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Article(id=1241067198639296921, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202411550, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1732809600000, receivedDateStr=2024-11-29, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773823078068, onlineDateStr=2026-03-18, pubDate=1741536000000, pubDateStr=2025-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773823078068, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773823078068, creator=13701087609, updateTime=1773823078068, updator=13701087609, issue=Issue{id=1241067197318091153, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773823077754, creator=13701087609, updateTime=1773823268053, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241067995544482681, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241067995544482682, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241067197318091153, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=769, endPage=773, ext={EN=ArticleExt(id=1241067198953869727, articleId=1241067198639296921, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the epidemiological characteristics of HIV cases among farmers in Guizhou Province, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the epidemiological characteristics of HIV-infected cases among farmers in Guizhou Province and provide a scientific basis for formulating AIDS prevention and control strategies.

Methods

The data of AIDS cases reported among farmers in Guizhou Province from 2010 to 2022 were selected from the Chinese AIDS Comprehensive Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemic characteristics, and a linear regression model was constructed with the year as the independent variable and the number of cases as the dependent variable to analyze the changing trend.

Results

From 2010 to 2022, 47 811 HIV/AIDS cases were reported among farmers in Guizhou Province, accounting for 60.40% of the total number of cases. The number of reported cases showed an upward trend (AAPC=23.10%). The male-to-female ratio of the cases was 2:1. The majority of the cases were over 50 years old (56.55%),and the number of cases in each age group showed an overall upward trend. The main mode of transmission was heterosexual transmission (97.74%), and non-commercial heterosexual intercourse was the main mode for both males (49.01%) and females (61.50%). The samples were mainly sourced from medical institution tests (76.56%), and the proportion of late detection was 74.97%.

Conclusion

From 2010 to 2022, the number of reported HIV/AIDS cases among farmers in Guizhou Province showed an upward trend. The cases were mainly elderly, with a high proportion of late detection, relatively low educational levels, and heterosexual contact was the main mode of transmission, mainly non-commercial heterosexual intercourse. Attention should be paid to the HIV epidemic among farmers, and AIDS prevention and control strategies targeting farmers need to be explored according to the characteristics of this population.

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目的

分析贵州省农民HIV感染者病例的流行病学特征，为制定艾滋病防控策略提供科学依据。

方法

从中国艾滋病综合防治信息系统中选取2010—2022年贵州省报告的农民艾滋病病例数据，采用描述流行病学方法分析其流行特征，以年度为自变量、病例数为因变量构建线性回归模型分析其变化趋势。

结果

2010—2022年贵州省报告农民HIV/AIDS病例47 811例，占总病例数的60.40%，报告病例数呈上升趋势（AAPC=23.10%）。病例的男女比为2∶1；年龄以50岁以上为主，占56.55%，各年龄组病例变化整体均呈上升趋势。传播途径以异性传播为主，占97.74%，其中男性（49.01%）和女性（61.50%）均以非商业异性性行为主；样本来源主要以医疗机构检测为主（76.56%）；晚发现比例达74.97%。

结论

2010—2022年贵州省农民HIV/AIDS报告病例数呈上升趋势，以老年病例为主，晚发现病例比例高，文化程度偏低，异性性接触为主要传播途径，以非商业异性性行为为主。农民HIV/AIDS疫情应引起重视，需结合该人群的特点，探索针对农民的艾滋病防治策略。

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郑敏，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=NZ29spjwf2FN20d+D93Q8A==, magXml=pE2rUFtSfENFIFJzLbhZVA==, pdfUrl=null, pdf=O5SOVOoKV9Q21gdMRT+DEA==, pdfFileSize=743950, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=AA8DMq/RENjPnLxVgxzq6Q==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=TsOBJlz5wttcmKFSd4oJTA==, mapNumber=null, authorCompany=null, fund=null, authors=

陈秀林（1998—），女，硕士在读，研究方向：艾滋病性病防治

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陈秀林（1998—），女，硕士在读，研究方向：艾滋病性病防治

