CAJ | 학술논문

目的了解广西壮族自治区(广西)中老年嫖客感染HIV现状、相关高危行为和危险因素.方法 2012年4-7月在广西艾滋病哨点对≥40岁的中老年嫖客进行面对面访谈,获取一般人口学、艾滋病知识知晓率、行为学、检测等信息,并采集3～5 ml血液检测HIV抗体,数据采用SPSS 18.0软件分析.结果 14个嫖客哨点共调查4260人,初中及以下文化程度占82.1％,72.0％在低档场所发生商业性交易,年龄越大嫖娼场所档次越低；嫖客艾滋病知识知晓率为74.2％,HIV阳性嫖客知晓率为65.8％；共检出73名HIV抗体阳性,阳性率(M)为1.40％,自愿咨询检测点来源人群较其他来源人群具有更高的HIV感染危险(OR=23.672,95％CI:4.984～112.434),中档场所嫖娼人群较低档场所具有较低的HIV感染危险(OR=0.410,95％CI:0.190～0.885),梅毒阴性(OR=0.255,95％CI:0.132 ～ 0.491)、丙型肝炎阴性(OR=0.154,95％CI:0.059 ～ 0.401)者HIV感染危险较低,嫖客婚内/外性行为安全套使用率均较低,且嫖娟场所档次越低,安全套使用率越低；嫖客既往HIV抗体检测率仅为4.6％,41名嫖客有CD4+T淋巴细胞检测结果,其中80.5％的CD4+T淋巴细胞数＜350 cell/μl,61.0％的CD4+T淋巴细胞数＜200 cell/μl.结论广西中老年嫖客HIV阳性率高,与低档场所暗娼发生无保护性行为是感染HIV的重要危险因素.
목적 료해엄서장족자치구(엄서)중노년표객감염HIV현상、상관고위행위화위험인소.방법 2012년4-7월재엄서애자병초점대≥40세적중노년표객진행면대면방담,획취일반인구학、애자병지식지효솔、행위학、검측등신식,병채집3～5 ml혈액검측HIV항체,수거채용SPSS 18.0연건분석.결과 14개표객초점공조사4260인,초중급이하문화정도점82.1％,72.0％재저당장소발생상업성교역,년령월대표창장소당차월저；표객애자병지식지효솔위74.2％,HIV양성표객지효솔위65.8％；공검출73명HIV항체양성,양성솔(M)위1.40％,자원자순검측점래원인군교기타래원인군구유경고적HIV감염위험(OR=23.672,95％CI:4.984～112.434),중당장소표창인군교저당장소구유교저적HIV감염위험(OR=0.410,95％CI:0.190～0.885),매독음성(OR=0.255,95％CI:0.132 ～ 0.491)、병형간염음성(OR=0.154,95％CI:0.059 ～ 0.401)자HIV감염위험교저,표객혼내/외성행위안전투사용솔균교저,차표연장소당차월저,안전투사용솔월저；표객기왕HIV항체검측솔부위4.6％,41명표객유CD4+T림파세포검측결과,기중80.5％적CD4+T림파세포수＜350 cell/μl,61.0％적CD4+T림파세포수＜200 cell/μl.결론 엄서중노년표객HIV양성솔고,여저당장소암창발생무보호성행위시감염HIV적중요위험인소.
Objective To monitor the current HIV prevalence,related risk behaviors and factors for HIV infection among the elderly male clients of the commercial female sex-workers (CFSW) in Guangxi.Methods Face to face interview on male clients aged ≥40 years old was carried out in April to July,2012.Information on demography,awareness of HIV prevention,related risk behaviors,history on HIV testing etc.were collected,with 3-5 ml full blood collected for testing on HIV.Data was analyzed by SPSS 18.0 software.Results 4260 clients were surveyed at 14 surveillance sites in which 82.1％ had received secondary or lower education,72.0％ experienced commercial sex in places with low-class sex trade.HIV awareness rate of clients was 74.2％ in which the rate of clients who were HIV positive was 65.8％.Among all the clients,73 were detected as HIV positive,with the HIV positive rate as 1.40％.Samples from voluntary counseling and testing sites showed higher risk to HIV infection than from other sources (OR=23.672,95％ CI:4.984-112.434).Samples from middle class population showed lower risk to HIV infection than those at low class (OR=0.410,95％CI:0.190-0.885).Among those who were syphilis negative (OR=0.255,95％CI:0.132-0.491) or hepatitis C virus (HCV) negative (OR=0.154,95％CI:0.059-0.401),the risk of getting HIV infected seemed to be low.Rate on condom use was low for clients among all of the sex-related behaviors regardless of the marriage status.In those lower-class sex trade places,lower rate on the condom use was seen.Rate for previous HIV testing for clients was only 4.6％.Among 41 clients who had received CD4 testing,80.5％ of them showed CD4 under 350 cell/μl,61.0％ were under 200 cell/μl.Conclusion The HIV positive rate for elderly male clients of the CFSWs was high in Guangxi.Unprotective sexual contact with low class sex workers was the most important risk factor for HIV infection.