目的评估北京市男男性行为者艾滋病与其他性传播疾病(STD)的现患率,以及兴奋剂、毒品的使用情况.了解男男性行为者行为特征及疾病感染的危险因素,为对该目标人群实施有效的行为干预措施,控制艾滋病病毒(HIV)传播提供科学依据。方法以常规监测信息为基础寻找种子,采用滚雪球方法招募200名研究对象。通过问卷调查收集被访者人口学、行为学信息。采用酶联免疫吸附试验(ELISA)进行HIV抗体初筛检测,初筛阳性样本采用免疫印迹法(WB)进行确证检测。采用ELISA(IgG)、快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体明胶颗粒凝集试验(TPPA)检测梅毒螺旋体。采集尿道及肛周拭子,采用ELISA法检测衣原体;采用涂片镜检和培养两种方法检测淋球菌。使用Epi Data 3.02软件建立数据库,对问卷及检测结果进行录入,运用SPSS 10.0进行统计学分析。结果共招募200名男男性行为者作为研究对象,平均年龄(26.44±6.3)岁。过去一年中同性性伴数超过1个的占86.5%,20.5%有异性多性伴。该群体在发生同性性行为时普遍存在主动肛交(77.5%)与被动肛交(63.0%)。21.5%的被访者承认既往曾使用过毒品。检出HIV抗体阳性13例,感染率6.5%;TPPA阳性48例,现患率24%;肛门拭子衣原体涂片阳性21例,阳性率10.5%;尿道拭子涂片衣原体阳性19例,阳性率9.5%;淋球菌尿道及肛门拭子涂片、培养阳性1例,阳性率0.5%。结论男男性行为者行为特征导致其性病、HIV感染风险较高,需要采取有针对性的综合防治措施加以控制。
Objective: To elucidate general characteristics of HIV/AIDS patients seeking care at Ditan Hospital in an attempt to guide early diagnosis in routine medical care. Materials and methods: A retrospective analysis of 185 HIV/AIDS cases from January 1990 to June 2002 was completed using SPSS statistical analysis. Results: Male to female ratio was 1.8 :1. Subjects ranged in age from 1 year old to 64 years old. 16 cases were younger than 20 years old with the median age among the younger subset at 7.7 years. 169 cases were older than 20 years old with a median age of 36 years old. 29% of the subjects were peasants. The remaining 71%, were of other unspecified occupations. 90.8% of individuals were of Han descent while 3.7% of individuals were of a minority heritage. 50.3% of subjects were married; 23.8% have never married; 8.1% were divorced; and the remaining 17.8% were of unknown marital status. Of those represented in this study, 36.8% came from the Henan province; 17.8% were from Beijing; 8.6% were from Shanxi; 31.4% from the other 20 provinces of China; and 5.4% from outside of China. Mode of transmission: 40.0% (74/185) contracted HIV through unprotected sexual contact; 29.2% (54/185) through receiving blood or plasma transfusions; 21.1%(39/185) through donating plasma; 7 cases were intravenous drug users; 7 cases were vertically transmitted. Mode of transmission was unknown in 4 cases. Clinical categories: An included 45 cases; B included 85 cases: C consisted of 76 cases. 12 cases were deceased. Initial presentation: 39 cases presented with fever ,cough and diarrhea. 37 cases had fever and cough only. 38 cases presented with chronic diarrhea. 16 cases were discovered incidentally at time of operation. 8 cases presented with fungal infection of the oral cavity or in esophagus. The common HIV associated symptoms and opportunistic infections were: weight loss and diarrhea, respiratory diseases, der-matologic diseases, anemia , neutropenia. Diseases of other organ systems were less common. Common misdiagnoses incl
