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摘要:
目的 通过分析2014—2020年四川省凉山彝族自治州（凉山州）婚检人群HIV抗体筛查结果，了解一般人群中HIV流行特征及趋势。 方法 收集并分析2014—2020年凉山州12个市/县婚检人群HIV抗体筛查资料以及HIV抗体筛查阳性者社会人口学特征、感染途径和接触史相关危险行为等内容。 结果 2014—2020年婚检男性HIV抗体阳性率高于女性；男性HIV抗体阳性率在1.49%～1.99%范围内，女性从2014年的0.89%上升到2020年的1.34%；两两比较不同地区婚检HIV抗体阳性率差异较大；婚检HIV抗体阳性者以男性居多，男女性别比从2014年2.08下降至2020年1.36；年龄以25～39岁组居多，<40岁组构成比呈下降趋势；民族以彝族为主，占95.49%；文化程度以文盲为主；异性传播构成比从2014年46.50%上升至2020年62.98%，注射吸毒传播构成比从2014年53.39%下降至2020年37.02%；注射毒品传播的HIV抗体阳性者中男性占86.53%，异性传播中女性多于男性，占58.61%；异性传播接触史以非婚非商业为主，构成比从2014年48.04%上升至2020年72.87%，其次为婚内异性传播。 结论 凉山州一般人群中艾滋病流行水平高，早期流行模式受注射吸毒传播影响。随后逐步向异性性传播方式转变，并以非婚非商业异性性接触史为主，流行模式相应变化，同时具有广泛流行地区异性传播的特点。在布拖县、昭觉县、美姑县等彝族聚居地区，需根据彝族少数民族特点开展针对性宣传及干预方式。 -
关键词:
- 婚检人群 /
- 艾滋病病毒/艾滋病患者 /
- 凉山州
Abstract:Objective To understand the characteristics and trends of HIV infection in general population in Liangshan prefecture of Sichuan province by analyzing the results of local premarital HIV screening results during 2014−2020. Methods The premarital HIV screening data in 12 counties in Liangshan during 2015−2020 were collected for the analysis on the socio-demographic characteristics, transmission route and contact history related to risk behaviors of HIV tested positive individuals. Results During 2014−2020, the premarital HIV positive rate in men was higher than that in women; The HIV positive rate fluctuated between 1.49% and 1.99% in men and increased from 0.89% in 2014 to 1.34% in 2020 in women. The HIV positive rate in different areas varied greatly; The HIV positive people were mainly men, and the sex ratio of HIV positive men and HIV positive women decreased from 2.08 in 2014 to 1.36 in 2020; The age of HIV positive individuals ranged from 25 to 39 years, and the proportion of those aged less than 40 years decreased. The HIV positive individuals were mainly in ethnic group of Yi, accounting for 95.49%. The HIV positive individuals were mainly illiterate. The proportion of heterosexual transmission increased from 46.50% in 2014 to 62.98% in 2020, while the proportion of injecting drug use decreased from 53.39% in 2014 to 37.02% in 2020; Men accounted for 86.53% of HIV positive people infected by injecting drug use, and there were more women infected by heterosexual transmission, accounting for 58.61%; Heterosexual transmission was mainly caused by non-marital and non-commercial sexual contacts with the proportion increasing from 48.04% in 2014 to 72.87% in 2020, followed by marital sexual contact. Conclusion The prevalence of HIV/AIDS in the general population of Liangshan was high. The early HIV transmission pattern was characterized by injection drug use. Since the control of injecting drug use related HIV epidemic, the HIV transmission pattern has gradually changed from injection drug use to heterosexual contact, especially non-marital non-commercial heterosexual contact, across Liangshan. It is necessary to take targeted health education and intervention measures in Yi ethnic group. -
Key words:
- Premarital check-up /
- HIV/AIDS /
- Liangshan prefecture
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表 1 2014－2020年凉山州12个市/县婚检人群分性别HIV抗体阳性率
Table 1. Gender specific HIV positive rate in premarital HIV screening in 12 counties in Liangshan, 2014−2020
