中越边境地区暗娼人群HIV感染及性行为特征对比分析

朱靖; 胡丹; 殷玥琪; 汪宁; 王蓓

doi:10.16462/j.cnki.zhjbkz.2020.12.002

中越边境地区暗娼人群HIV感染及性行为特征对比分析

doi: 10.16462/j.cnki.zhjbkz.2020.12.002

朱靖^1, ,,
胡丹²,
殷玥琪³,
汪宁⁴,
王蓓³

1.
210029 南京，南京医科大学附属江宁医院
2.
210029 南京，南京医科大学医政学院
3.
210009 南京，东南大学公共卫生学院
4.
102206 北京，中国疾病预防控制中心性病艾滋病预防控制中心

基金项目:

“十二五”科技重大专项 2012ZX10001-001

详细信息

通讯作者:
朱靖，E-mail：zhujingkmmc@126.com

中图分类号: R512.91;R373.51
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出版历程
- 收稿日期: 2020-02-25
- 修回日期: 2020-05-01
- 刊出日期: 2020-12-10

Comparative analysis of HIV prevalence and sexual behaviors between Chinese and Vietnamese female sex workers

ZHU jing^{1
, ,},
HU Dan²,
YIN Yue-qi³,
WANG Ning⁴,
WANG Bei³

1.
The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing 210029, China
2.
Center of Health Policy Research, School of Health Policy and Management, Nanjing Medical University, Nanjing 210029, China
3.
Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing 210009, China
4.
National Center of AIDS/STD Control and Prevention, Chinese Center of Disease Control and Prevention, Beijing 102206, China

Funds:

The Mega-projects of National Science Research for The 12th Five Year Plan 2012ZX10001-001

More Information

Corresponding author: ZHU jing, E-mail: zhujingkmmc@126.com

摘要

摘要: 目的了解中越边境地区中国籍与越南籍暗娼人群(female sex workers, FSWs)的人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染现状，分析两组人群HIV感染相关因素以及性行为特征。方法 2015-2016年期间在云南省河口县开展横断面调查，方便抽样纳入中国籍与越南籍FSWs。问卷收集调查对象的社会人口学特征、HIV相关知识态度、性行为等信息；采集血液样本进行HIV、单纯疱疹病毒2型(herpes simplex virus type 2, HSV-2)以及梅毒感染检测；多因素Logistic回归分析模型筛选HIV感染相关因素。结果合计纳入1 263名FSWs，中国籍调查对象227人，HIV感染率为0.44%；越南籍调查对象1 036人，HIV感染率为2.12%。越南籍FSWs最近1月商业性性伴数量以及性服务费用均高于中国籍FSWs(均有P＜0.001)。经多因素Logistic回归分析模型分析，HSV-2感染(OR=3.83, 95% CI: 1.37~10.76; P=0.032)、HIV知识知晓不合格(OR=10.40, 95% CI: 3.77~28.66; P=0.001)，以及接受HIV相关干预服务(OR=0.27, 95% CI: 0.08~0.84; P=0.022)是越南籍FSWsHIV感染的相关因素。结论中国籍与越南籍FSWs感染HIV的风险模式可能存在差异，后续HIV干预工作应针对越南籍FSWs增加服务的覆盖与可及性；对于中国籍FSWs，建议加强与固定性伴安全套使用的行为干预。
- 边境 /
- 暗娼 /
- 人类免疫缺陷病毒 /
- 性行为
Abstract: Objective To assess the prevalence of human immunodeficiency virus (HIV) infection of Chinese and Vietnamese female sex workers (FSWs), and to examine the risk factors and patterns of sexual behaviors that associated with HIV between the two groups. Methods A cross-sectional survey was conducted between 2015 and 2016 in Hekou County, Yunnan Province, China. Convenience sampling method was used to recruit participates, and a questionnaire survey was conducted to collect information on demographics, sexual behavior, HIV related knowledge and attitude. Blood samples were collected for testing of HIV, herpes simplex virus type 2 (HSV-2) and syphilis. Multivariate Logistic regression model was used to examine factors correlated with HIV infection. Results Of 1 263 respondents who participated in the study, 227 were Chinese and 1 036 were Vietnamese. HIV prevalence in Chinese FSWs and Vietnamese FSWs were 0.44% and 2.12%, respectively. Vietnamese FSWs were more likely to have higher commercial sexual service charge and more commercial sexual partners compared with Chinese FSWs. HSV-2 positive (OR=3.83, 95% CI: 1.37-10.76, P=0.032), insufficient HIV related knowledge (OR=10.40, 95% CI: 3.77-28.66, P=0.001), and accepted HIV related interventions (OR=0.27, 95% CI: 0.08-0.84, P=0.022) were associated with HIV infection in the multivariate Logistic regression model. Conclusions There may be different risk patterns of HIV acquisition between Chinese and Vietnamese FSWs. Improving coverage and accessibility in future interventions of HIV prevention is in great need for Vietnamese FSWs. In addition, condom use with regular, no commercial sexual partners need to be strengthened targeting Chinese FSWs.
- Border region /
- Female sex workers /
- Human immunodeficiency virus /
- Sexual behavior

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表 1 中国籍与越南籍FSWs的社会人口学特征[n (%)]

Table 1. Social-demographic characteristics of Chinese and Vietnamese FSWs [n (%)]

