Study On The Effects Of Alcohol Use On HIV Infection Among People Aged 50 Years And Older

BackgroundIn recent years, Prevalence of AIDS appears a downward trend, and the rnumber of new cases and dead doll were lower than that of 2011 through the joint efforts of the full participation of all countries in the world, but in developing countries,the situation of HIV infection continues to show an upward tendency. China is a low HIV prevalence country, but the absolute number of HIV/AIDS is big because of the large population in our country. The annual number of new HIV infections has declined since 2007, while the annual number and the proportion of new HIV infection people aged over 50 has increased.Compared with younger patients, HIV/AIDS aged over 50 has lower effective immune response to antivirus drug, and it is faster to develop into AIDS. In addition, the combination of HIV infection, antivirus thrapy and age increase the possibility of suffering other chronic desease in HIV/AIDS aged over 50, which speed up their death, therefore, it is important to prevent and control of HIV/AIDS to decrease the number of new patients aged over 50, and to curb the growth of the HIV infection and death in these people. The most important things is to know the pattern of HIV infection among HIV/AIDS aged over 50 and carry out target prevention program.Studies at home and abroad have confirmed that alcohol consumption was popular in people aged over 50, and alcohol consumption was a risk factor of high risk sexual behavior. Alcohol consumption can decrease the cognition that condom can prevent sexually transmitted disease,in the same time, it can influent the attitude of condom use and decrease the skill of the correct use of condoms.which increase the risk of unprotected sex. In compare with other people, studies carried on HIV aged over 50 in our country is latter, and more research has focused on the knovledge, attitudes and report on epidemic situation, there are fewer research on the effect of alcohol consumption on HIV infection patients aged over 50. for these reasons, this study is to analysis on the alcohol consumption and characteristics of sexual behavior of HIV/AIDS and health people over 50 years old people in Liuzhou city, and the effects of alcohol on HIV infection in people aged over 50 by conditional Logistic regression. bjectives 1.To analysis on the status and epidemiological characteristics of HIV infection of the over 50 years old HIV/AIDS in Liuzhou city. 2.To analysis the different of alcohol consumption status and high risk behaviors after drinking between HIV-infected and non-HIV-infected persons, 3.To explore the prevention strategies and measures to decrease the high risk sexual behaviors after drinking of the over 50 years old people. MethodsCase-control study was conducted among the over 50 years old HIV/AIDS who could be followed up in Liuzhou and Luzhai county from Jan 2010 to June 2012, each HIV case was matched by one non-HIV-infected person paired by age, gender and residence. Questionnaires were used to investigate demographic characteristics, alcohol consumption,high risk behavior, HIV detection, medical-care seeking behaviors and knowledge of HIV/AIDS et al. Qualitative survey was conducted through face to face in-depth interviews among several types of people such as case, control, staff of CDC AIDS prevention department, doctors and follow up staffs in antiviral therapy station, follow up staffs of community health service or health clinics in towns and townships and staffs of VCT clinics. SPSS13.0 was used to analyse the date of quantitative research. HIV/AIDS infection people were divided into two groups basis on infection HIV, which were analysed with univariate analysis and multivariate analysis. In qualitative analysis, recording was transcribed into text firstly, and then a summary method was used to analyze the qualitative data. Results 1. The characteristic of sexual behavior of HIV/AID528 HIV/AIDS aged over 50 were recruited in this study,84.8% of them were infected by sex contact, commercial sex behavior and non-business casual sexual partners were the main transmission, there were 67.5% and 11.1% respectively in male patients, while regular sexual partners or HIV positive spouse and commercial sex behavior were the main transmission in female patients, there were 65.6% and 19.6% respectively, in case group, 67.4% of them were found to be infected with HIV through seeing doctor because of other disease, and 57% of case group were develop into AIDS. In 367 patients who had spouse or regular sexual partners, 92.1% of them did not use condom before diagnosed AIDS, 68.6% of male patients had commercial sex behavior, and most of them had sex trade in inn and rental home and did not use condom, 55.5% of respondents never used condom because of dislike and unnecessary. 33 female HIV/AIDS of case group who had commercial sex behavior were all sex workers, most of them worked at roadside or low grade places in local city, the main reason of not using condom was unlikess. 13.3% of HIV/AIDS patients had happened non-business casual sexual behavior, 75.7% of them never used condom, and the main reason was sex partner seemed healthy.4.7% of case group had ever injected drug,64% of drug users had shared their needles, Men who have sex with men was not found in case group. 2. The risk factors of HIV infectionCompared with non drinkers, Mild drinking(OR=11.957,P=0.029)and more commercial sex trade(OR=6.535, P=0.045) were risk factors of HIV infection,and more higher scores of knowledge of HIV/AIDS(OR=0.391,P=0.027) were protective factors of HIV infection. 3. Alcohol status and its influence on sex behaviorThe percent of alcohol consumption(50.9%)in case group was higher than that’s in control group(38.4%)(χ2=19.801,P<0.001), 72.2% of people from case and control groups drunk liqueur and 52.8% of them drunk beer. The rate of at-risk drinking in case group(25.3%)was higher than control(18.5%), with spouse and regular sex partner were protective factor of at-risk drinking. The rate of commercial sex after at-risk drinking was higher(90.0%) than that of non at-risk drinking in case group(65.1%)(χ2=13.965,P<0.001), while the rate of commercial sex(88.2% VS. 28.4%,χ2=42.829,P<0.001)and non-business casual sexual behavior(25.3% VS. 7.7%, χ2=9.446,P=0.009) of at-risk drinking people were higher than non at-risk drinking in control group. And condom use among people who at-risk drinking was lower than that of non at-risk drinking in control group(Z=2.418,P=0.016). 4. Measurements for decreasing HIV infection among people aged 50 and over ①Propaganda and education on HIV should be strengthened and emphasis on elder people throught their favorite methods as peer education, doctors, broadcast, newspaper and billboard, let people aged 50 and over know the severity of AIDS epidemic in their area and how to prevent HIV infection and the use of condom, and enhance their ability to prevent AIDS. ② It need to strengthen the family ethics and legal education on people aged 50 and over, let them know sex outside marriage is offends against the family ethics and it is a legal behavior so as to reduce or eliminate the sex outside marriage.③Education on alcohol and health should be strengthened to let them know the relationship between alcohol consumption and health, the damage of at-sisk drinking in many ways, such as health talk and video. ④Strengthen the education of people aged over 50 with alcohol, carry out alcohol treatment for alcohol addicts, reduce the incidence of at-risk drinking and sexual behavior after drinking, meanwhile, the trainning of condom use should be strengthen to increase the rate of condom use in sex after drinking. ⑤To reduce and eliminate the feals on AIDS by education, let people know the detecting method and treatment of HIV/AIDS, encourage the people aged 50 and over come to HIV detecting in VCT spot voluntary, meanwhile, improve spouse/sexual-partners notification, to require the HIV/AIDS to notify their spouse/sexual-partners about their HIV-positive status within one month and decrease the rate of HIV transmission in families. ConclusionAlcohol consumption and at-risk drinking were popular in people aged over 50 in Liuzhou city, more work should be took to reduce the incidence of alcohol consumption, at-risk drinking, extramarital sex behavior after drink, and improve condom use in people aged over 50, the program of prevention and control and follow up of HIV/AIDS should be further carry out to decrease the new cases and improve the quality of life.