Health related behaviors among HIV-infected people who are successfully linked to care: an institutional-based cross-sectional study
Health related behaviors among HIV-infected people who are successfully linked to care: an institutional-based cross-sectional study
复制标题
成功获得护理的艾滋病毒感染者的健康相关行为：基于机构的横断面研究
DOI：
10.1186/s40249-020-00642-1
复制
发表时间：
2020-03-10
影响因子：
8.1
通讯作者：
Cheng, Feng
中科院分区：
文献类型：
--
作者：
Xu, Jun-Fang;Wang, Pei-Cheng;Cheng, Feng
背景
截至2019年10月底，中国报告的艾滋病病毒感染者/艾滋病病人达95.8万人。不健康的生活方式因素，如吸烟、饮酒、使用违禁药物以及缺乏体育活动，已被发现会削弱抗逆转录病毒治疗（ART）对病毒载量和艾滋病相关生活质量的积极影响。此外，艾滋病病毒阳性者的危险性行为使其伴侣面临艾滋病传播和其他性传播感染的风险。本研究旨在确定艾滋病病毒感染者/艾滋病病人不健康行为的流行情况及相关影响因素，特别是那些与艾滋病感染和抗逆转录病毒治疗效果密切相关的因素。
方法
采用基于机构的横断面研究设计，收集北京和云南省艾滋病病毒感染者/艾滋病病人（PLWHA）的数据。问卷调查包括以下信息：社会人口学特征、健康行为信息、性风险行为。采用二元逻辑回归模型分析一般不健康健康行为和危险性行为的影响因素。
结果
共有2575名艾滋病病毒感染者/艾滋病病人参与研究，其中78.3%（2017/2575）为男性。在一般健康行为方面，34.2%（987/2544）吸烟；33.8%（870/2575）饮酒；2.3%（49/2134）报告在过去6个月内使用过违禁药物。从性行为角度来看，59.0%（1519/2575）在过去6个月内有过性行为。在有过性行为的人群中，92.0%（1398/1519）有固定性伴侣。在无固定性伴侣的人群中，38.0%（46/121）有三个以上性伴侣。在有过性行为的男性中，34.7%（448/1292）报告在过去6个月内与男性发生过性行为，其中16.7%（75/448）有群体性行为。在参与者中，72.2%（1053/1458）每次性行为都使用避孕套，而6.4%（94/1458）的人从不使用避孕套。男性艾滋病病毒感染者/艾滋病病人更有可能有性风险行为（调整后的比值比[OR]=2.208，95%置信区间[CI]：1.147 - 4.252）和一般不健康健康行为（调整后的OR = 2.029，95%CI：1.480 - 2.783）。与不饮酒者相比，饮酒的参与者有更高危险性行为的几率是其1.546倍（95%CI：1.302 - 1.827，P = 0.001）。
结论
艾滋病病毒感染者/艾滋病病人是一个易出现健康问题行为的群体，尤其是男性更有可能饮酒、有更多性伴侣、有更多性风险行为，包括群体性行为、不使用避孕套和使用毒品。因此，现在有必要针对艾滋病病毒感染者/艾滋病病人开展以性别特异性风险行为减少为重点的干预措施，以控制艾滋病感染的传播并提高抗病毒治疗的效果。
BackgroundBy the end of October 2019, there were 958 thousand people were reported living with HIV/AIDS in China. Unhealthy lifestyle factors, such as smoking, drinking alcohol, using illicit drugs and no physical activity have been found to mitigate the positive impact of antiretroviral therapy (ART) on viral load and HIV-related quality of life. Moreover, risky sexual behavior among HIV-positive persons places their partners at risk for HIV transmission and other sexually transmitted infections. The aim of the study is to determine the prevalence of unhealthy behavior of people living with HIV/AIDS and related influencing factors, particularly those that are closely connected with HIV infection and ART effects.MethodsAn institutional based cross-sectional study design was used to collect data from people living with HIV/AIDS (PLWHA) in Beijing and Yunnan Province. The following information was included in the questionnaire survey: social-demographic characteristics, health behavior information, sexual risk behaviors. Binary logistic regression model was conducted to analyze the influencing factors of unhealthy general health behaviors and risky sexual behaviors.ResultsIn total, 2575 PLWHA were included in the study and 78.3% (2017/2575) were male. For the general health behaviors, 34.2% (987/2544) smoke; 33.8% (870/2575) drank alcohol and 2.3% (49/2134) reported the use of illicit drugs in the previous 6 months. From the sexual behaviors perspective, 59.0% (1519/2575) had sex in the previous 6 months. Among people who had sex, 92.0% (1398/1519) had fixed sexual partners. Among those with no fixed sexual partner, 38.0% (46/121) had more than three partners. Among men who had sex, 34.7% (448/1292) reported having sex with men in the previous 6 months and 16.7% (75/448) of these had group sexual activity. Among participants, 72.2% (1053/1458) used condoms every time they had sex while 6.4% (94/1458) of people never used condom. Male people living with HIV/AIDS were more likely to have sexual risk behaviors (adjusted odds ratio [OR] = 2.208, 95% confidence interval [CI]: 1.147–4.252) and unhealthy general health behaviors (adjustedOR= 2.029, 95%CI: 1.480–2.783). The odds of higher risk sexual behaviors was 1.546 times (95%CI:1.302–1.827,P= 0.001) greater among participants who drank alcohol compared with their non-drinking counterparts.ConclusionsPLWHA is a group that is vulnerable to problematic health behaviors, especially for men who were more likely to drink alcohol, have more sexual partners, more sexual risk behaviors including group sexual activity, not using condoms and using drugs. Therefore, interventions focusing on gender-specific risk behaviors reduction for people living with HIV/AIDS are now necessary to control the spread of HIV infection and improve the efficacy of antiviral treatment.