变量	FSWs		合计	χ²/Z值	P值
变量	中国籍FSWs (n=227)	越南籍FSWs (n=1 036)	合计	χ²/Z值	P值
年龄(岁)^a	21(19, 27)	22(19, 27)	22(19, 27)	-0.117	0.907
民族				2.541	0.111
汉族/京族	112(49.34)	451(43.53)	563(44.58)
少数民族	115(50.66)	585(56.47)	700(55.42)
婚姻状况				31.118	< 0.001
未婚	163(71.81)	539(52.03)	702(55.58)
同居或在婚	42(18.50)	276(26.64)	318(25.18)
离异或丧偶	22(9.69)	221(21.33)	243(19.24)
文化程度				27.856	< 0.001
小学及以下	43(18.94)	275(26.54)	318(25.18)
初中	154(67.84)	506(48.84)	660(52.26)
高中及以上	30(13.22)	255(24.61)	285(22.57)
注：^a表示M(P₂₅, P₇₅)。

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表 2 中国籍与越南籍FSWs一般性行为特征[n (%)]

Table 2. Sexual behaviors of Chinese and Vietnamese FSWs [n (%)]

变量	FSW		χ²/Z值	P值
变量	中国籍FSWs (n=227)	越南籍FSWs (n=1 036)	χ²/Z值	P值
初次性行为年龄(岁)^a	17(16, 19)	18(16, 19)	-1.138	0.225^b
目前固定性伴			13.180	< 0.001
有	138(60.79)	492(47.49)
没有	89(39.21)	544(52.51)
最近1个月与固定性伴性行为			0.210	0.647
发生过	125(90.58)	439(89.23)
未发生	13(9.42)	53(10.77)
最近1个月与固定性伴安全套使用			23.144	< 0.001
坚持使用	22(17.60)	69(15.72)
部分时间	58(46.40)	113(25.74)
从不	45(36.00)	257(58.54)
与固定性伴未坚持使用安全套原因			3.468	0.177
对方不愿使用	49(47.57)	139(37.57)
相信对方	45(43.69)	188(50.81)
其他	9(8.74)	43(11.62)
注：^a表示M(P₂₅, P₇₅)；^b经非参数检验计算。

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表 3 中国籍与越南籍FSWs商业性性行为特征[n (%)]

Table 3. Commercial sexual behaviors of Chinese and Vietnamese FSWs [n (%)]

变量	FSWs		χ²/Z值	P值
变量	中国籍FSWs (n=227)	越南籍FSWs (n=1 036)	χ²/Z值	P值
初次商业性性行为年龄(岁)^a	20(18, 25)	20(17, 25)	-0.925	0.355
最近1次与客人使用安全套			0.013	0.908
用了	221(97.36)	1 021(98.55)
没用	6(2.64)	15(1.45)
平均每次性服务费用(元)^a	500(300, 800)	80(50, 100)	-24.151	< 0.001
最近1个月商业性伴数量^a	2(1, 4)	110(75, 150)	-23.437	< 0.001
最近1个月与商业性性伴安全套使用			1.212	0.546
从未使用	3(1.32)	15(1.45)
有时使用	16(7.05)	54(5.21)
每次使用	208(91.63)	967(93.34)
注：^a表示M(P₂₅, P₇₅)。

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表 4 中国籍与越南籍FSWs人群HIV/STIs及毒品检测结果[n (%)]

Table 4. HIV/STIs and drug using testing of Chinese and Vietnamese FSWs [n (%)]

变量	FSWs		χ²/Z值	P值
变量	中国籍FSWs (n=227)	越南籍FSWs (n=1 036)	χ²/Z值	P值
HIV检测			2.950	0.086
阴性	226(99.56)	1 014(97.88)
阳性	1(0.44)	22(2.12)
梅毒检测			1.316	0.251
阴性	226(99.56)	1 022(98.65)
阳性	1(0.44)	14(1.35)
HSV-2检测			1.916	0.166
阴性	140(61.67)	587(56.66)
阳性	87(38.33)	449(43.34)

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表 5 越南籍FSWsHIV感染多因素Logistic回归分析模型分析

Table 5. Logistic regression model analysis for factors correlated with HIV infection of Vietnamese FSWs

变量	例数	HIV感染		单因素分析OR值(95% CI)	P值	多因素分析OR值(95% CI)	P值
变量	例数	例数	阳性率(%)	单因素分析OR值(95% CI)	P值	多因素分析OR值(95% CI)	P值
HSV-2感染					0.078		0.032
阴性	587	9	1.53	1.00		1.00
阳性	449	13	2.90	1.92(0.81~4.52)		3.83(1.37~10.76)
文化程度					0.066
文盲	114	6	5.26	1.00
小学	161	8	4.97	0.94(0.32~2.79)	0.913
初中	506	8	1.58	0.29(0.10~0.85)	0.024
高中及以上^a	255	0	0	0.07(0.01~0.59)	< 0.001
HIV知识知晓					< 0.001		0.001
合格	907	11	1.21	1.00		1.00
不合格	129	11	8.53	7.59(3.22~17.90)		10.40(3.77~28.66)
曾在越南从业					0.112
没有	978	19	1.94	1.00
有过	58	3	5.17	2.75(0.79~9.59)
最近1次商业性性行为安全套使用					0.010
用了	1 021	20	1.96	1.00
没用	15	2	13.33	7.70(1.63~36.39)
HIV相关干预服务					0.010		0.022
没接受	103	6	5.83	1.00		1.00
接受过	933	16	1.71	0.28(0.11~0.74)		0.27(0.08~0.84)
吸毒史					0.091
无	1 007	20	1.99	1.00
有	29	2	6.90	3.66(0.81~16.43)
注：^a以0.5代替数字为0的单元格计算OR值。

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