江苏省50岁及以上男性HIV/AIDS患者确证前后性行为特征调查-东南大学学报医学版

江苏省50岁及以上男性HIV/AIDS患者确证前后性行为特征调查

单位：江苏省疾病预防控制中心性病与艾滋病防制所, 江苏南京 210009

分类号：R512.91

出版年·卷·期（页码）：2023·42·第四期（619-626）

摘要：

目的:分析江苏省≥50岁男性艾滋病病毒感染和艾滋病(HIV/AIDS) 患者性行为特征,为中老年人艾滋病防治措施制定提供数据支持。方法:从艾滋病防治基本信息系统中筛选2016—2017年报告、≥50岁男性病例,调查HIV确证前后性行为信息。结果:招募对象1 417例,46.7%经同性性行为感染,50~59岁、60~69岁和≥70岁感染途径构成比不同(P<0.001);确证前发生异性、同性性行为比例为82.9%和47.1%,确证后降至44.6%和11.5%;58.2%确证后存在婚内性行为;确证前安全套每次均用比例极低,确证后升高(P<0.001)。50~59岁年龄组同性性行为发生比例更高;30.3%在确证前既有异性也有同性性行为;确证前曾检测HIV比例为10.9%。结论:江苏省中老年男性病例性行为比例高、安全套使用比例低、自我检测意识弱,应进一步扩大中老年男性人群艾滋病检测和综合干预覆盖面。

Objective: To analyze the sexual behavior characteristics of men aged 50 years and above with HIV infection before and after HIV confirmation in Jiangsu Province; to provide data support for HIV prevention measures among middle-aged and elderly population. Methods: Newly reported HIV-infected males over 50 years old were selected from the National HIV/AIDS Surveillance System for 2016—2017. Information on sexual behaviors before and after HIV diagnosis were collected through one-to-one questionnaire survey. Results: A total of 1 417 eligible participants were finally recruited into this study, of whom 46.7% were infected with HIV through homosexual behaviors, and the route of HIV transmission differed by age groups(P<0.001). The incidence of heterosexual and homosexual risk activities decreased from 82.9% and 47.1% in the past one year before HIV diagnosis to 44.6% and 11.5% after diagnosis. 58.2% of survey subjects had marital sex after HIV confirmation. The frequency of condom use every time was very low before HIV confirmation, but increased after HIV confirmation(P<0.001). Higher rates of homosexual activities occurred in the 50-59 age group. 30.3% of the survey subjects had both heterosexual and homosexual sex within 1 year before HIV confirmation; 10.9% of the survey subjects had been tested for HIV before confirmation. Conclusion: Elderly men are at great risk of contracting HIV due to high rate of sexual activities, low proportion of condom use and weak awareness of self-testing in Jiangsu Province. Targeted and precise publicity education and intervention strategies must be implemented immediately to increase coverage of testing and public education through basic public health services.

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