CAJ | 학술논문

目的分析中国吸毒者、暗娼、性病门诊就诊者、男男性行为者、孕产妇5类人群的艾滋病病毒(HIV)感染流行趋势,为艾滋病综合防治和科学干预提供信息和依据.方法 1995-2009年,在哨点监测期内以重复横断面调查的方法对吸毒者、暗娼、性病门诊就诊者、男男性行为者、孕产妇5类人群进行监测(采血及问卷调查).结果吸毒人群HIV抗体阳性检出率(中位数)在疫情较重省份从1996年开始呈快速上升,1999-2000年达到高点(19.2%),2001-2003年逐步下降,2004年后趋于平稳状态;在疫情居中省份从2001年开始呈小幅上升,2004年达到相对高点(2.9%)后趋于平稳,近两年又呈小幅下降趋势;在疫情较轻省份一直处于低水平.暗娼人群HIV抗体阳性检出率(中位数)在疫情较重省份从1999年开始小幅上升并达到高点(1.5%),之后下降并维持在较低水平;在疫情居中省份和较轻省份一直处于低水平.性病门诊就诊人群HIV抗体阳性检出率(中位数)一直维持在较低水平,低于0.7%.男男性行为人群HIV抗体阳性检出率近两年均大于1%,部分哨点大于10%,且呈快速上升趋势,成为近年来推动艾滋病疫情发展的重要原因之一.孕产妇人群HIV抗体阳性检出率(中位数)在疫情较重省份从1997年开始呈缓慢上升,之后趋于平稳状态(0.3%);在疫情居中省份和较轻省份一直处于低水平.结论男男性行为人群HIV抗体阳性检出率呈上升趋势;吸毒者、暗娼、性病门诊就诊者、孕产妇人群的HIV抗体阳性检出率都趋于相对平稳状态.吸毒人群疫情仍集中在疫情较重的6个省份.暗娼和性病门诊就诊人群疫情总体仍处于较低水平,但流行范围在不断扩大.
목적 분석중국흡독자、암창、성병문진취진자、남남성행위자、잉산부5류인군적애자병병독(HIV)감염류행추세,위애자병종합방치화과학간예제공신식화의거.방법 1995-2009년,재초점감측기내이중복횡단면조사적방법대흡독자、암창、성병문진취진자、남남성행위자、잉산부5류인군진행감측(채혈급문권조사).결과 흡독인군HIV항체양성검출솔(중위수)재역정교중성빈종1996년개시정쾌속상승,1999-2000년체도고점(19.2%),2001-2003년축보하강,2004년후추우평은상태;재역정거중성빈종2001년개시정소폭상승,2004년체도상대고점(2.9%)후추우평은,근량년우정소폭하강추세;재역정교경성빈일직처우저수평.암창인군HIV항체양성검출솔(중위수)재역정교중성빈종1999년개시소폭상승병체도고점(1.5%),지후하강병유지재교저수평;재역정거중성빈화교경성빈일직처우저수평.성병문진취진인군HIV항체양성검출솔(중위수)일직유지재교저수평,저우0.7%.남남성행위인군HIV항체양성검출솔근량년균대우1%,부분초점대우10%,차정쾌속상승추세,성위근년래추동애자병역정발전적중요원인지일.잉산부인군HIV항체양성검출솔(중위수)재역정교중성빈종1997년개시정완만상승,지후추우평은상태(0.3%);재역정거중성빈화교경성빈일직처우저수평.결론 남남성행위인군HIV항체양성검출솔정상승추세;흡독자、암창、성병문진취진자、잉산부인군적HIV항체양성검출솔도추우상대평은상태.흡독인군역정잉집중재역정교중적6개성빈.암창화성병문진취진인군역정총체잉처우교저수평,단류행범위재불단확대.
Objective To effectively monitor the time trend of HIV prevalence and epidemic among injecting drug users ( IDUs ), female sex workers (FSWs), sexually transmitted disease (STD)clinic attendants, men who have sex with men (MSM) and pregnant women etc., to provide information for evaluation on strategies regarding comprehensive HIV prevention and effectiveness of intervention, in China. Methods Cross-sectional studies had been repeatedly conducted on sentinel surveillance program with uniformed questionnaire and collection of venous blood specimen among IDUs, FSWs, STD clinic attendants, MSM and pregnant women, from 1995 to 2009. Results HIV prevalence (median) among IDUs had been increasing rapidly since 1996, reaching the plateau (19.2%) in 1999-2000, then gradually decreasing in 2001-2003, and leveling off since 2004 in those relatively hard-hit epidemic provinces. HIV prevalence among drug users had increased a bit since 2001, achieving high level (2.9%) in 2004 before leveling off, showing a slight downward trend in the past two years among the medially-hit epidemic provinces, while it maintained at a low level in those low epidemic provinces. HIV prevalence (median) among FSWs had been slightly increasing,reaching a high level ( 1.5% ) in 1999, then decreased and maintained at a low level in relatively hard-hit provinces. HIV prevalence among FSWs maintained at a low level in medially-hit and low epidemic provinces. HIV prevalence(median) among STD clinic attendants had been maintained at a lower level, lower than 0.7%. HIV prevalence among MSM had been consistently greater than 1%, and was increasing year by year, becoming one of the most important drivers of the HIV/AIDS epidemic over the past years. HIV prevalence (median) among pregnant women had slightly been increasing since 1997, then leveling off over the past years in those relatively hard-hit provinces (0.3%). HIV prevalence among pregnant women had maintained at a low level in the medial and low epidemic provinces. Conclusion Data from sentinel surveillance programs showed a leveling-off situation on HIV prevalence rates among IDUs, FSWs, sexually transmitted infections clinic patients and pregnant women. However, HIV prevalence among MSM had increased significantly since 2005, indicating the high speed of transmission among this population. Epidemic among IDUs had still been concentrated in those relatively hard-hit epidemic provinces. As for FSWs and STD patients, the overall epidemic remained at low level, but the areas of epidemic kept expanding.