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HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study[J].AIDS Research and Therapy, 2019, 16(1): 6., articleTitle=HIV late presentation and advanced HIV disease among patients with newly diagnosed HIV/AIDS in Southwestern China: a large-scale cross-sectional study, refAbstract=null), Reference(id=1241067222358085898, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, doi=null, pmid=null, pmcid=null, year=2022, volume=49, issue=12, pageStart=2143, pageEnd=2148, url=null, language=null, rfNumber=[15], rfOrder=26, authorNames=施雅莹, 余继熙, 刘芳, journalName=现代预防医学, refType=null, unstructuredReference=施雅莹，余继熙，刘芳，等.成都市2010-2019年新报告HIV/AIDS病例晚发现的影响因素及晚发现病例的生存情况分析[J].现代预防医学，2022，49（12）：2143-2148., articleTitle=成都市2010-2019年新报告HIV/AIDS病例晚发现的影响因素及晚发现病例的生存情况分析, refAbstract=null), Reference(id=1241067222454554896, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, doi=null, pmid=null, pmcid=null, year=2022, volume=49, issue=12, pageStart=2143, pageEnd=2148, url=null, language=null, rfNumber=[15], rfOrder=27, authorNames=Shi YY, Yu JX, Liu F, journalName=Modern Preventive Medicine, refType=null, unstructuredReference=Shi YY, Yu JX, Liu F, et al. Analysis of factors influencing late detection of newly reported HIV/AIDS cases and survival of late detected cases in Chengdu from 2010 to 2019[J]. Modern Preventive Medicine, 2022, 49(12):2143-2148.(In Chinese), articleTitle=Analysis of factors influencing late detection of newly reported HIV/AIDS cases and survival of late detected cases in Chengdu from 2010 to 2019, refAbstract=null), Reference(id=1241067222525858068, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, doi=null, pmid=null, pmcid=null, year=2022, volume=9, issue=3, pageStart=null, pageEnd=null, url=null, language=null, rfNumber=[16], rfOrder=28, authorNames=The Lancet HIV, journalName=Lancet HIV, refType=null, unstructuredReference=The Lancet HIV. Time to tackle late diagnosis[J]. Lancet HIV,2022, 9(3): e139., articleTitle=Time to tackle late diagnosis, refAbstract=null)], funds=[Fund(id=1241067215710113802, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, awardId=2022YFC2304901, language=CN, fundingSource=国家重点研发计划(2022YFC2304901), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241067203450163676, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, xref=1., ext=[AuthorCompanyExt(id=1241067203454357981, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, companyId=1241067203450163676, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health and Wellness, The Key Laboratory of Environmental Pollution and Disease Surveillance, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China), AuthorCompanyExt(id=1241067203462746590, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, companyId=1241067203450163676, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.贵州医科大学公共卫生与健康学院，环境污染与疾病监控教育部重点实验室，贵州 贵阳 561113)]), AuthorCompany(id=1241067203542438372, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, xref=2., ext=[AuthorCompanyExt(id=1241067203575992805, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, companyId=1241067203542438372, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.贵州省疾病预防控制中心，贵州 贵阳 550004)])], figs=[ArticleFig(id=1241067208609157934, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Figure 1, caption=Trends in the number and proportion of HIV / AIDS cases among farmers in Guizhou Province from 2010 to 2022, figureFileSmall=XTr+N/HYhwAxl9G/zcl+ew==, figureFileBig=AA8DMq/RENjPnLxVgxzq6Q==, tableContent=null), ArticleFig(id=1241067208684655419, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=图1, caption=2010—2022年贵州省农民HIV/AIDS病例数及比例变化趋势, figureFileSmall=XTr+N/HYhwAxl9G/zcl+ew==, figureFileBig=AA8DMq/RENjPnLxVgxzq6Q==, tableContent=null), ArticleFig(id=1241067208940507982, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Figure 2, caption=Trends in reported HIV/AIDS cases among farmers of different genders, figureFileSmall=YxQkecfFCbm/RFMZYDom7Q==, figureFileBig=oP04Xy/PZES/dF7YgCQ99A==, tableContent=null), ArticleFig(id=1241067209024394076, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=图2, caption=不同性别的农民HIV/AIDS报告病例变化趋势

注：APC为年平均变化百分比；*为P<0.05。

, figureFileSmall=YxQkecfFCbm/RFMZYDom7Q==, figureFileBig=oP04Xy/PZES/dF7YgCQ99A==, tableContent=null), ArticleFig(id=1241067209133445994, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Figure 3, caption=Trends in reported HIV/AIDS cases among farmers of different age groups, figureFileSmall=O8droj00lx+OVDQofzPz0g==, figureFileBig=ztkzWSXUg1p3O+qOf+BpRg==, tableContent=null), ArticleFig(id=1241067210664366971, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=图3, caption=不同年龄组的农民HIV/AIDS报告病例变化趋势

