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1、广东省艾滋病流行概况及预防控制策略General HIV/AIDS Epidemic Situation and Prevention Strategy in Guangdong 广东省艾滋病防治研究所Guangdong Center for Disease Control 王晔Wang YeNovember 20, 2007主要内容Major contents流行概况 Epidemic situationHIV流行率监测 HIV epidemic monitoring吸毒者人群行为学监测Behavior monitoring on drug users问题与挑战 Problems and c

2、hallenges当前我省应采取的预防控制策略 Prevention and control strategies should be taken in our province at present流行概况Epidemic Situation1986年:发现首例境外HIV感染者;In 1986: the first HIV infected case was found on a non-Guangdong person1990年:首次从出境归来的本省HIV感染者;In 1990: the first HIV infected case was found on a Guangdong pe

3、rson returning from abroad1996年:首次从本省静脉吸毒者中检出HIV感染者:In 1996: the first HIV infected case was tested from a Guangdong injected drug user19861996年:感染例数虽逐年有所上升,但仍呈较平稳的状态,年平均上升仅为10.2%,此后报告感染例数迅速增加:1986-1996: infected cases are rising but still stable with an average rate of 10.2%, after this report the

4、cases increase rapidly2005年:由于开展大筛查而达到高峰,年报告数为5223例:In 2005: with the investigation reaching the summit, the cases are 5223 reported for this year. 2006年维持平稳,当年报告5180例。In 2006: the situation is stable and the reported cases are 5180.流行概况Epidemic Situation2006年底:At the end of 2006:累计报告HIV感染者18207例,Ac

5、cumulated reported HIV infected cases are 18207AIDS病人1641例,死亡677例。AIDS patients are 1641 cases and 677 dead.报告数居全国第五位。The reported cases ranks No. 5 throughout the nation.据专家估计,我省到2007年底估计存活的HIV感染者约4.9万。Experts estimate that the living HIV infected persons are about 49,000 by end of 2008 in Guangdon

6、g.广东省累计报告HIV感染者地区分布(2006.12)Distribution of Accumulated HIV/AIDS Cases in Guangdong (Dec. 2006)性别分布Gender distribution男性:15203例,占83.5;Male女性: 3004例,占16.5。 Female广东省19862006年HIV感染者性别分布Distribution of Accumulated HIV/AIDS Cases in Guangdong (1986- 2006)年龄分布Age distribution年龄不详: 4797例,占26.3Unknown年龄清楚:

7、13410例,占63.7Known传播途径分布Spread channels distribution传播途径不详:7030例,占38.6Unknown传播途径清楚:11177例;占61.4 Known目前我省HIV/AIDS流行特点Current HIV/AIDS Epidemic characteristics in Guangdong全省21个市均出现HIV流行,珠江三角洲地区仍是流行最严重的地区,但HIV传播正从珠江三角洲向两翼漫延,疫情呈全省低流行,局部高流行态势;All 21 cities have epidemics. Pan-pearl Delta is still the m

8、ost serious area with a tendency spreading to both wings. The epidemic appears as low throughout the province and high in some cities.吸毒人群仍是HIV感染的最主要人群,但经性途径感染者逐年增加,女性感染者和母婴传播明显增多。HIV正从高危人群向一般人群扩散;Drug users are still the major group infected with HIV. There is an increasing tendency by means of sex

9、ual transmission. The infections of female and mother-to-child transmission has an obvious increase.只有个别通过既往卖血、输血或血液制品感染,近几年无明显变化;Only several cases infected with blood selling and transfusion and blood products and there is no obvious change in recent years.男男同性恋者中的HIV感染情况有待进一步查明。The infection situ

10、ation among MSM is pending for further investigation. HIV流行率监测 HIV Epidemic Monitoring1992年开始建立监测哨点,到2007年全省在21个市共设立:Monitoring stations have been established since 1992. Up to 2007, in 21 cities there are: I类哨点64个;Stations of Category III类哨点194个;Stations of Category II针对性病门诊就诊者、暗娼和青年学生的综合哨点5个。5 Com

11、prehensive stations for sexual diseases, prostitutes and young students.性病门诊就诊者监测Monitoring on incoming patients at the sexual disease clinics HIV感染率从1997年的0.03升至2006年的0.20;HIV infected rate increased from 0.03% in 1997 to 0.20% in 2006阳性哨点比例从1998年的10(1/10)升至2006年的56(9/16)。 HIV positive stations inc

12、reased from 10% in 1998 (1/10) to 56% in 2006 (9/16)2006年最高为0.79。 The highest is 0.79% in 2006暗娼监测Monitoring on prostitution1998年首次检出HIV感染者(0.14),但一直维持在较低的感染率;The first cases were tested in 1998 (0.14%) but keeping a low rate.2006年检出率为0.53。 The tested rate for 2006 is 0.53%.孕产妇监测Monitoring on pregna

13、nt women孕产妇的两个点除2002年检出一例HIV感染者外,其他时间还未检出。 At the two stations for pregnant women, only one case was found in 2002 and there is no report afterwards. 高危人群行为学监测吸毒行为 Monitoring on behavior of high risk population drug use高危人群行为学监测安全套使用Monitoring on behavior of high risk population usage of condoms社区中的

