2004-2015年重慶市經男男性行為感染HIV者空間自相關分析
本文選題:男男性行為 + 艾滋病; 參考:《中國疾病預防控制中心》2017年碩士論文
【摘要】:背景目的分析重慶市2004年1月至2015年12月經男男性行為感染HIV者空間聚集性特點,并通過訪談方式進行男男性行為者(MSM)相關行為調查,為重慶市艾滋病防治工作提供參考依據(jù)。方法收集中國疾病預防控制中心“艾滋病綜合防治信息管理系統(tǒng)”中2004-2015年報告的現(xiàn)住址為重慶市、自述傳播途徑為男性性行為傳播的HIV感染者和艾滋病患者(HIV/AIDS)的信息,包括病例錄入時的年齡、現(xiàn)住地址、職業(yè)、文化程度和婚姻狀況等方面。剔除地址不詳者后,共收集HIV/AIDS 6604例。采用ArcGIS 10.3進行全局空間自相關分析和局部空間自相關分析。此外,于2015年11月和2016年5月,采用方便抽樣法在重慶市疾病預防控制中心對23名MSM進行面對面訪談。納入標準:在重慶市城區(qū)進行自愿咨詢檢測并通過口頭知情同意愿意參加訪談者;男性并自述為MSM。訪談內容包括基本情況、性取向、性角色、主要交友活動場所、主要發(fā)生性行為場所、有無長期外出重慶市經歷和藥物濫用等。結果2004-2015年期間,僅2010年報告例數(shù)比2009年有所下降,其余年份整體呈增長趨勢;6604例經男男性行為感染HIV者的年齡主要集中在15-34歲,約占68.5%(4522例)。除2005年以外(Moran'sI指數(shù)為-0.046,P值為0.823),2004—2015年全局空間自相關呈正相關關系(Moran's I分別為0.308、0.254、0.335、0.683、0.673、0.558、0.620、0.673、0.685、0.654和0.649,P值分別為0.001、0.009、0.001、0.001、0.001、0.001、0.001、0.001、0.001、0.001 和0.001);局部Moran's I分析表明重慶市2004-2015年高-高型聚集區(qū)發(fā)展分為兩個時間階段,從2004-2007年僅有的渝中區(qū)、江北區(qū)、沙坪壩區(qū)等區(qū)域擴充到2008-2015年的九龍坡區(qū)、南岸區(qū)和渝北區(qū)。熱點分析表明從2008-2015年,高值區(qū)域主要集中在渝中區(qū)、江北區(qū)、沙坪壩區(qū)、九龍坡區(qū)、南岸區(qū)、北碚區(qū)、渝北區(qū)和巴南區(qū)。本研究共訪談23名MSM,年齡20-44歲。職業(yè)包括金融、服務、工人、機關文職、學生和無業(yè)。HIV檢測結果為陽性者有11名,HIV檢測結果為陰性者有12名。文化程度在大專及以上學歷有16名。研究對象集中在市區(qū)酒吧和浴池活動原因有:市區(qū)酒吧人員流動性大。市區(qū)內酒吧多,信息來源多且相互交流方便。市區(qū)內的浴池名氣大,吸引本地人與外來游客的來訪。市區(qū)內酒吧會開展各種活動,對年輕人有吸引力。結論重慶市經男男性行為感染HIV者,年齡段多在15-34歲,空間上呈現(xiàn)聚集性分布,以經濟發(fā)達的主城區(qū)為中心。重慶市中心地區(qū)因人員流動量大,酒吧、浴池場所多等原因吸引大量的MSM人群集中到市中心區(qū)域活動。MSM開始以網(wǎng)絡交友為主,并且不能堅持使用安全套,提示需注重網(wǎng)絡干預并探討更深入的干預措施。
[Abstract]:Objective to analyze the spatial clustering characteristics of MSM in men infected with HIV from January 2004 to December 2015, and to investigate the related behaviors of MSM in Chongqing from January 2004 to December 2015, so as to provide a reference for the prevention and treatment of AIDS in Chongqing. Methods the current address of the 2004-2015 report of the China Centers for Disease Control and Prevention Information system for the Integrated Prevention and Control of AIDS was collected in Chongqing. The self-reported route of transmission was HIV / AIDS / HIV / AIDS among men who had sex with men. This includes age, current address, occupation, education and marital status at the time of case entry. After removing the unknown address, 6604 cases of HIV/AIDS were collected. Global spatial autocorrelation analysis and local spatial autocorrelation analysis are carried out with ArcGIS 10.3. In addition, in November 2015 and May 2016, 23 MSM patients were interviewed in Chongqing Centers for Disease Control and Prevention by the convenient sampling method. Inclusion criteria: voluntary counseling and testing in Chongqing City and willing to participate in interviews through oral informed consent; male and self-described as MSM. The contents of the interview included basic situation, sexual orientation, sex role, main place of making friends, main place of sexual intercourse, whether there was long-term experience of going out and drug abuse in Chongqing, etc. Results in the period of 2004-2015, the number of cases reported in 2010 was lower than that in 2009. In other years, 6604 cases of HIV infected by male sex were mainly aged 15-34 years, accounting for 68.5% of 4522 cases. In addition to 2005, the MoransI index was -0.046 (P = 0.823) and the global spatial autocorrelation was positive correlation (P = 0.3080.2540.3350.683), respectively. The results of local Moran's I analysis showed that the development of high and high concentration areas in Chongqing in 2004-2015 was divided into two stages: 0.001 / 0. 009 / 0. 001 / 0. 001 / 0. 001 and 0. 001 / 0. 001, respectively, and 0. 649% (P = 0. 649) respectively, and the results of local Moran's I analysis showed that the development of high and high concentration areas in Chongqing was divided into two stages, which were: 0. 00 0. 00 0. 00 0. 001 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001, 0. 001 and 0. 001. From only Yuzhong District, Jiangbei District and Shapingba District in 2004-2007 to Jiulongpo District, Nanan District and Yubei District from 2008 to 2015. The hot spot analysis shows that from 2008 to 2015, the high value regions are mainly concentrated in Yuzhong District, Jiangbei District, Shapingba District, Jiulongpo District, Nanan District, Beibei District, Yubei District and Banan District. A total of 23 MSMs aged 20-44 years were interviewed in this study. Occupations include finance, services, workers, agency clerical, student and unemployed. There are 11 HIV positive people and 12 HIV negative people. Education level in college and above has 16. The reasons why the subjects were concentrated in urban bars and baths were: the mobility of bar staff in urban areas was high. There are many bars in the city, many sources of information and easy to communicate with each other. The baths in the city are so famous that they attract both local and foreign visitors. Bars in the city offer a variety of activities that appeal to young people. Conclusion most of the men infected with HIV in Chongqing are aged 15 to 34 years old, and their spatial distribution is concentrated, with the economic development of the main urban area as the center. The central area of Chongqing attracted a large number of MSM people to the downtown area activities. MSM started to make friends mainly on the Internet, and could not insist on using condoms, because of the large turnover of people, bars and baths, and so on. It is suggested that we should pay attention to network intervention and explore more in-depth intervention measures.
【學位授予單位】:中國疾病預防控制中心
【學位級別】:碩士
【學位授予年份】:2017
【分類號】:R512.91
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