注：APC为年平均变化百分比；*为P<0.05。

, figureFileSmall=O8droj00lx+OVDQofzPz0g==, figureFileBig=ztkzWSXUg1p3O+qOf+BpRg==, tableContent=null), ArticleFig(id=1241067210815361926, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Table 1, caption=

Results of Joinpoint regression analysis of reported HIV / AIDS cases among farmers in Guizhou Province from 2010 to 2022

, figureFileSmall=null, figureFileBig=null, tableContent=
变量AAPC(95%CI，%)P值时间段（年）APC(95%CI，%)P值
合计23.10(21.36～24.88)<0.0012010—201355.02(45.47～70.46)<0.001
2013—201829.52(22.87～33.65)<0.001
2018—2022-3.03(-7.6～1.82)0.117
性别
男24.69(22.85～26.85)<0.0012010—201360.70(50.34～78.69)<0.001
2013—201831.29(24.52～35.70)<0.001
2018—2022-3.36(-8.20～2.34)0.098
女20.25(18.35～22.27)<0.0012010—201346.65（37.61～65.36）<0.001
2013—201826.13（18.00～30.38）0.002
2018—2022-2.39（-8.50～2.75）0.227
年龄组（岁）
18～293.63(2.69～4.67)<0.0012010—201322.96(17.62～32.39)<0.001
2013—201811.21(6.18～13.54)0.013
2018—2022-16.54(-19.184～-16.54)<0.001
30～3911.33(9.59～13.33)<0.0012010—201243.38(29.05～61.13)<0.001
2012—201818.57(12.97～21.17)0.004
2018—2022-10.76(-15.38～5.43)<0.001
40～4921.70(20.01～23.46)<0.0012010—201451.61(44.02～47.90)<0.001
2014—201824.18(11.85～34.53)<0.001
2018—2022-4.28(-12.58～0.71)0.086
≥5036.96(34.72～39.42)<0.0012010—2013104.41(84.57～122.39)<0.001
2013—201838.63(32.16～45.07)<0.001
2018—2022-0.1(-5.76～6.46)0.946
), ArticleFig(id=1241067210987328407, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=表1, caption=

2010—2022年贵州省报告农民HIV/AIDS病例joinpoint回归分析结果

, figureFileSmall=null, figureFileBig=null, tableContent=
变量AAPC(95%CI，%)P值时间段（年）APC(95%CI，%)P值
合计23.10(21.36～24.88)<0.0012010—201355.02(45.47～70.46)<0.001
2013—201829.52(22.87～33.65)<0.001
2018—2022-3.03(-7.6～1.82)0.117
性别
男24.69(22.85～26.85)<0.0012010—201360.70(50.34～78.69)<0.001
2013—201831.29(24.52～35.70)<0.001
2018—2022-3.36(-8.20～2.34)0.098
女20.25(18.35～22.27)<0.0012010—201346.65（37.61～65.36）<0.001
2013—201826.13（18.00～30.38）0.002
2018—2022-2.39（-8.50～2.75）0.227
年龄组（岁）
18～293.63(2.69～4.67)<0.0012010—201322.96(17.62～32.39)<0.001
2013—201811.21(6.18～13.54)0.013
2018—2022-16.54(-19.184～-16.54)<0.001
30～3911.33(9.59～13.33)<0.0012010—201243.38(29.05～61.13)<0.001
2012—201818.57(12.97～21.17)0.004
2018—2022-10.76(-15.38～5.43)<0.001
40～4921.70(20.01～23.46)<0.0012010—201451.61(44.02～47.90)<0.001
2014—201824.18(11.85～34.53)<0.001
2018—2022-4.28(-12.58～0.71)0.086
≥5036.96(34.72～39.42)<0.0012010—2013104.41(84.57～122.39)<0.001
2013—201838.63(32.16～45.07)<0.001
2018—2022-0.1(-5.76～6.46)0.946
), ArticleFig(id=1241067211113157542, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Table 2, caption=

