一起商业异性性行为引起的艾滋病聚集性疫情调查  

Investigation of a HIV cluster outbreak linked to commercial heterosexual activities

作　　者：唐慧玲[1] 蒋均[2] 王凤英[1] 方琼楼[1] 朱珂 范钦[2] 金屡华 吴斌[1] TANG Huiling;JIANG Jun;WANG Fengying;FANG Qionglou;ZHU Ke;FAN Qin;JIN Luhua;WU Bin(Jinhua Center for Disease Control and Prevention,Jinhua 321002,Zhejiang,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 320051,Zhejiang,China)

机构地区：[1]金华市疾病预防控制中心,浙江金华321002 [2]浙江省疾病预防控制中心,杭州320051

出　　处：《中国艾滋病性病》2024年第11期1173-1176,共4页Chinese Journal of Aids & STD

基　　金：金华市科技计划(2022-4-221,2022-4-222)。

摘　　要：目的明确浙江省P县一起商业异性性行为引起的艾滋病聚集性疫情病例之间的传播关系。方法应用流行病学调查方法收集聚集性疫情相关病例及其性伴的社会人口学信息、流动状况、HIV检测史、感染相关危险因素等信息,结合HIV分子传播网络监测开展分析。结果2023年10月监测到的分子传播簇包含6例病例,簇中男性4例,女性2例;病例2的度值为4,为高传播风险病例。病例2的男性性伴除上述4例男性病例外,还追溯到11名,检出3例HIV阳性(其中2例为既往阳性)。15名男性性伴中,非婚非商业异性性伴1名,商业异性性伴14名;HIV阳性7例(6例既往阳性,1例新确诊),其余均阴性。HIV聚集性疫情共涉及病例9例,其中男性7例;年龄≥50岁8例;职业均为农民或民工。9例HIV感染患者中,1例经非婚非商业异性性传播,1例婚内传播,7例经商业异性性传播。结论这是一起发生在本地的艾滋病聚集性疫情,传播模式以病例2为核心通过商业异性性行为传播,继而引起配偶间和非婚非商业固定性伴间的传播。性伴溯源调查在传统流行病学调查基础上结合HIV分子传播网络技术,同时在公安部门的支持下,大大提升了艾滋病溯源能力。Objective To elucidate the transmission dynamics of a HIV cluster outbreak associated with commercial heterosexual activities in County P,Zhejiang Province,China.Methods Epidemiological investigation methods were employed to collect sociodemographic characteristics,mobility information,previous HIV testing history,high-risk sexual behavior history,and details of sexual partners of individuals involved in the cluster.The analysis was conducted in conjunction with monitoring of the HIV molecular transmission network.Results In October 2023,molecular surveillance identified a transmission cluster comprising six cases,including four males and two females.Case 2 exhibited a degree value of 4,indicating a high transmission risk.In addition to the four male cases in the cluster,the male sexual partners of Case 2 were traced back to an additional 11 individuals,among whom three tested positive for HIV(two of whom were previously known positives).Among the 15 male partners,there was one non-commercial,non-marital heterosexual partner and 14 commercial heterosexual partners.Seven tested positive for HIV(six previously known positives and one newly diagnosed),while the others tested negative.The cluster outbreak involved nine cases,with seven being male;eight were aged 50 years or older,and all were either farmers or migrant workers.Among the nine HIVinfected individuals,one was linked to noncommercial and nonmarital heterosexual transmission,one to marital transmission,and seven to commercial heterosexual transmission.Conclusions This localized HIV cluster outbreak was primarily driven by commercial heterosexual activities centered on Case 2 that subsequently led to transmission within marital and stable partnerships.The integration of partner tracing through traditional epidemiological investigation,enhanced by HIV molecular transmission network technology and supported by law enforcement,significantly improved the capacity for HIV source tracing.

关 键 词：艾滋病 商业异性性行为 分子传播网络 聚集性疫情 

分 类 号：R512.91[医药卫生—内科学]