乌鲁木齐市高危人群艾滋病哨点监测分析及HIV流行趋势预测

发布时间：2018-03-17 12:18

本文选题：艾滋病　切入点：吸毒者　出处：《新疆医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:通过对吸毒者、男男性行为者、暗娼三类高危人群艾滋病感染状况、行为特征等相关研究,了解此三类人群的HIV感染状况和流行的危险因素。利用2009-2016年乌鲁木齐市相应人群HIV感染状况,对2017-2019年艾滋病流行趋势进行预测。方法:按照《全国艾滋病哨点监测实施方案》,通过哨点监测系统获取乌鲁木齐市2009-2016年三类高危人群哨点监测数据,采用多因素logistic回归分析HIV感染的影响因素。依据2009-2016年乌鲁木齐市艾滋病疫情监测数据,分别建立吸毒者,男男性行为者及暗娼HIV感染率的ARIMA模型,进行回代拟合,并预测2017-2019年HIV感染率。结果:1.吸毒者HIV感染率为16.51%;注射吸毒比例为75.30%;共用针具比例为23.62%;多因素logistic回归分析结果显示,维吾尔族及其他少数民族(OR(28)6.76,95%CI:3.48~13.11;OR(28)2.96,95%CI:1.27~6.87)、30~40岁(OR(28)2.34,95%CI:1.42~3.85)、平均每天注射吸毒次数高(OR(28)2.34,95%CI:1.34~4.10)、共用针具(OR(28)5.63,95%CI:3.76~8.43)是吸毒者感染HIV的危险因素。2.男男性行为者HIV感染率为6.62%;男男性行为者与同性发生性行为时每次都使用安全套的比例为44.00%;最近六个月与同性发生商业性行为的男男性行为者为5.66%,男男性行为者最近一次与同性发生商业性行为时安全套的使用率为89.64%;男男性行为者与异性发生性行为的比例为9.48%,男男性行为者与异性发生性行为时安全套使用率为56.66%。多因素logistic回归分析结果显示,外省(OR(28)1.72,95%CI:1.30~2.27)、维吾尔族(OR(28)1.85,95%CI:1.27~2.68)、40岁(OR(28)1.63,95%CI:1.16~2.31)是男男性行为者感染HIV的危险因素。3.暗娼HIV感染率为0.47%;暗娼最近一次与客人发生性行为时使用安全套比例为89.49%;多因素logistic回归分析结果显示,离异或丧偶(OR=2.48,95%CI:1.06~5.82)是暗娼感染HIV的危险因素;相对于小学及以下文化程度的暗娼人群,初中、高中或中专、大专及以上者感染HIV的风险低(OR=0.51,95%CI:0.26~0.99;OR=0.16,95%CI:0.07~0.39;OR=0.23,95%CI:0.06~0.83)。4.吸毒者ARIMA模型(2,1,0)预测的2017-2019年HIV感染率分别为7.68%、6.45%、5.94%,呈逐年下降;MSM人群ARIMA模型(3,0,0)预测的2017-2019年HIV感染率分别为10.13%、5.48%、6.34%,HIV感染率有波动;暗娼ARIMA模型(1,0,0)预测的2017-2019年HIV感染率为分别为0.35%、0.39%、0.41%,呈基本平稳略有上升趋势。结论:乌鲁木齐市高危人群HIV感染及传播的危险因素广泛存在,应进一步加强针对三类高危人群制定有的放矢的干预措施及策略;时间序列ARIMA模型较好地模拟HIV感染率在时间序列上的变动趋势,可以为卫生部门控制艾滋病及制定艾滋病防治策略和干预措施提供依据。
[Abstract]:Objective: to study HIV / AIDS infection status and behavioral characteristics among drug users, men who have sex with men and sex workers. To understand the status of HIV infection and the risk factors of epidemic in these three groups. Using the HIV infection status of corresponding population in Urumqi city from 2009-2016, Methods: according to the implementation Program of National AIDS Sentinel Surveillance, the sentinel surveillance data of three types of high-risk population in Urumqi from 2009 to 2016 were obtained through the sentinel surveillance system. Multivariate logistic regression analysis was used to analyze the influencing factors of HIV infection. According to the surveillance data of HIV / AIDS in Urumqi from 2009 to 2016, the ARIMA models of HIV infection rate among drug users, men who had sex with men and female sex workers were established, and the HIV infection rates of drug addicts, men who had sex with men and female sex workers were analyzed. The infection rate of HIV in 2017-2019 was predicted. Results: the infection rate of HIV among drug addicts was 16.51, the proportion of injecting drug users was 75.300.The proportion of needle sharing was 23.62. The results of multivariate logistic regression analysis showed that, The Uygur and other minority nationalities have a high number of injections per day of drug abuse, OR286.76-95CI3.483.481.282.9695CI282.9695CIQ: 1.276.876.873040, and the average number of times of injecting drug abuse per day is high OR282.3495 95 CI: 1.344.100.The HIV infection rate among men who have sex with men is 6.62; the rate of HIV infection among men who have sex with men is 6.62; the rate of HIV infection among men who have sex with men is 6.62; the rate of HIV infection among men who have sex with men is 6.62; the rate of HIV infection among men who have sex with men is 6.62; and the infection rate of men who have sex with men is 6.62. The proportion of men who had commercial sex with the same sex in the last six months was 5.66. The rate of condom use by men who had sex with men during the last commercial sex with the same sex was 89.64. The ratio of sex to heterosexual sex was 9.48, and the condom use rate was 56.66.Multivariate logistic regression analysis showed that, The prevalence rate of HIV among male sex workers was 0.47. The proportion of condom used in sexual intercourse with clients was 89.49. The results of multivariate logistic regression analysis showed that the risk factors for men who had sex with men were: 1.7295%, 1.7295% CI: 1.7295%, and 1.855% CI: 1.275.95% CI: 1.162.31. The prevalence rate of HIV was 0.47; the proportion of female sex workers who had sex with their clients was 89.49; the multivariate logistic regression analysis showed that the rate of condom use in sex with clients was 89.49. The results of multivariate logistic regression analysis showed that the prevalence rate of HIV infection was 0.47; the proportion of condom use in sexual intercourse with clients was 89.49; the results of multivariate logistic regression analysis showed that:. Divorce or widowhood is a risk factor for HIV infection among prostitutes, as compared with those with primary school or lower education level, junior high school, high school or technical secondary school. The risk of HIV infection among those with college or above is low: OR0.51C95CI0.99: OR0.160.167CI0.07 / 0.39CI0.2395CI0.2395CI0.2395CI0.2395CI0.2395CI0.2395CI0.2395CI0. The HIV infection rate in 2017-2019 is 7.686.455.940.The HIV infection rate predicted in 2017-2019 is 10.13135.486.340.The HIV infection rate in 2017-2019 is 10.13135.486.34. The HIV infection rate in 2017-2019 was 0.35 and 0.390.39, respectively, showing a steady and slightly rising trend. Conclusion: the risk factors of HIV infection and transmission are widespread in high risk population in Urumqi. It is necessary to further strengthen the targeted intervention measures and strategies for the three groups of high-risk groups, and the time series ARIMA model can better simulate the trend of HIV infection rate in time series. It can provide basis for health department to control AIDS and formulate AIDS prevention and treatment strategy and intervention.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91;R181

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