Characteristics of HIV / AIDS cases among farmers of different genders in Guizhou Province from 2010 to 2022 ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征报告病例数
(n=47 811)		性别χ2值P值
男(n=31 932)女(n=15 879)
年龄（岁）75.480<0.001
18～293 566（7.46）2 153（6.74）1 413（8.90）
30～396 571（13.74）4 471（14.00）2 100（13.23）
40～4910 637（22.25）7 085（22.19）3 552（22.37）
≥5027 037（56.55）18 223（57.07）8 814（55.51）
婚姻状况1 853.767<0.001
离异或丧偶22 300（46.64）15 016（47.02）7 284（45.87）
已婚20 197（42.24）12 082（37.84）8 115（51.11）
未婚5 235（10.95）4 774（14.95）461（2.90）
不详79（0.10）60（0.19）19（0.12）
民族33.783<0.001
汉族32 025（66.98）21 454（67.19）10 571（66.57）
布依族4 673（9.77）3 044（9.53）1 629（10.26）
苗族4 009（8.39）2 672（8.37）1 337（8.42）
侗族2 546（5.33）1 806（5.66）740（4.66）
其他4 558（9.53）2 956（9.26）1 602（10.09）
文化程度888.407<0.001
小学及以下32 914（68.84）20 608（64.54）12 306（77.50）
初中12 821（26.82）9 605（30.08）3 216（20.25）
高中或中专1 541（3.22）1 250（3.91）291（1.83）
大专及以上535（1.12）469（1.47）66（0.42）
传播途径275.457<0.001
异性传播46 747（97.77）30 998（97.08）15 749（99.18）
同性传播476（1.00）476（1.49）0
其他或不详588（1.23）458（1.43）130（0.82）
样本来源421.482<0.001
医疗机构a36 606（76.56）24 959（78.16）11 647（73.35）
重点人群b8 401（17.57）4 898（15.34）3 503（22.06）
羁押人员635（1.33）543（1.70）92（0.58）
献血人群450（0.94）330（1.03）120（0.76）
其他1 719（3.60）1 202（3.76）517（3.26）
), ArticleFig(id=1241067211373204408, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=表2, caption=

2010—2022年贵州省不同性别农民HIV/AIDS病例特征［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
基本特征报告病例数
(n=47 811)		性别χ2值P值
男(n=31 932)女(n=15 879)
年龄（岁）75.480<0.001
18～293 566（7.46）2 153（6.74）1 413（8.90）
30～396 571（13.74）4 471（14.00）2 100（13.23）
40～4910 637（22.25）7 085（22.19）3 552（22.37）
≥5027 037（56.55）18 223（57.07）8 814（55.51）
婚姻状况1 853.767<0.001
离异或丧偶22 300（46.64）15 016（47.02）7 284（45.87）
已婚20 197（42.24）12 082（37.84）8 115（51.11）
未婚5 235（10.95）4 774（14.95）461（2.90）
不详79（0.10）60（0.19）19（0.12）
民族33.783<0.001
汉族32 025（66.98）21 454（67.19）10 571（66.57）
布依族4 673（9.77）3 044（9.53）1 629（10.26）
苗族4 009（8.39）2 672（8.37）1 337（8.42）
侗族2 546（5.33）1 806（5.66）740（4.66）
其他4 558（9.53）2 956（9.26）1 602（10.09）
文化程度888.407<0.001
小学及以下32 914（68.84）20 608（64.54）12 306（77.50）
初中12 821（26.82）9 605（30.08）3 216（20.25）
高中或中专1 541（3.22）1 250（3.91）291（1.83）
大专及以上535（1.12）469（1.47）66（0.42）
传播途径275.457<0.001
异性传播46 747（97.77）30 998（97.08）15 749（99.18）
同性传播476（1.00）476（1.49）0
其他或不详588（1.23）458（1.43）130（0.82）
样本来源421.482<0.001
医疗机构a36 606（76.56）24 959（78.16）11 647（73.35）
重点人群b8 401（17.57）4 898（15.34）3 503（22.06）
羁押人员635（1.33）543（1.70）92（0.58）
献血人群450（0.94）330（1.03）120（0.76）
其他1 719（3.60）1 202（3.76）517（3.26）
), ArticleFig(id=1241067211532587974, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Table 3, caption=

The distribution of heterosexual transmission modes of HIV / AIDS cases among farmers of different genders and age groups in Guizhou Province from 2010 to 2022 ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
异性传播感染方式合计(n=47 676)年龄组（岁）
18～29(n=3 276)30～39(n=6 234)40～49(n=10 388)≥50(n=26 849)
男性
商业性行为8 320(26.84)345(18.31)870(20.91)1 681(24.46)5 424(30.00)
固定性伴性行为1 962(6.33)136(7.22)299(7.19)457(6.65)1 070(5.92)
非商业性行为15 192(49.01)1 000(53.08)2 091(50.25)3 536(51.45)8 565(47.37)
其他55 23(17.82)403(21.39)901(21.65)1 199(17.45)3 021(16.71)
女性
商业性行为740(4.70)62(4.45)99(4.78)207(5.89)372(4.24)
固定性伴2 684(17.04)203(14.58)360(17.37)543(15.45)1 578(18.00)
非商业性行为9 684(61.49)696(50.00)1 186(57.21)2 180(62.02)5 623(64.12)
其他2 641(16.77)431(30.96)428(20.65)585(16.64)1 196(13.64)
), ArticleFig(id=1241067211662611414, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=表3, caption=

