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目的了解凉山彝族自治州孕产妇艾滋病病毒(HIV)感染和流行情况,为制定当地艾滋病的防治策略提供科学依据。方法选取2009-2015年每年4-6月在凉山州西昌市、彝族聚居地的昭觉县和布拖县妇幼保健院,准备分娩和接受孕产期保健的孕产妇进行连续采样监测,问卷调查了解一般人口学、生育情况和行为特征等情况,并采用酶联免疫吸附试验法检测HIV抗体。采用SPSS 19.0统计软件对数据进行整理和分析。结果 2009-2015年,孕产妇人群哨点共监测有效研究对象6 780人,检出HIV抗体阳性者288例,阳性率4.25%。2009-2015年各年HIV的阳性检出率分别为1.35%(9/665)、2.95%(18/611)、3.57%(36/1 008)、6.86%(82/1 196)、4.57%(48/1 050)、3.71%(39/1 050)和4.67%(56/1 200),呈现缓慢上升趋势(χ2=7.71,P=0.005)。分析发现昭觉和布拖地区的孕产妇HIV感染风险高于西昌地区[比值比(OR)=2.95,95%可信区间(CI)=1.39~6.24]。孕产妇是彝族(OR=6.08,95%CI=1.76~20.96)、生育次数1次(OR=1.55,95%CI=1.06~2.25)和2次(OR=1.74,95%CI=1.20~2.52)、丈夫有外出打工史(OR=1.40,95%CI=1.04~1.87)、丈夫有吸毒史(OR=1.86,95%CI=1.04~3.33)、丈夫患有性病(OR=2.26,95%CI=1.30~3.93),是感染HIV的危险因素。文化程度较高的研究对象感染HIV风险较低(OR=0.34,95%CI=0.13~0.85)。结论凉山彝族自治州孕产妇HIV抗体阳性率较高,HIV在该人群中有升高趋势。特别是对文化程度低,丈夫有吸毒史、外出打工史和患有性病的彝族孕产妇,感染HIV的风险更高。
Objective To understand the prevalence and prevalence of HIV among pregnant women in Liangshan Yi Autonomous Prefecture and provide a scientific basis for the development of prevention and treatment strategies for local AIDS. Methods From April to June of each year in 2009-2015, Zhaojue County and Buwa County Maternal and Child Health Care Hospital in Xichang City and Liangshan Prefecture, Liangshan Prefecture were sampled continuously and monitored by maternal sampling and questionnaires. General demography, reproductive status and behavior characteristics and other conditions, and the use of enzyme-linked immunosorbent assay HIV antibody. Using SPSS 19.0 statistical software to organize and analyze the data. Results Between 2009 and 2015, 6 780 sentinel sites of pregnant women were monitored. 288 HIV-positive cases were detected, the positive rate was 4.25%. The positive rates of HIV in 2009-2015 were 1.35% (9/665), 2.95% (18/611), 3.57% (36/1 008), 6.86% (82/1 196), 4.57% (48/1 050), 3.71% (39/1 050) and 4.67% (56/1 200), showing a slow upward trend (χ2 = 7.71, P = 0.005). The risk of HIV infection among pregnant women in Zhaojue and Budu areas was higher than that in Xichang [odds ratio (OR) = 2.95, 95% confidence interval (CI) = 1.39-6.24]. The pregnant women were Yi nationality (OR = 6.08, 95% CI = 1.76 ~ 20.96), one childbearing time (OR = 1.55,95% CI = 1.06 ~ 2.25) (OR = 1.40, 95% CI = 1.04-1.87), husband had drug abuse history (OR = 1.86,95% CI = 1.04-3.33), husband had venereal disease (OR = 2.26, 95% CI = 1.30 ~ 3.93), is a risk factor for HIV infection. People with higher education had a lower risk of HIV infection (OR = 0.34, 95% CI = 0.13-0.85). Conclusion The positive rate of HIV antibody in pregnant women in Liangshan Yi Autonomous Prefecture is high, and the HIV prevalence in this population is on the rise. In particular, the Yi ethnic pregnant women who have a low education level, a husband who has a history of drug abuse, a working history of migrant workers and sexually transmitted diseases have a higher risk of HIV infection.