Disparities in HIV and syphilis prevalence and risk factors between older male clients with and without steady sex partners in southwestern rural China.
Disparities in HIV and syphilis prevalence and risk factors between older male clients with and without steady sex partners in southwestern rural China.
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DOI：
10.1186/s12879-017-2367-z
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发表时间：
2017-04-12
影响因子：
3.7
通讯作者：
Tang Z
中科院分区：
文献类型：
--
作者：
Chen L;His JH;Wu X;Shen Z;Lu H;Chen H;Huang H;Zhang H;Ruan Y;Shao Y;Tang Z
在广西报告的艾滋病病例中，异性性交占93%，广西占中国报告艾滋病病例总数的10%。老年男性特别容易感染性传播疾病，例如，广西46%的艾滋病病例是50岁以上的男性。由于这是一个在中国研究不足的人群，有效的预防和控制政策尚未制定。因此，本研究的目的是使用一个大规模的横断面调查，以了解人口和行为因素与老年男性客户的女性性工作者（FSWs）中的艾滋病和梅毒感染的高发区，中国广西农村。2012年在低成本商业性场所的FSW老年男性客户中进行了大规模的横断面调查。问卷调查收集社会人口学和性行为信息。采集血样进行HIV和梅毒感染检测。在3485名调查对象中，2509人（72.0%）有固定的性伴侣，976人（28.0%）没有固定的性伴侣。HIV和梅毒感染率分别为3.0%和3.2%。与有固定性伴侣的人相比，没有固定性伴侣的人感染艾滋病毒的几率更高（AOR：1.90，95% CI：1.27-2.86），梅毒感染（AOR：1.53，95%CI：1.02-2.30），且有HIV或梅毒感染相关因素，包括最近一个月内有非商业性的偶然性行为（AOR：3.29，95% CI：2.42-4.46），>10年商业性行为史（AOR：1.31，95% CI：1.12-1.53），上个月商业性行为事件>2起（AOR：1.53，95% CI：1.19-1.96），上个月使用春药（AOR：1.40，95% CI：1.16-1.70）。没有固定伴侣的患者发生异性性行为的几率较低（AOR：0.66，95%CI：0.56-0.79），对艾滋病毒/艾滋病的认识和知识的几率较低（AOR：0.75，95%CI：0.64-0.88），接受过艾滋病毒检测的几率较低（AOR：0.65，95%CI：0.44-0.98）。在中国西南部农村地区，低成本商业性场所的老年男性顾客感染艾滋病毒和梅毒的风险很高，特别是那些没有稳定性伴侣的人。迫切需要改善对这一被忽视的风险人群的干预措施。
Heterosexual intercourse accounted for 93% of reported HIV cases in Guangxi, and Guangxi had 10% of China’s total number of reported HIV cases. Older men are particularly vulnerable to STIs, for example, 46% of Guangxi’s HIV cases were men over 50 years of age. As this is an under-studied population in China, effective prevention and control policies have yet to be developed. Thus, the aim of this study was to use a large-scale cross-sectional survey to understand the demographic and behavior factors associated with HIV and syphilis infections among older male clients of female sex workers (FSWs) in a high epidemic area of rural Guangxi, China. A large-scale cross-sectional survey was conducted in 2012 among older male clients of FSWs in low-cost commercial sex venues. Questionnaire interviews were administered to collect sociodemographic and sexual behavior information. Blood samples were collected for HIV and syphilis infection tests. Of the 3485 participants, 2509 (72.0%) clients had a steady sex partner and 976 (28.0%) clients had no steady sex partner. The overall prevalence of HIV and syphilis infection were 3.0% and 3.2%, respectively. Compared to those with a steady sex partner, clients with no steady partner had higher odds of HIV infection (AOR: 1.90, 95% CI: 1.27–2.86), syphilis infection (AOR: 1.53, 95% CI: 1.02–2.30), and having factors associated with HIV or syphilis infection, including non-commercial casual sex encounters in last month (AOR: 3.29, 95% CI: 2.42–4.46), >10 years of commercial sex history (AOR: 1.31, 95% CI: 1.12–1.53), >2 incidents of commercial sex in last month (AOR: 1.53, 95% CI: 1.19–1.96), and aphrodisiac use in last month (AOR: 1.40, 95% CI: 1.16–1.70). Clients with no steady partner had lower odds of having heterosexual intercourse (AOR: 0.66, 95% CI: 0.56–0.79), awareness and knowledge of HIV/AIDS (AOR: 0.75, 95% CI: 0.64–0.88), and having had HIV tests (AOR: 0.65, 95% CI: 0.44–0.98). Older male clients of low-cost commercial sex venues in rural southwestern China are at high risk for HIV and syphilis infection, especially those with no steady sex partner. Improved interventions are urgently needed for this neglected risk population.