2010—2022年贵州省不同性别各年龄组农民HIV/AIDS病例异性传播方式分布［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
异性传播感染方式合计(n=47 676)年龄组（岁）
18～29(n=3 276)30～39(n=6 234)40～49(n=10 388)≥50(n=26 849)
男性
商业性行为8 320(26.84)345(18.31)870(20.91)1 681(24.46)5 424(30.00)
固定性伴性行为1 962(6.33)136(7.22)299(7.19)457(6.65)1 070(5.92)
非商业性行为15 192(49.01)1 000(53.08)2 091(50.25)3 536(51.45)8 565(47.37)
其他55 23(17.82)403(21.39)901(21.65)1 199(17.45)3 021(16.71)
女性
商业性行为740(4.70)62(4.45)99(4.78)207(5.89)372(4.24)
固定性伴2 684(17.04)203(14.58)360(17.37)543(15.45)1 578(18.00)
非商业性行为9 684(61.49)696(50.00)1 186(57.21)2 180(62.02)5 623(64.12)
其他2 641(16.77)431(30.96)428(20.65)585(16.64)1 196(13.64)
), ArticleFig(id=1241067211863938012, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=EN, label=Table 4, caption=

Late detection of HIV/AIDS cases in farmers［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量报告病例数（n=47 811）晚发现病例数（n=35 846）χ2值P值
性别284.332<0.001
男31 932（66.79）24 693（77.33）
女15 879（33.21）11 153（70.24）
年龄组（岁）829.784<0.001
18～293 566（7.46）2 096(58.78)
30～396 571（13.74）4 540(69.09)
40～4910 637（22.25）7 912(74.38)
≥5027 037（56.55）21 298(78.77)
检测来源189.246<0.001
被动检测发现38 552（80.63）29 419（76.31）
主动检测发现9 259（19.10）6 427（69.41）
), ArticleFig(id=1241067215525565433, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241067198639296921, language=CN, label=表4, caption=

农民HIV/AIDS病例晚发现病例情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量报告病例数（n=47 811）晚发现病例数（n=35 846）χ2值P值
性别284.332<0.001
男31 932（66.79）24 693（77.33）
女15 879（33.21）11 153（70.24）
年龄组（岁）829.784<0.001
18～293 566（7.46）2 096(58.78)
30～396 571（13.74）4 540(69.09)
40～4910 637（22.25）7 912(74.38)
≥5027 037（56.55）21 298(78.77)
检测来源189.246<0.001
被动检测发现38 552（80.63）29 419（76.31）
主动检测发现9 259（19.10）6 427（69.41）
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贵州省农民HIV/AIDS病例的流行病学特征分析
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陈秀林 1 , 袁智 2 , 姚永明 2 , 陶锐 2 , 马琳 2 , 王大朋 1 , 郑敏 1, 2
现代预防医学 | 流行病与统计方法 2025,52(5): 769-773
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现代预防医学 | 流行病与统计方法 2025, 52(5): 769-773
贵州省农民HIV/AIDS病例的流行病学特征分析
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陈秀林1, 袁智2, 姚永明2, 陶锐2, 马琳2, 王大朋1, 郑敏1, 2
作者信息
  • 1.贵州医科大学公共卫生与健康学院，环境污染与疾病监控教育部重点实验室，贵州 贵阳 561113
  • 2.贵州省疾病预防控制中心，贵州 贵阳 550004

    • 陈秀林（1998—），女，硕士在读，研究方向：艾滋病性病防治

通讯作者:

郑敏，E-mail:
Analysis of the epidemiological characteristics of HIV cases among farmers in Guizhou Province
Xiu-lin CHEN1, Zhi YUAN2, Yong-ming YAO2, Rui TAO2, Lin MA2, Da-peng WANG1, Min ZHENG1, 2
Affiliations
  • School of Public Health and Wellness, The Key Laboratory of Environmental Pollution and Disease Surveillance, Ministry of Education, Guizhou Medical University, Guiyang, Guizhou 561113, China
出版时间: 2025-03-10 doi: 10.20043/j.cnki.MPM.202411550
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摘要
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目的

