National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
Int J Environ Res Public Health. 2023 Feb 3;20(3):2714. doi: 10.3390/ijerph20032714.
The proportion of elderly people living with HIV (PLHIV) is increasing in China. To advance targeted interventions and substantially improve their quality of life, we investigate indicators of loneliness and sexual behavior among elderly PLHIV in 10 districts/counties in China during the COVID-19 pandemic.
The demographic information and laboratory test results of the potential respondents were initially collected from the China Information System for Disease Control and Prevention. A two-stage stratified cluster sampling was used. The questionnaire survey was individually provided to all PLHIV aged +60.
We recruited 1017 valid respondents with a median age of 66 years (interquartile range of 63-71), of which 776 (76.3%) were male. Overall, 341 respondents (33.5%) lived alone, and 304 (29.9%) felt lonely. A total of 726 respondents (71.4%) informed others of their HIV diagnosis. Among the 726 respondents, children were the most common group with whom the older people shared their HIV infection status, accounting for 82.9%. Approximately 20% of the older PLHIV engaged in sexual behavior in the last year, and 70% reported not using condoms. A significantly greater risk of loneliness was found among the females (AOR = 1.542, CI: 1.084, 2.193), those who suffered discrimination from informed people (AOR = 4.719, CI: 2.986, 7.459), were diagnosed <1 year prior (AOR = 2.061, CI: 1.345, 3.156), those living alone (AOR = 2.314, CI: 1.632, 3.280), those having no friends (AOR = 1.779, CI: 1.327, 2.386), and those who had a divorced or widowed marital status (AOR = 1.686, CI: 1.174, 2.421).
Compared with non-lonely participants, the lonely participants were more likely to have a rural registered residence, a lower education level, no friends, be divorced or widowed, live alone, and lack knowledge of smartphones and reproductive health. The influence of COVID-19 had caused social activities to be more confined to the community, which impacts elderly HIV patients suffering from severe discrimination within families and communities.
中国的老年 HIV 感染者（PLHIV）人数不断增加。为了推进有针对性的干预措施，大幅提高他们的生活质量，我们调查了 COVID-19 大流行期间中国 10 个区/县的老年 PLHIV 的孤独感和性行为指标。
从中国疾病预防控制信息系统初步收集潜在受访者的人口统计学信息和实验室检测结果。采用两阶段分层聚类抽样。对所有年龄在+60 岁以上的 PLHIV 单独进行问卷调查。
我们共招募了 1017 名有效应答者，中位年龄为 66 岁（四分位距为 63-71），其中 776 名（76.3%）为男性。总体而言，341 名（33.5%）应答者独居，304 名（29.9%）感到孤独。共有 726 名（71.4%）应答者告知他人其 HIV 诊断。在 726 名应答者中，与子女分享 HIV 感染状况的比例最高，占 82.9%。大约 20%的老年 PLHIV 在过去一年中发生性行为，70%的人报告没有使用安全套。与非孤独者相比，女性（OR = 1.542，95%CI：1.084，2.193）、遭受知情者歧视的人（OR = 4.719，95%CI：2.986，7.459）、诊断时间<1 年的人（OR = 2.061，95%CI：1.345，3.156）、独居的人（OR = 2.314，95%CI：1.632，3.280）、没有朋友的人（OR = 1.779，95%CI：1.327，2.386）以及离异或丧偶的人（OR = 1.686，95%CI：1.174，2.421）更易感到孤独。
与非孤独者相比，孤独者更有可能来自农村户籍、受教育程度较低、没有朋友、离异或丧偶、独居且缺乏智能手机和生殖健康知识。COVID-19 的影响使得社会活动更加局限于社区，这对遭受家庭和社区严重歧视的老年 HIV 患者产生了影响。
