云南省德宏州新报告艾滋病病毒感染者溯源调查

目的 对新报告HIV感染者的高危接触者进行逐级追踪调查和HIV检测(溯源调查),评价其作为一种艾滋病检测和防控策略的有效性和可行性.方法 对云南省德宏州2008年8-10月新报告的HIV感染者335例及其高危接触者(接触者)进行溯源调查.结果将335例中的309例以及从接触者中发现的148例HIV感染者纳入本次溯源调查.累计报告接触者3395人,其中有联系信息的接触者704人(20.7%);704人中成功追踪调查361人(51.3%);其中67.6%(244/361)为HIV感染情况不详;有83.2%(203/244)接受HIV检测,新检出HIV阳性56例,阳性检出率为27.6%(56/203).HIV感染者的配偶有联系信息的比例和追踪调查率分别为68.8%(280/407)、68.2%(191/280);远高于商业性伴1.2%(24/1978)、16.7%(4/24),非商业非配偶性伴37.3%(202/542)、22.3%(45/202),以及共用针具者34.1%(140/410)、56.4%(79/140).结论 溯源调查新检出的HIV阳性率高;但是对商业性伴和非商业非配偶性伴的追踪调查存在难度;开展溯源调查有助于发现更多的HIV感染者、掌握和控制艾滋病疫情.

Tracing the sources of newly reported HIV infections in Dehong prefecture of Yunnan province

Objective To trace and provide HIV-testing among those having contacts with HIV-infected individuals at various levels in Dehong prefecture, Yunnan province and to evaluate the effectiveness and feasibility of such investigation as a supplemental strategy for HIV testing and control. Methods Newly reported HIV infections from August throughout October in Dehong prefecture, in 2008 were asked to provide contact information of persons whom they had high risk contacts with. Persons having had risk contacts with HIV-infected cases were hereof interviewed and their blood tested on the sero-status of HIV. Results A total of 335 HIV cases were newly reported during this three-month period. A total of 309 cases of them and 148 HIV infections identified thereafter from their risk contacts were under informed consent, to participate in this study. A total number of 3395 risk contacts were reported, of whom only 20.7% (704/3395) had 'contact information' and 51.3% (361/704) were successfully located and interviewed, including 117 previously confirmed HIV infections and 244 people with unknown HIV status. The majority of them (203 or 83.2% of 244) were then tested for HIV and 56(27.6% of 203) were tested positive for HIV. The proportion of having detailed contact information and the proportion of being traced or followed among reported risk contacts of HIV infections were 68.8% and 68.2% for spouses of HIV patients, respectively, which were much higher than those among commercial sex partners (1.2% and 16.7%), casual sex partners (37.3% and 22.3% ) and peers who sharing needles (34.1% and 56.4% ). Conclusion Newly reported HIV infections reported a large number of risk contacts and new HIV infections were identified among them. It was extremely difficult to trace commercial sex partners or casual sex partners on their HIV infection status. Nevertheless, tracing the risk contacts of newly reported HIV infections seemed to be helpful in identifying new HIV infections and in understanding the nature of transmission towards controlling the HIV epidemics.