分析贵州省农民HIV感染者病例的流行病学特征，为制定艾滋病防控策略提供科学依据。

方法

从中国艾滋病综合防治信息系统中选取2010—2022年贵州省报告的农民艾滋病病例数据，采用描述流行病学方法分析其流行特征，以年度为自变量、病例数为因变量构建线性回归模型分析其变化趋势。

结果

2010—2022年贵州省报告农民HIV/AIDS病例47 811例，占总病例数的60.40%，报告病例数呈上升趋势（AAPC=23.10%）。病例的男女比为2∶1；年龄以50岁以上为主，占56.55%，各年龄组病例变化整体均呈上升趋势。传播途径以异性传播为主，占97.74%，其中男性（49.01%）和女性（61.50%）均以非商业异性性行为主；样本来源主要以医疗机构检测为主（76.56%）；晚发现比例达74.97%。

结论

2010—2022年贵州省农民HIV/AIDS报告病例数呈上升趋势，以老年病例为主，晚发现病例比例高，文化程度偏低，异性性接触为主要传播途径，以非商业异性性行为为主。农民HIV/AIDS疫情应引起重视，需结合该人群的特点，探索针对农民的艾滋病防治策略。

HIV感染者  /  农民  /  Joinpoint趋势分析  /  流行特征
Objective

To analyze the epidemiological characteristics of HIV-infected cases among farmers in Guizhou Province and provide a scientific basis for formulating AIDS prevention and control strategies.

Methods

The data of AIDS cases reported among farmers in Guizhou Province from 2010 to 2022 were selected from the Chinese AIDS Comprehensive Prevention and Control Information System. Descriptive epidemiological methods were used to analyze the epidemic characteristics, and a linear regression model was constructed with the year as the independent variable and the number of cases as the dependent variable to analyze the changing trend.

Results

From 2010 to 2022, 47 811 HIV/AIDS cases were reported among farmers in Guizhou Province, accounting for 60.40% of the total number of cases. The number of reported cases showed an upward trend (AAPC=23.10%). The male-to-female ratio of the cases was 2:1. The majority of the cases were over 50 years old (56.55%),and the number of cases in each age group showed an overall upward trend. The main mode of transmission was heterosexual transmission (97.74%), and non-commercial heterosexual intercourse was the main mode for both males (49.01%) and females (61.50%). The samples were mainly sourced from medical institution tests (76.56%), and the proportion of late detection was 74.97%.

Conclusion

From 2010 to 2022, the number of reported HIV/AIDS cases among farmers in Guizhou Province showed an upward trend. The cases were mainly elderly, with a high proportion of late detection, relatively low educational levels, and heterosexual contact was the main mode of transmission, mainly non-commercial heterosexual intercourse. Attention should be paid to the HIV epidemic among farmers, and AIDS prevention and control strategies targeting farmers need to be explored according to the characteristics of this population.

