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目的了解昭通市暗娼人群(FSW)梅毒感染及其影响因素,为制定防制策略提供依据。方法采用普查法抽取1 330名A类、B类和C类不同场所FSW进行问卷调查,抽取静脉血进行梅毒检测,采用SPSS19.0进行卡方检验、倾向分数的Logistic回归、单因素和多因素Logistic回归分析。结果 C类、B类和A类FSW分别为375例(28.20%),611例(45.94%)和344例(25.86%);FSW梅毒抗体阳性率3.68%(49/1 330),C类、B类和A类FSW的梅毒抗体阳性率分别是5.87%,3.27%和2.03%,采用倾向分数的Logistic回归分析显示,C类FSW梅毒抗体阳性率高于B类(OR=2.95,95%CI 1.23~6.99,P=0.01)和A类(OR=1.65,95%CI 0.69~3.94,P=0.26)。多因素Logistic回归分析显示,上一个工作地点为外省(OR=2.07,95%CI 1.12~3.81)、第一次与客人发生性行为年龄为40岁以上(OR=2.77,95%CI 1.12~6.81)以及最近一个月与客人发生性行为未坚持使用安全套(OR=3.89,95%CI1.97~7.67)均能增加FSW感染梅毒的风险。结论昭通市C类FSW梅毒抗体阳性率高于B类和A类FSW,应根据不同场所FSW提供针对性行为干预的同时,开展梅毒的普查普治工作,控制传染源,遏制梅毒在昭通市的流行。
Objective To understand the prevalence of syphilis infection among FSWs in Zhaotong City and its influencing factors, so as to provide evidence for the development of control strategies. Methods A total of 1 330 FSWs in category A, B and C were selected by census method, and venous blood samples were collected for syphilis testing. SPSS 19.0 was used for chi-square test, Logistic regression of propensity scores, single factor and multiple factors Logistic regression analysis. Results There were 375 cases (28.20%), 611 cases (45.94%) and 344 cases (25.86%) of FSW in category C, B and A. The positive rate of FSW syphilis was 3.68% (49/1 330) The positive rates of syphilis antibodies in class B and class A FSW were 5.87%, 3.27% and 2.03%, respectively. Logistic regression analysis using propensity score showed that the positive rate of class C FSW syphilis antibody was higher than that of class B (OR = 2.95,95% CI 1.23 to 6.99, P = 0.01) and A (OR = 1.65, 95% CI 0.69 to 3.94, P = 0.26). Multivariate Logistic regression analysis showed that the last working place was other provinces (OR = 2.07, 95% CI 1.12-3.81), the first sexual activity with guests was over 40 years old (OR = 2.77,95% CI 1.12-6.81 ) And the non-adherence to condom use (OR = 3.89, 95% CI, 197- 7.67) for sexual activity with guests in the most recent month increased the risk of syphilis infection in FSW. Conclusions The positive rate of C-type FSW syphilis antibodies in Zhaotong City is higher than that in Class B and Class A FSWs. At the same time, we should provide targeted behavior interventions according to FSW in different places. At the same time, we should carry out the general survey of syphilis, control the source of infection, and contain syphilis in Zhaotong popular.