14、干预Interventions in community针具交换Injection needles exchange问题与挑战Problems and challenges 基层政府部门对艾滋病防治工作认识不足 Insufficient awareness on HIV/AIDS prevention of government departments at grassroots level对艾滋病防治工作的严重性、紧迫性和严峻性认识不足,没有充分认识到艾滋病流行对经济发展、社会稳定造成的危害;Insufficient awareness on the seriousness, urgency

15、 and rigorousness of HIV/AIDS prevention work; insufficient awareness of the dangers of HIV/AIDS epidemic to the economy development and social stability没有认识到艾滋病防治是一项复杂的社会系统工程,仍片面认为艾滋病防治工作是卫生部门的事情,未能真正形成多部门积极主动参与艾滋病防治的局面。 Insufficient awareness on the problem that HIV/AIDS prevention and treatment i

16、s a complicated social systematic project; still consider it as a matter of health departments; active involvement of multi-departments has not yet been established.问题与挑战Problems and challenges 宣传教育不够深入 Insufficient publicity and education新闻传媒宣传的频率和覆盖面还不够,尤其是省和一些市级的电视台,未能履行免费播放预防艾滋病性病的公益广告;Insuffici

17、ent frequency and coverage of media, especially on TV programs at provincial and city level; no free welfare advertisement on HIV/AIDS prevention一些系统和单位没有把艾滋病防治宣传工作作为自身的职责,没有开展相应的活动; Some departments dont regard the work of HIV/AIDS prevention as their responsibilities and havent carried out relevan

18、t activities. 禁毒和艾滋病的公益广告很少在电视台播出Seldom see any welfare advertisement on drug prevention and HIV/AIDS prevention on TV programscooperationInterventionPAFIII ProgramSurveillanceCooperation问题与挑战Problems and challenges 干预措施覆盖面不足,质量有待提高 Insufficient coverage of interventions and the quality of intervent

19、ions to be improved因此安全套推广、针具交换等具体干预工作进展缓慢,覆盖面不足。Slow progress of interventions about condoms promotion and injected needles exchange如2007年全省安全套推广材覆盖19个地市59个县区的3009个场所,发放安全套60多万只;In 2007, the coverage of condoms promotion is only 19 prefecture cities and 59 county level cities and 3009 closed settin

20、gs and the distribution of condoms is just over 600,000.针具交换才覆盖5个地市131个点,发放针具15万多只;The coverage of injected needles exchange is only 5 prefecture cities, 131 stations and the distribution of injected needles is just over 150,000.美沙酮替代治疗门诊虽然已开诊33个,但维持治疗的人数不足4000人,只占社区吸毒者很少的比例。Although 33 methadone su

21、bstitute treatment clinics are open, the treated number is less 4000, accounting for a very tiny proportion among drug users in community.问题与挑战Problems and challenges 防治力量薄弱Weak capacity in prevention and treatment省、市、县(区)三级艾办至今没有专职人员;Up to now there is still no professional staff in Disease Control

22、 Center (CDC) at the levels of province, city and county(district).21个地级市疾病预防控制中心只有7个设立艾滋病防治科室,121个县(区)除深圳市的2个区和佛山的三水市外,目前都没有艾滋病防治的专们科室;Among 21 CDCs at the level of prefectural city, there are only 7 CDCs with HIV/AIDS Prevention and Treatment Office. Among 121 counties (districts), except for 2 di

23、stricts and Sanshui City of Foshan, there is no special office for HIV/AIDS Prevention and Treatment up to now.省疾控中心艾滋病防治研究所也只有12人正式职工;Even in the Research Institute of CDC at the provincial level, there are only 12 regular staff. 而云南、新疆、河南、广西、贵州等省卫生行政部门都已成立了有专职人员的艾防机构(其中云南15人),云南、广西、河南、新疆、四川、山东等省级疾

24、控中心的艾滋病防治科人员均在30人以上(云南50人、广西、新疆、四川、山东在35人以上)While the Health Departments of Yunnan, Xinjiang, Henan, Guangxi, Guizhou have established special organs on HIV/AIDS prevention (Yunnan has 15 staff); the HIV/AIDS Prevention Offices of the CDCs at the provincial level in Yunnan, Guangxi, Henan, Xinjiang,

25、 Sichuan and Shandong all have above 30 staff (50 staff in Yunnan and above 35 staff in Guangxi, Xinjiang, Sichuan and Shandong).问题与挑战Problems and challenges 流行因素广泛存在Epidemic factors widely exist吸毒行为屡禁不绝,人数高居不下,新型毒品不断出现,范围不断扩大;Drug use is difficult to stop; the number of drug users keeps high; new t

26、ypes of drugs come out continuously;共用注射器吸毒的比例居高不下;The proportion of injected drug uses sharing needles keeps high;卖淫嫖娼活动屡禁不止;虽然调查表明暗娼安全套使用率较高,但性病发病率居高不下;Prostitution is difficult to stop; although investigation shows that the usage frequency of condoms keeps high, the incidence of sexual diseases s

27、till keeps high;改革开放后人们的性观念发生了变化,非婚性行为和一夜情等多性伴的现象不断增多。After reforming and opening up, most people have a change in their attitudes towards sex, sexual behaviors with non-spouses and one-night stands increase.当前我省应采取的预防控制策略 Prevention and Control Strategies should be taken in our Province加大政府投入 Increase governmental inputs加强多部门的合作,建立健全防治工作责任制 Strengthen cooperation among var

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