年份 男性 女性 筛查数（人） 阳性率（%） 筛查数（人） 阳性率（%） 2014 33 656 1.81 33 656 0.89 2015 29 951 1.63 29 960 0.88 2016 36 623 1.97 36 824 1.11 2017 39 144 1.76 39 150 1.08 2018 35 696 1.49 35 733 0.97 2019 34 564 1.99 34 622 1.43 2020 29 333 1.90 30 905 1.34 
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表 2 2014－2020年凉山州12个市/县婚检人群分地区HIV抗体阳性率（%）
Table 2. Area specific HIV positive rate in premarital HIV screening in 12 counties in Liangshan, 2014−2020（%）
年份 布拖 昭觉 美姑 金阳 甘洛 雷波 德昌 西昌 冕宁 盐源 宁南 会东 2014 3.67 1.87 1.27 0.60 1.38 0.09 0.25 0.27 0.44 − 0.19 − 2015 2.23 2.16 2.06 1.36 1.25 0.40 0.26 0.24 0.43 − 0.30 − 2016 2.62 3.21 2.34 1.91 1.40 0.47 0.60 0.46 0.37 0.14 0.31 0.17 2017 3.24 2.68 2.21 1.21 1.22 0.21 0.63 0.51 0.63 0.33 0.72 0.20 2018 4.04 3.43 1.74 0.99 1.18 0.37 0.58 0.29 0.62 0.25 0.21 0.29 2019 10.22 4.07 2.77 1.79 1.29 0.67 0.85 0.37 0.64 0.38 0.53 0.18 2020 8.12 3.95 1.91 1.73 1.13 0.48 0.42 0.40 0.31 0.31 0.16 0.13 注：−. 数据缺失
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表 3 2014－2020年凉山州12个市/县婚检HIV抗体阳性者的基本特征
Table 3. Basic characteristics of HIV positive people in premarital HIV screening in 12 counties in Liangshan, 2014−2020
特征 2014年 2015年 2016年 2017年 2018年 2019年 2020年 例数（例） 构成比（%） 例数（例） 构成比（%） 例数（例） 构成比（%） 例数（例） 构成比（%） 例数（例） 构成比（%） 例数（例） 构成比（%） 例数（例） 构成比（%） 性别 男性 600 67.49 471 64.61 713 64.58 670 62.56 516 61.50 692 58.79 539 57.71 女性 289 32.51 258 35.39 391 35.42 401 37.44 323 38.50 485 41.21 395 42.29 年龄组（岁） <25 122 13.72 101 13.85 150 13.59 147 13.72 120 14.30 155 13.17 104 11.13 25～ 679 76.38 561 76.96 805 72.92 771 71.99 607 72.35 797 67.71 659 70.56 40～ 88 9.90 67 9.19 149 13.49 153 14.29 112 13.35 225 19.12 171 18.31 民族 彝族 856 96.29 693 95.06 1 051 95.20 1 026 95.80 795 94.75 1 117 94.90 901 96.47 汉族 29 3.26 29 3.98 48 4.35 37 3.45 41 4.89 53 4.50 30 3.21 其他 4 0.45 7 0.96 5 0.45 8 0.75 3 0.36 7 0.60 3 0.32 文化程度 文盲 578 65.09 486 66.76 754 68.30 701 65.45 538 64.13 690 58.62 555 59.42 小学 258 29.05 184 25.27 273 24.73 275 25.68 221 26.34 369 31.35 287 30.73 初中 40 4.50 47 6.46 62 5.62 72 6.72 63 7.51 95 8.07 68 7.28 高中或中专 9 1.02 9 1.24 9 0.81 15 1.40 9 1.07 14 1.19 16 1.71 大专及以上 3 0.34 2 0.27 6 0.54 8 0.75 8 0.95 9 0.77 8 0.86
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表 4 2014－2020年凉山州12个市/县婚检HIV抗体阳性者的感染途径构成
Table 4. HIV transmission routes in HIV positive people in premarital HIV screening in 12 counties in Liangshan, 2014−2020
年份 注射毒品 异性传播 同性传播 例数
（例）构成比
（%）例数
（例）构成比
（%）例数
（例）构成比
（%）2014 464 53.27 406 46.61 1 0.12 2015 389 54.63 323 45.37 0 0.00 2016 562 51.85 522 48.15 0 0.00 2017 528 50.00 527 49.91 1 0.09 2018 318 38.13 516 61.87 0 0.00 2019 440 37.90 717 61.76 4 0.34 2020 364 39.39 560 60.61 0 0.00
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表 5 2014－2020年凉山州12个市/县婚检HIV抗体阳性者的异性传播方式
Table 5. HIV heterosexual transmission in HIV positive people in premarital HIV screening in 12 counties in Liangshan, 2014−2020
年份 商业 非婚非商业业 婚内 例数
（例）构成比
（%）例数
（例）构成比
（%）例数
（例）构成比
（%）2014 5 2.79 86 48.05 88 49.16 2015 31 12.45 154 61.85 64 25.70 2016 27 6.40 289 68.48 106 25.12 2017 60 13.76 305 69.95 71 16.29 2018 59 12.83 321 69.78 80 17.39 2019 68 11.06 404 65.69 143 23.25 2020 34 6.88 360 72.88 100 20.24
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