Epidemic Status Of HIV/AIDS And Analysis Of Sentinel Surveillance Data In Kashi, Xinjiang Uygur Autonomous Region

Objectives:To know the epidemic status of HIV/AIDS in Kashi and to know HIV infection status and high risk behavior characteristics,and to explore the influence factors of HIV infection among six kind of sentinel surveillance populations(DUS & FSW & MSM & PRG & STD & YST).Methods:Collected epidemic data of 5833 HIV/AIDS in Kashi from 1997 to 2015 and collected social demography,knowledge awareness about HIV/AIDS,risk behavior characteristics among six kind of sentinel surveillance populations by monitoring questionnaire,and tested HIV,Syphilis,HCV infection status.Analyzed the HIV epidemic and time trends of risk behavior characteristics,knowledge awareness and HIV infection rates by linear by linear test and examined factors of HIV infection by chi-square test among those surveillance populations.Results Epidemic Status of HIV/AIDS Among a total of 5833 HIV/AIDS was reported in Kashi from 1997 to 2015,991 cases were died while 4842 were reported alive.There were two obviously increasing trends in both the number of HIV/AIDS reported and cases died.Heterosexual transmission was the main way of HIV prevalence(71.9%)and still keep an increasing proportion(P<0.001)in Kashi,Xinjiang province.Analysis on Sentinel Surveillance Data 1.Fundamental state A total of 22540 participants was recruited from 2009 to 2015,including 6366(28.2%)DUS,5725(25.4%)FSW,831(3.7%)MSM,2406(10.7%)PRG,2393(10.6%)PRG and 4819(21.4%)YST.2.Awareness rate of HIV knowledge In six kind of sentinel surveillance populations,FSW had the highest awareness rate of HIV knowledge(92.1%),versus the lowest awareness rate in PRG(79.8%).Awareness rate of HIV knowledge were increasing with the monitor time in all six kind of sentinel surveillance populations(All of P<0.001).3.HIV infection DUS had the highest HIV infection rate(5.5%)while the infection rate were not more than 0.7% in other five kind of populations.However,there was a decreasing trend of HIV infection rate in DUS(P<0.001).4.High risk behavior characteristics 24.5 percent DUS had ever shared needle with others,2.8 percent insisted using condom every time when they had sex with their spouse or cohabitant in the last year while 25.0 percent could insist when they had sex with commercial partner in the last year.From 2009 to 2015,there is a decreasing trend in DUS of sharing needle with others(P<0.001),and when DUS had sex with both spouse/cohabitant and commercial partner in the last year,the condom use percentage were increased(Both P<0.001).DUS who had shared needle with others,who did use condom when they had sex with spouse/cohabitant in the last year,who did not use condom while commercial sex in the last year had a higher HIV infection rate than who had not shared needle with others,who did not use condom when they had sex with spouse/cohabitant,who did use condom while commercial sex(All of P<0.05).The multivariable Logistic regression analysis showed that participants on marriage(OR=0.66,95%CI: 0.46~0.95),received peer education in the last year(OR=0.51,95%CI: 0.40~0.64)were protecting factors for DUS stopping away from HIV;Lower knowledge about AIDS(OR=1.50,95%CI: 1.13~2.00),using heroin(OR=1.67,95%CI: 1.14~2.45),needle sharing(OR=5.87,95%CI: 4.51~7.64),syphilis infection(OR=1.69,95%CI: 1.22~2.32)and HCV infection(OR=3.50,95%CI: 2.64~4.62)were risk factors for DUS infecting HIV.53.6 percent of FSW could insist using condom every time when they had sex with whoremaster in the last month,0.4 percent of FSW had a drug using behavior.From 2010 to 2015,there was a increasing trend in FSW of condom using when they had sex with whoremaster in the last month(P<0.001).12.9 percent of MSM could insist using condom every time when they had sex with men in the last 6 months while 37.4% percent could insist using condom every time when they had commercial sex with men in the last 6 months.From 2011 to 2015,the percentage of condom use when MSM had sex with both men and money boy in the last 6 months had a increasing trend with the monitor time(Both P<0.05).0.1 percent of PRG had a drug using behavior while 0.2 percent for whose husband was a drug user,0.7 percent of PRG had extramarital sex.The percentages of STD who had sex with FSW and who had sex with causal partner in the last 3 months were 50.7% and 40.6% respectively.From 2010 to 2015,the percentage of STD who had sex with FSW in the last 3 months was increased,versus to the decreasing trend of the percentage who had sex with causal partner in the last 3 months(Both P<0.001).46.7 percent of YST had not used condom while their first sexual behavior,the condom insisting use percentages of YST who had sex with spouse/heterosexual cohabitant and who had sex with causal partner and who had commercial sex in the last 1 year were 11.0%,19.8% and 14.3% respectively.From 2010 to 2015,the percentage of condom use for the first sex in YST was increasing with the monitor time(P=0.002).Conclusions:HIV epidemic is still serious in Kashi and heterosexual become the most primary transmission route.HIV infection rates are decreased among monitoring high risk populations in recent years,but the percentage of HIV risk behavior is still high and influence factors of HIV infection are numerous and complicated.Therefore,formulating pertinent strategies,strengthening intervention,reducing the incidence of risk behavior are essential to decrease HIV transmission among high risk population.