HIV-infected individuals  /  Farmers  /  Join point trend analysis  /  Epidemic characteristics
陈秀林, 袁智, 姚永明, 陶锐, 马琳, 王大朋, 郑敏. 贵州省农民HIV/AIDS病例的流行病学特征分析. 现代预防医学, 2025 , 52 (5) : 769 -773 . DOI: 10.20043/j.cnki.MPM.202411550
Xiu-lin CHEN, Zhi YUAN, Yong-ming YAO, Rui TAO, Lin MA, Da-peng WANG, Min ZHENG. Analysis of the epidemiological characteristics of HIV cases among farmers in Guizhou Province[J]. Modern Preventive Medicine, 2025 , 52 (5) : 769 -773 . DOI: 10.20043/j.cnki.MPM.202411550
正文
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我国报告的HIV感染人群数据显示，农民的比例已超过60%[1-2]。在西南地区的贵州省、广西省和云南省新报告的病例中，农民占比呈逐年上升趋势[3-5]。这一群体通常文化程度较低，对艾滋病的感染风险认知不足，缺乏防护意识，因此成为HIV感染的脆弱人群[6]。本研究对2010—2022年间贵州省农民HIV感染者的流行特征进行分析，为艾滋病防控措施的制定提供依据。
1　资料与方法
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1.1　资料来源
本研究所用数据来自中国艾滋病综合防治信息系统，下载了报告日期为2010年1月1日—2022年12月31日的HIV/AIDS病例数据。纳入标准：（1）现住址为贵州省；（2）人群分类为农民；（3）确诊时年龄≥18岁。
1.2　方法
描述农民HIV感染者的年龄、性别、民族、婚姻状况、文化程度、晚发现、感染途径、病例来源等。根据我国《晚发现艾滋病病毒感染临床管理专家共识》的定义[7]，晚发现界定为HIV感染后，首次检测的CD4+T淋巴细胞计数<350个/μl或出现艾滋病定义性事件。
1.3　统计学分析
采用Excel 2021数据整理，SPSS 24.0进行统计分析。计数资料以例数和百分比描述，使用χ2检验，检验水准α=0.05。采用Joinpoint regression progra（JRP）5.2.0软件分析农民报告病例的趋势变化，计算平均年度变化百分比（average annual percent change，AAPC）和年度变化百分比（annual percent change，APC）及95%CI，AAPC和APC的正负值反映报告病例数平均每年上升或下降的百分比，AAPC或APC≠0且P<0.05，表示有上升或下降趋势；AAPC或APC=0且P≥0.05，表示趋势稳定。针对男性和女性整体趋势比较，采用成对比较（pairwise comparison）中的平行性检验（test of parallelism）。
2　结果
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2.1　时间分布
在2010—2022年间，贵州省累积报告农民HIV/AIDS病例47 811例，占总病例数的60.40%。2010年报告456例，此后逐年增加至2021年达到最高点，为6 322例，2022年稍有下降，为5 363例。农民病例所占当年总报告数比例从2010年的26.36%增长到2022年的67.36%，见图1。AAPC为23.10%（95%CI：21.36%～24.88%），P<0.001。在2010—2013年间，APC为55.02%（95%CI：45.47%～70.46%），呈快速上升趋势（P<0.001）。2013—2018年间，APC为29.52%（95%CI：22.87%～33.65%），显示上升趋势减缓（P<0.001）；而在2018—2022年间，APC为-3.03%（95%CI：-7.6%～1.82%），虽然呈下降趋势，但差异无统计学意义（P=0.116）。见表1。
2.2　人群特征
累积报告的47 811例农民病例中，男性占66.79%，女性占33.21%，男女比例为2∶1。病例年龄主要集中在50岁以上，占56.55%，其次是40～49岁年龄组，占22.25%。18～39岁年龄组的病例在2010年占59.87%，随后逐年下降，2022年仅占13.07%，而50岁以上年龄组从2010年的18.64%上升到2022年的65.71%。离异丧偶和已婚占主要比例，分别为46.64%和42.24%。男性以离异丧偶为主，占47.02%，女性则以已婚有配偶为主，占51.11%。病例中汉族最多，占66.98%，其次是布依族，占9.77%。文化程度方面以小学及以下为主，占68.84%。见表2。
男性和女性HIV/AIDS病例数均呈先上升后稳定的趋势，男性上升速率大于女性（AAPC：24.69% vs.20.25%），见图2。50岁以上HIV/AIDS病例的上升速率最快，AAPC为36.96%（95%CI：34.72%～39.42，P<0.001）；40～49岁年龄组在2014年前呈快速上升趋势，2014—2018年间上升趋势减缓，2018—2022年间趋于稳定，AAPC为21.70%（95%CI：20.01%～23.46%，P<0.001）；18～29岁和30～39岁年龄组呈先上升后下降的趋势，AAPC分别为3.63%（95%CI：2.69%～4.67%）和11.33%（95%CI：9.59%～13.33%，P<0.001）。见表1、图3。
2.3　感染途径
农民HIV感染者的主要传播途径为异性传播，占97.77%（46 747/47 811），同性传播仅占1.00%（476/47 811）。异性传播中，男性占66.31%（30 998/46 747），主要以非商业性行为和商业性行为为主，分别占49.01%（15 192/30 998）和26.84%（8 320/30 988），随着年龄增长，男性的商业性行为比例也有所增加，50岁以上的占比达65.19%（5 424/8 320）；女性占33.69%（15 749/46 747），经固定性伴性行为感染的女性病例以50岁以上为主，占58.79.%（1 578/2 684）。见表3。
