| 摘要: |
| ［摘要］ 目的 了解云南省性病就诊者人类免疫缺陷病毒（HIV）感染状况、分布特征及影响因素，并分析性病门诊新发现HIV/获得性免疫缺陷综合征（AIDS）病例的流行病学特征。方法 采用主动监测和被动监测相结合方式，多维度收集云南省性病就诊者基本人口学信息、接受HIV检测及阳性发现情况、HIV感染相关影响因素、新报告HIV/AIDS病例特征等资料，综合分析性病就诊者HIV感染状况及分布特征。结果 2023年云南省共检测性病就诊者63 287例，其中HIV筛查阳性885例，筛查阳性率为1.40%；HIV确证阳性829例，确证阳性率为1.31%。男性性病就诊者HIV筛查阳性率和确证阳性率显著高于女性（P<0.05），边境地区性病就诊者HIV筛查阳性率和确证阳性率显著高于非边境地区（P<0.05）。HIV确证阳性率分布存在正向空间自相关性，Moran′s I为0.077（Z=1.883，P=0.035）。性病门诊2023年新报告HIV/AIDS病例111例，男女性别比为3.63∶1，职业以农民为主（60.36%），年龄集中在20～49岁（63.06%），79.28%为异性性传播，19.82%为同性性传播。哨点监测数据显示，年龄≥34岁、有注射毒品史、有同性性行为史、近1年患过性病、近1年接受过HIV检测并知晓结果的性病门诊男性就诊者HIV感染率更高（P<0.05）。结论 云南省性病就诊者HIV阳性率总体处于较高水平，应重点关注边境地区以及空间分布呈现“高-高”聚集的地区，男性、有高危行为及性病史的就诊者存在更高的HIV感染风险。性病门诊新发现HIV/AIDS病例以男性青壮年为主，文化程度不高，主要通过性途径传播。为精准指导艾滋病防治工作，今后应持续开展对该人群的综合监测。 |
| 关键词: 云南 性病就诊者 人类免疫缺陷病毒 获得性免疫缺陷综合征 监测 空间自相关 |
| DOI：10.3969/j.issn.1674-3806.2025.04.03 |
| 分类号: |
| 基金项目:国家科技重大专项课题（编号：2018ZX10715006） |
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| Analysis on multi-dimensional surveillance data of HIV infection status and characteristics of newly diagnosed cases among sexually transmitted disease clinic clients in Yunnan Province |
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SONG Lijun, FU Liru, ZHANG Zuyang, XIAO Minyang, LI Xuehua, NIU Jin, HU Yi, SU Xingfang, SHI Yuhua
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Institute of Sexually Transmitted Disease and Acquired Immunodeficiency Syndrome Prevention and Control, Yunnan Center for Disease Control and Prevention, Kunming 650500, China
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| Abstract: |
| ［Abstract］ Objective To understand the infection status, distribution characteristics and influencing factors of human immunodeficiency virus(HIV) in sexually transmitted disease(STD) clinic clients in Yunnan Province, and to analyze the epidemiological characteristics of newly diagnosed cases of HIV/acquired immunodeficiency syndrome(AIDS) in the STD clinic. Methods A combination of active and passive monitoring methods was adopted to collect the data of the STD clinic clients in Yunnan Province such as basic demographic information, their acceptance of HIV testing and the situation of positive findings, the influencing factors related to HIV infection, and the characteristics of newly diagnosed HIV/AIDS cases from multiple dimensions. The HIV infection status and distribution characteristics of the STD clinic clients were comprehensively analyzed. Results In 2023, a total of 63 287 STD clinic clients were detected in Yunnan Province. Among them, 885 cases were positive for HIV screening, with a positive screening rate of 1.40%, and 829 cases were confirmed as HIV positive, with a confirmed positive rate of 1.31%. The positive rates of HIV screening and confirmatory test in the male STD clinic clients were significantly higher than those in the female STD clinic clients(P<0.05), and the positive rates of HIV screening and confirmatory test in the STD clinic clients from the border areas were significantly higher than those from the non-border areas(P<0.05). The distribution of the positive rates of confirmed HIV showed a positive spatial autocorrelation, and Moran′s I was 0.077(Z=1.883, P=0.035). In 2023, 111 new cases of HIV/AIDS were reported in the STD clinic. The male-to-female ratio was 3.63∶1. The majority of the patients were farmers(60.36%), and their age ranged from 20 to 49 years(63.06%). In the 111 new cases of HIV/AIDS, 79.28% of the cases were transmitted through heterosexual act, and 19.82% of the cases were transmitted through same-sex sexual behavior. The sentinel monitoring data indicated that the male STD clinic clients with age ≥34 years, a history of injecting drug use, a history of same-sex sexual behaviour, having sexually transmitted diseases in the past year, undergoing HIV testing in the past year and knowing the results had a higher HIV infection rate(P<0.05). Conclusion The HIV positive rate in STD clinic clients in Yunnan Province is generally at a relatively high level. The border areas and the regions where the spatial distribution shows a “high-high” aggregation should be given key attention. Male patients with high-risk behaviors and a history of sexually transmitted diseases have a higher risk of HIV infection. The newly diagnosed cases of HIV/AIDS in the STD clinic are mainly young and middle-aged men. They have a low educational level and are infected with HIV/AIDS mainly through sexual contact. In order to accurately guide the prevention and control of AIDS, comprehensive monitoring of this population should be continuously carried out in the future. |
| Key words: Yunnan Sexually transmitted disease clinic clients Human immunodeficiency virus(HIV) Acquired immunodeficiency syndrome(AIDS) Surveillance Spatial autocorrelation |
