| [Objective] (1). To describe the HIV/syphilis infection in high-risk population of Liuzhou in 2007 and 2008; (2). To analyze epidemiological characteristics of HIV high-risk groups in 2007 and 2008,and to better understand risk factors related to HIV/syphilis infection, so as to provide early warning for HIV/syphilis infection; (3).To compare change trends of population infected by HIV/syphilis between 2007 and 2008 in order to provide evidences for interventions and consequent evaluation of these interventions for HIV/AIDS.[Method] (1). The project and questionnaires for commercial sex workers (CSW), drug users (DU) and men having sex with men (MSM) population provided by national AIDS center were used for collection of behavior information and serological tests were performed in this cross-sectional study to analyze:①General characteristics of subjects including demographic information and behavior information of sex, drug use and seeking medical care;②HIV/syphilis prevalence including positive distribution,characteristics of cases with HIV/syphilis positive and high risk of HIV/syphilis infection;③To monitor the population HIV/syphilis changes in risk factors of syphilis infection; (2). Sampling methods were as follows:stratified and random sampling was for CSW; snowball sampling method was used for DU, convenience sampling and snowball sampling methods was performed to collect samples for MSM; (3). EpiData3.1 and SPSS 13.0 were used to questionnaire record and data analysis, respectively. [Results]Total 2148 eligible subjects consisting of 851 CSWs,807 drug users and 490 MSMs were recruited and investigated for survey questionnaire and blood sample collection.1) Socio-demographic characteristics:CSW and MSM mainly ranged from 15 to 25 years old and DU ranged from 30 to 40 years old. Most of the three kinds of high risk population were the Han people, and DUs Were mainly local residents, mobility of CSW and MSM was significant; Most of the subjects were unmarried and MSM was the population with the highest level of education among the three type groups.2) Sex behavior characteristics:CSW:The median age of first sex and first commercial sex were 18 and 20 years respectively; there was 7 months of being sex workers per year and there was 20 days per month, with 1 client in one day and with 7 clients in recent a week, the condom use with clients was significantly better than the spouse. DU: 43.1% DU had sex behavior in last month but only 39% DU used condoms,33.1% DU had sex with spouse more than once a week in the past year,34 DU had commercial sex for drugs,70.3% DU used condom in recent sex behavior and 75.7% used condoms occasionally,only 5.4% per day. Condom used rate was higher to spouse and casual partner. Homosexual in DU was rarely. MSM:The median age of first sex and 20 years,67.3% MSM first sex partner was male, Condom used rate was low with different sex partners.3) rate of needle sharing were relatively high in drug user population.4) Situation of STD and behavior of seeking medical care:CSWs with STD symptoms tended to choose general hospital, DUs usually selected out-patient department of STD and MSMs liked to private clinics.5) Accesses to medical service:more than half of the high-risk groups were coved by the interventions. TV, and free materials were the main channel for subjects to get necessary information.2. HIV/syphilis prevalence:1) Detection rate of HV in CSW, DU, MSM were 0.24%,18% and 1.40% respectively; the detection rate of syphilis were 1.88% ,4% and 5.3% respectively; 2)Characteristics of subjects with HIV/Syphilis positive:CSWs with HIV/Syphilis positive were young, unmarried, local with less AIDS awareness, and worked in low grade position; DU with HIV/Syphilis positive were most at young age having first sex, femal, unmarried or divorced, and like to share needle; Most MSMs with HIV/Syphilis positive were unmarried, divorced, with low education level, less awareness and low income. Unprotected sex existed in all three groups.3) Factors affecting HIV/ syphilis infection:(DCSW:age having the first sex, marriage status, working place, condom use situation and accesses to medical service, worked in low grade position, a younger age having the first sex and low frequenc of condum use with regular sex partner were risk factors, but condum use in sex every time was a protective factor;②DU:education level, marriage status, the first time of DU, having a partner of DU or not, needle sharing rate. Unmarriaged status and needle sharing were high risk factors;③MSM:age, marriage status, education level, age having the first time of anal sex, condum use situation, Divorce and low education level were high risk factors.3. Thr changes of related factors in HIV/syphilis infection awareness of HIV/STI in CSW and DU was significantly improved, rate of condom use in commercial sex was increased, but not in regular sexual partners, no changes of awareness and behavior were observed in MSM. Rate of needle sharing and coverage in DU were significantly increased.Conclusion (1). The HIV detection rates of CSW, DU and MSM were as follows:0.24%,18%and 1.40%; the syphilis detection rates of CSW, DU and MSM were 1.88% ,4% and 5.3%, respectively. (2). High risk factors to HIV/syphilis:CSW:a younger age having the first sex and low frequenc of condum use with regular sex partner were risk factors, but condum use in sex every time was a protective factor; DU: Unmarriaged status and needle sharing were high risk factors; MSM: Divorce and low education level were high risk factors. (3) Intervention models current in Liuzhou have effective but needs to be improved. |
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