下载2010年1月1日—2019年12月31日的相关资料,描述性行为发生率的变化趋势,采用广义估计方程(GEE)模型分析HIV/AIDS确诊后一年内高危性行为的相关因素。结果 2 528例HIV/AIDS中,确诊前性行为发生率60.48%而确诊后一年内在57.09%~60.11%之间,女性(趋势χ^(2)=5.417,P=0.020)和未婚者(趋势χ^(2)=6.684,P=0.010)确诊后一年内的性行为发生率呈下降趋势,男性(趋势χ^(2)=4.301,P=0.038)、已婚(趋势χ^(2)=4.061,P=0.044)和ART者(趋势χ^(2)=4.783,P=0.029)的性行为发生率呈上升趋势。高危性行为发生率由61.61%下降至3.98%(趋势χ^(2)=1 606.933,P<0.001),多因素结果显示:已婚(OR=2.374,95%CI:1.478~3.811)和未ART者(OR=1.837,95%CI:1.431~2.358)更易发生高危性行为。性别和年龄亚组分析显示,已婚和未接受ART治疗与高危性行为的关联方向保持一致。结论 HIV/AIDS确诊后一年内仍保持性活跃且存在高危性行为,仍具备二代传播、感染其他性传播疾病和不同HIV型别毒株或耐药毒株风险,应提供精准干预,促进HIV/AIDS坚持使用安全套。Objective To understand the changes of unprotected sexual behavior and its influencing factors among HIV/AIDS patients within one year after HIV/AIDS diagnosis.Methods All data were obtained from the National Comprehensive HIV/AIDS Prevention and Care Information System,between January 1,2010 and December 31,2019.The changing trends of patients with sexual behavior were described,and the generalized estimating equation(GEE)models were used to analysis influencing factors of unprotected sexual behavior among HIV/AIDS patients within one year after HIV/AIDS diagnosis.Results Among 2528 HIV/AIDS cases,the prevalence of sexual behavior before diagnosis was 60.48%and within one year after diagnosis ranged from 57.09%to 60.11%,with a decreasing trend in the prevalence of sexual behavior within one year after diagnosis among females(trendχ^(2)=5.417,P=0.020)and unmarried(trendχ^(2)=6.684,P=0.010).Males(trendχ^(2)=4.301,P=0.038),married(trendχ^(2)=4.061,P=0.044),and those who received antiretroviral therapy(ART)(trendχ^(2)=4.783,P=0.029)showed an increasing trend in the incidence of sexual behavior.The incidence of high-risk sexual behavior decreased from 61.61%to 3.98%(trendχ^(2)=1606.933,P<0.001),and the multifactorial results showed that married(OR=2.374,95%CI:1.478-3.811)and those without ART(OR=1.837,95%CI:1.431-2.358)were more likely to have high-risk sexual behavior.Gender and age subgroup analyses showed that the direction of association between married and those without ART and high-risk sexual behaviors remained consistent.Conclusion People who remain sexually active and have high-risk sexual behavior within one year after HIV/AIDS diagnosis are still at risk for second-generation transmission, infection with othersexually transmitted diseases and different HIV type strains or drug-resistant strains, and should be provided with precise interventionsto promote condom use adherence in HIV/AIDS.

关 键 词：艾滋病病毒感染者/艾滋病患者 确诊 性行为 变化 相关因素 

分 类 号：R512.91[医药卫生—内科学]