Entz A T, Ruffolo V P, Chinveschakitvanich V, Soskolne V, van Griensven G J
College of Population Studies, Chulalongkorn University, Bangkok, Thailand.
AIDS. 2000 May 26;14(8):1027-34. doi: 10.1097/00002030-200005260-00015.
Mobile populations are thought to be at high risk for HIV-1 infection. This study aims to determine the prevalence of HIV-1 infection, HIV-1 subtypes and socio-demographic and behavioural risk factors among fishermen in the Gulf of Thailand and the Andaman Sea.
A cross-sectional survey, consisting of face-to-face interviews and the collection of oral fluid samples, was conducted in Samut Sakorn, Ranong, Songkhla and Traat Provinces, Thailand, between January and April 1998. Oral fluid samples were double-tested for HIV-1 antibody by IgG antibody capture enzyme-linked immunosorbent assay and enzyme immunoassay, and confirmed by Western blot. The presence of subtypes B' and E was assessed using a peptide enzyme immunoassay.
Of the 818 fishermen (582 Thai, 137 Burmese, 99 Khmer) 15.5% were HIV-1 positive: 14.6% among Thai, 16.1% among Burmese and 20.2% among Khmer. Of the 119 HIV-1 positive samples available for subtyping, 72 (61%) were subtype E, 15 (13%) were subtype B'; the subtype could not be determined for 32 (27%) samples. Sixteen per cent of subjects had ever visited a commercial sex worker outside Thailand. This behaviour was more prevalent among Khmer (40%) than among Thai and Burmese (12%). In univariate logistic regression analysis, being 25 to 32 years of age, compared with being older or younger; working as a fisherman between 4 and 10 years, compared with working for a shorter or longer period; being unmarried; being a steersman or mechanic, compared with being a skipper or ship hand; greater number of visits to commercial sex workers; having visited a commercial sex worker outside Thailand; alcohol or drug use before or during sex; being tattooed; and having a history of sexually transmitted disease were significantly related to prevalent HIV-1 infection. Male-to-male sex and injection drug use were rarely reported in this population. In multivariate analysis, being 25 to 32 years of age, being unmarried, having a tattoo and a greater number of visits to commercial sex workers remained in the model to predict HIV-1 prevalence. A history of drug injection was predictive for infection with HIV-1 subtype B'.
These findings indicate a high HIV-1 prevalence among fishermen in the Gulf of Thailand and the Andaman Sea. Risk factor analysis suggests that heterosexual intercourse is the major mode of transmission in this population. Increased efforts to reduce the spread of HIV-1 among this epidemiologically important group are urgently needed.
流动人群被认为是感染HIV-1的高危人群。本研究旨在确定泰国湾和安达曼海渔民中HIV-1感染率、HIV-1亚型以及社会人口学和行为危险因素。
1998年1月至4月间，在泰国的沙没沙空府、拉廊府、宋卡府和达叻府进行了一项横断面调查，包括面对面访谈和采集口腔液样本。通过IgG抗体捕获酶联免疫吸附试验和酶免疫测定法对口腔液样本进行HIV-1抗体双检测，并通过免疫印迹法进行确认。使用肽酶免疫测定法评估B'和E亚型的存在情况。
在818名渔民（582名泰国人、137名缅甸人、99名高棉人）中，15.5%的人HIV-1呈阳性：泰国人中有14.6%，缅甸人中有16.1%，高棉人中有20.2%。在119份可用于亚型分析的HIV-1阳性样本中，72份（61%）为E亚型，15份（13%）为B'亚型；32份（2�%）样本无法确定亚型。16%的受试者曾在泰国境外光顾过商业性工作者。这种行为在高棉人（40%）中比在泰国人和缅甸人（12%）中更为普遍。在单因素逻辑回归分析中，年龄在25至32岁之间，与年龄较大或较小相比；从事渔民工作4至10年，与工作时间较短或较长相比；未婚；担任舵手或机械师，与担任船长或船员相比；光顾商业性工作者的次数较多；在泰国境外光顾过商业性工作者；在性行为前或性行为期间饮酒或吸毒；纹身；以及有性传播疾病史与现患HIV-1感染显著相关。该人群中很少报告男男性行为和注射吸毒情况。在多因素分析中，年龄在25至32岁之间、未婚、有纹身以及光顾商业性工作者的次数较多仍保留在预测HIV-1感染率的模型中。有药物注射史可预测感染HIV-1 B'亚型。
这些发现表明泰国湾和安达曼海渔民中HIV-1感染率很高。危险因素分析表明，异性性行为是该人群中的主要传播方式。迫切需要加大力度减少HIV-1在这一具有重要流行病学意义的群体中的传播。