2.4　样本来源及晚发现情况
样本来源以医疗机构检测为主，占76.56%（36 606/47 811），且占比逐年增加，从2010年的26.36%上升至2022年的67.36%。其次是重点人群检测，占17.57%（8 401/47 811），占比逐年下降，从2010年的27.41%下降至2022年的12.23%。
感染者中晚发现病例占74.97%（35 846 /47 811），男性晚发现比例为77.33%，高于女性的70.24%，差异有统计学意义（χ2=284.332，P<0.001）。不同年龄晚发现比例差异有统计学意义（χ2=829.784，P<0.001）。相较于医疗机构术前检测、健康体检、羁押人员和献血人员被动检测发现的农民HIV/AIDS病例（晚发现比例为76.31%），通过主动咨询检测、性病门诊筛查和性伴推动检测等手段检测发现的农民病例晚发现比例（69.41%）相对较低，差异有统计学意义（χ2=189.246，P<0.001）。见表4。
3　讨论
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本研究分析了2010—2022年间贵州省农民HIV感染者的流行病学特征，结果显示这一人群的报告数量从2010年的456例激增至2021年的6 322例。农民占全部感染者的比例也从2010年的26.36%上升至2022年的67.36%。这一特征与广西省（68.4%）[2]、四川省（60.0%）[8]和赣州市（66. 5%）[9]地区的结论一致，反映了农村地区HIV疫情的持续加重，此现象可能与多个因素相关[6]，包括农村经济结构的变化、外出务工人员的增多以及农村性传播网络的扩展，另外，还可能与贵州省依托基本公共卫生服务开展艾滋病筛查等一系列措施有关。
性传播是农民HIV感染的主要传播途径，基本为异性传播（97.8%），但其中非商业性行为传播比例高于商业性行为，这与其他研究中男性以商业性行为为主的结论不一致[1,9]。非商业性行为人群更加的隐蔽，难以实施宣教干预措施，进一步加大了防控难度。研究还发现男性发生商业性行为的比例明显高于女性，且随着年龄增长比例有所增加，其他学者研究也证实了50～70岁的男性中有75%仍有性生活[10]，而这种性需求往往被家庭和社会忽视，容易发生老年男性的不安全性行为。还有研究表明，老年嫖客中农民占比高[11]，由于经济条件、风险感知等原因，安全套的使用率较低[12]，增加了该人群感染艾滋病的风险。
本研究结果发现，贵州省农民HIV感染者的晚发现比例高达74.97%，高于江苏省（55.1%）[13]和广西省（70.2%）[14]，其中男性的晚发现比例高于女性，老年人晚发现高于青年人，与四川省研究结论一致[15]，这表明在老年男性群体中，HIV感染的诊断和治疗延误问题更为严重。女性在婚检和孕期会接受全面的身体检查，包括HIV检测，若在检查中感染了HIV能够及早被发现，从而避免病程发展到晚期阶段，而大多数男性一般只有在出现临床症状时才会意识到去检测。然而，对晚发现感染者而言不仅导致更差的健康预后和高病死率，而由于长期未达到病毒学抑制，晚发现感染者还具有较高的社区传播风险[16]，因此，针对这类高风险人群的早期筛查和干预显得尤为重要。
本研究还发现，样本来源中医疗机构检测逐年增加，表明卫生资源的分配和宣传的有效性。然而，重点人群检测的比例逐年下降，提示对高危人群的检测力度不足。通过主动咨询检测和性病门诊筛查等措施的实施，可以降低晚发现比例，提高HIV感染者的早期诊断和治疗率，主动筛查的力度应该进一步加强。
综上，贵州省农民HIV/AIDS病例数呈上升趋势，以老年病例为主，晚发现病例比例高，文化程度偏低，以异性非商业性行为主要传播途径为主。建议加强对农民群体的HIV/AIDS宣传教育，提高其对HIV/AIDS的认知水平和风险意识。同时，应加大对农村地区医疗资源的投入，增强检测服务的可及性和便利性，以促进HIV/AIDS的早期发现和治疗。
基金
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  • 国家重点研发计划(2022YFC2304901)
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2025年第52卷第5期
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doi: 10.20043/j.cnki.MPM.202411550
  • 接收时间：2024-11-29
  • 首发时间：2026-03-18
  • 出版时间：2025-03-10
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  • 收稿日期：2024-11-29
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国家重点研发计划(2022YFC2304901)
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    1.贵州医科大学公共卫生与健康学院，环境污染与疾病监控教育部重点实验室，贵州 贵阳 561113
    2.贵州省疾病预防控制中心，贵州 贵阳 550004

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2种不同金属材料的力学参数
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species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
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species		 占总种数比例
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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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