2005-2008年北京嫖客人群感染艾滋病的危险行为改变研究

目的了解2005-2008年嫖客艾滋病知识、行为特征及其艾滋病病毒（HIV）抗体阳性率、梅毒血清学试验（RPR）阳性率的变化趋势,为指导在嫖客人群中开展防治艾滋病行为干预提供依据。方法每年4-6月和10-12月,对新入收教所的嫖客进行普查,采用统一的男性监测调查表对调查对象进行流行病学调查。结果 2005-2008年共调查2888名嫖客,其文化程度有逐年增高趋势（χ2=146.907,P〈0.05）;其艾滋病传播途径的知晓率有逐年上升趋势（χ2=44.296,P〈0.05）,但AIDS非传播途径的知晓率低于传播途径的知晓率;最近一次与小姐发生性行为不使用安全套的比例有逐年上升的趋势（χ2=20.969,P〈0.05）;最近一个月与小姐发生性行为每次都使用安全套的比例呈现出逐年下降的趋势（χ2=60.455,P〈0.05）;最近一次与固定性伴发生性行为使用安全套的比例有逐年下降的趋势（χ2=59.795,P〈0.05）。结论嫖客中HIV处于低流行水平,但嫖客感染HIV的风险有逐年上升趋势,应加强对嫖客的监测和危险行为干预,提高其安全套使用率。

Study on behavioral changes among clients of commercial sex workers in Beijing from 2005 to 2008

Objective To understand changes of risk behaviors among clients of commercial sex workers （CSWs） from 2005 to 2008. Method Annual investigations from April to June and from October to December were conducted from 2005 to 2008. Results Educational backgrounds of CSWs clients increased significantly form 2005 to 2008（χ2=146.907,P0.05）,and their knowledge of HIV/AIDS improved significantly（χ2=44.296,P0.05.The proportion of not using condoms when having sex with CSWs at the last visit significantly increased year by year（χ^2=20.969,P0.05）,but the proportion of consistent using condoms in their sex with CSWs in the last month significantly decreased（χ^2=60.455,P0.05）,and the proportion of using condoms with regular sex partners in the last sex intercourse also decreased significantly（χ^2=59.795,P0.05）. Conclusion Although HIV infection among CSWs clients remains at a low level,the risk for infecting HIV tends to increase,and therefore active surveillance and interventions for risk behaviors among them should be strengthened,so as to improve condom use in the target population.