2004-2015年重庆市经男男性行为感染HIV者空间自相关分析

发布时间：2018-05-16 03:12

本文选题：男男性行为 + 艾滋病　；参考：《中国疾病预防控制中心》2017年硕士论文

【摘要】：背景目的分析重庆市2004年1月至2015年12月经男男性行为感染HIV者空间聚集性特点,并通过访谈方式进行男男性行为者(MSM)相关行为调查,为重庆市艾滋病防治工作提供参考依据。方法收集中国疾病预防控制中心“艾滋病综合防治信息管理系统”中2004-2015年报告的现住址为重庆市、自述传播途径为男性性行为传播的HIV感染者和艾滋病患者(HIV/AIDS)的信息,包括病例录入时的年龄、现住地址、职业、文化程度和婚姻状况等方面。剔除地址不详者后,共收集HIV/AIDS 6604例。采用ArcGIS 10.3进行全局空间自相关分析和局部空间自相关分析。此外,于2015年11月和2016年5月,采用方便抽样法在重庆市疾病预防控制中心对23名MSM进行面对面访谈。纳入标准:在重庆市城区进行自愿咨询检测并通过口头知情同意愿意参加访谈者;男性并自述为MSM。访谈内容包括基本情况、性取向、性角色、主要交友活动场所、主要发生性行为场所、有无长期外出重庆市经历和药物滥用等。结果2004-2015年期间,仅2010年报告例数比2009年有所下降,其余年份整体呈增长趋势;6604例经男男性行为感染HIV者的年龄主要集中在15-34岁,约占68.5%(4522例)。除2005年以外(Moran'sI指数为-0.046,P值为0.823),2004—2015年全局空间自相关呈正相关关系(Moran's I分别为0.308、0.254、0.335、0.683、0.673、0.558、0.620、0.673、0.685、0.654和0.649,P值分别为0.001、0.009、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001 和0.001);局部Moran's I分析表明重庆市2004-2015年高-高型聚集区发展分为两个时间阶段,从2004-2007年仅有的渝中区、江北区、沙坪坝区等区域扩充到2008-2015年的九龙坡区、南岸区和渝北区。热点分析表明从2008-2015年,高值区域主要集中在渝中区、江北区、沙坪坝区、九龙坡区、南岸区、北碚区、渝北区和巴南区。本研究共访谈23名MSM,年龄20-44岁。职业包括金融、服务、工人、机关文职、学生和无业。HIV检测结果为阳性者有11名,HIV检测结果为阴性者有12名。文化程度在大专及以上学历有16名。研究对象集中在市区酒吧和浴池活动原因有:市区酒吧人员流动性大。市区内酒吧多,信息来源多且相互交流方便。市区内的浴池名气大,吸引本地人与外来游客的来访。市区内酒吧会开展各种活动,对年轻人有吸引力。结论重庆市经男男性行为感染HIV者,年龄段多在15-34岁,空间上呈现聚集性分布,以经济发达的主城区为中心。重庆市中心地区因人员流动量大,酒吧、浴池场所多等原因吸引大量的MSM人群集中到市中心区域活动。MSM开始以网络交友为主,并且不能坚持使用安全套,提示需注重网络干预并探讨更深入的干预措施。
[Abstract]:Objective to analyze the spatial clustering characteristics of MSM in men infected with HIV from January 2004 to December 2015, and to investigate the related behaviors of MSM in Chongqing from January 2004 to December 2015, so as to provide a reference for the prevention and treatment of AIDS in Chongqing. Methods the current address of the 2004-2015 report of the China Centers for Disease Control and Prevention Information system for the Integrated Prevention and Control of AIDS was collected in Chongqing. The self-reported route of transmission was HIV / AIDS / HIV / AIDS among men who had sex with men. This includes age, current address, occupation, education and marital status at the time of case entry. After removing the unknown address, 6604 cases of HIV/AIDS were collected. Global spatial autocorrelation analysis and local spatial autocorrelation analysis are carried out with ArcGIS 10.3. In addition, in November 2015 and May 2016, 23 MSM patients were interviewed in Chongqing Centers for Disease Control and Prevention by the convenient sampling method. Inclusion criteria: voluntary counseling and testing in Chongqing City and willing to participate in interviews through oral informed consent; male and self-described as MSM. The contents of the interview included basic situation, sexual orientation, sex role, main place of making friends, main place of sexual intercourse, whether there was long-term experience of going out and drug abuse in Chongqing, etc. Results in the period of 2004-2015, the number of cases reported in 2010 was lower than that in 2009. In other years, 6604 cases of HIV infected by male sex were mainly aged 15-34 years, accounting for 68.5% of 4522 cases. In addition to 2005, the MoransI index was -0.046 (P = 0.823) and the global spatial autocorrelation was positive correlation (P = 0.3080.2540.3350.683), respectively. The results of local Moran's I analysis showed that the development of high and high concentration areas in Chongqing in 2004-2015 was divided into two stages: 0.001 / 0. 009 / 0. 001 / 0. 001 / 0. 001 and 0. 001 / 0. 001, respectively, and 0. 649% (P = 0. 649) respectively, and the results of local Moran's I analysis showed that the development of high and high concentration areas in Chongqing was divided into two stages, which were: 0. 00 0. 00 0. 00 0. 001 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001 and 0. 001. From only Yuzhong District, Jiangbei District and Shapingba District in 2004-2007 to Jiulongpo District, Nanan District and Yubei District from 2008 to 2015. The hot spot analysis shows that from 2008 to 2015, the high value regions are mainly concentrated in Yuzhong District, Jiangbei District, Shapingba District, Jiulongpo District, Nanan District, Beibei District, Yubei District and Banan District. A total of 23 MSMs aged 20-44 years were interviewed in this study. Occupations include finance, services, workers, agency clerical, student and unemployed. There are 11 HIV positive people and 12 HIV negative people. Education level in college and above has 16. The reasons why the subjects were concentrated in urban bars and baths were: the mobility of bar staff in urban areas was high. There are many bars in the city, many sources of information and easy to communicate with each other. The baths in the city are so famous that they attract both local and foreign visitors. Bars in the city offer a variety of activities that appeal to young people. Conclusion most of the men infected with HIV in Chongqing are aged 15 to 34 years old, and their spatial distribution is concentrated, with the economic development of the main urban area as the center. The central area of Chongqing attracted a large number of MSM people to the downtown area activities. MSM started to make friends mainly on the Internet, and could not insist on using condoms, because of the large turnover of people, bars and baths, and so on. It is suggested that we should pay attention to network intervention and explore more in-depth intervention measures.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R512.91

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