廖建英，陈坚，梁旭，谭兰芬

【摘要】目的了解百色市暗娼（female sex workers，FSWs）人群的艾滋病新發感染情况，并探索该人群中影响艾滋病新发感染的因素，为百色市暗娼的艾滋病防控工作提供科学依据。方法从2016年起对百色市暗娼人群开展持续3年的队列研究，每年随访一次获取其行为学的情况，并进行血清学检测，分析包括入组后有过≥1次随访的基线HIV血清检测为阴性的暗娼，计算该人群HIV的新发感染密度，并建立HIV新发感染影响因素的logistic回归模型。结果纳入队列研究人群共703人，随访保持率为35.8%。队列人群以中年已婚、文化程度低的壮族女性为主，多数是在中低档服务场所，广泛接受过艾滋病干预服务。累计队列人群HIV的观察总人年数为1238.72人年，估计新发感染密度为1.13/100人年（95%CI：0.62～1.79/100人年）。最近一个月安全套的使用频率与暗娼人群的HIV感染有关，非每次使用者感染HIV的风险是每次使用者的17.172倍（95%CI：3.055～96.526）。结论百色市暗娼人群的HIV新发感染率高于一般社区人群，要继续加强暗娼防控工作，构建形成全方位立体化的安全套使用推广体系，以阻断暗娼这个桥梁人群向一般人群传播HIV的危险。

【关键词】暗娼;HIV;队列研究;新发感染;影响因素

中图分类号：R512.91文献标志码：ADOI：10.3969/j.issn.1003-1383.2021.11.002

Study on  new HIV infection status and influencing

factors among female sex workers in Baise

LIAO Jianying1， CHEN Jian2， LIANG Xu1， TAN Lanfen2

（1.School of Public Health and Management， Youjiang Medical University for Nationalities， Baise 533000， Guangxi， China;

2. Department of AIDS， Baise Center for Disease Control and Prevention， Baise 533000， Guangxi， China）

【Abstract】ObjectiveTo investigate the new HIV infection situation among female sex workers （FSWs） in Baise and explore the factors affecting the new HIV infection among the population， so as to provide scientific evidence for the prevention and control of AIDS in Baise. MethodsA three-year cohort study was carried out on female sex workers in Baise City from 2016. They were followed up once a year to obtain the statement of their behaviors， and serological tests were carried out. The female sex workers with negative baseline HIV serum test who had been followed up for ≥ 1 time after enrollment were analyzed， the incidence density of new HIV infection in this population was calculated， and the logistic regression model of influencing factors of new HIV infection was established. ResultsA total of 703 people were included in the cohort study， and the follow-up retention rate was 35.8%. The cohort was mainly middle-aged， married and poorly educated Zhuang women， most of whom were in medium and low-grade service places， and had widely accepted AIDS intervention services. The total observed person years of HIV in the cumulative cohort population was 1238.72 person years， and the estimated incidence density of new infections was 1.13/100 person years （95%CI： 0.62-1.79/100 person years）. The frequency of condom use in the last month was related to HIV infection among female sex workers， and the risk of HIV infection among non users was 17.172 times higher than that of each user （95%CI： 3.055-96.526）. ConclusionThe new HIV infection rate of FSWs in Baise city is higher than that of general community population. The prevention and control of FSWs should be continued to strengthen to build a comprehensive and three-dimensional condom use promotion system， so as to block the risk of HIV transmission from FSWs to general population.

【Key words】FSWs; HIV; cohort study; new infection;  influencing factors

暗娼人群（female sex workers，FSWs）由于性伴数量多，自我保护意识弱，容易在频繁的性服务工作中感染HIV病毒及其他性病，并且作为桥梁人群将HIV传染到嫖娼人群及其他一般人群，因此对暗娼人群的监测和管理对于HIV的防控工作来说具有非常重要的意义。性服务工作者由于流动性大，人群不够稳定，对于该人群的队列研究不多，但前瞻性队列研究是获得HIV新发感染率的重要方法[1]，对掌握艾滋病疫情十分重要。……