Zhang Yi, Geng Mengjie, Xing Yi, Ren Xiang, Chen Li, Liu Jieyu, Song Xinli, Qin Yang, Wang RuoLin, Jiang Jianuo, Guo Tongjun, Yuan Wen, Ma Yinghua, Ma Jun, Wang Liping, Song Yi, Dong Yanhui
Institute of Child and Adolescent Health, School of Public Health, Peking University, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
UNESCO Chair on Global Health and Education of Peking University, Beijing, China.
J Med Virol. 2024 Jul;96(7):e29808. doi: 10.1002/jmv.29808.
To investigate the progress of disparities in human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS), gonorrhea, and syphilis among children and adolescents aged 6-22 years in China during 2013-2021. A total of 614 325 cases data were extracted from the Chinese Information System for Infectious Diseases Control and Prevention during 2013-2021. Puberty health education data were drew from the Student Health Surveillance in 2021. Disparity patterns and average annual percentage changes (AAPCs) in sexually transmitted infections (STIs) incidence or new cases in China were examined using descriptive statistics and joinpoint regression. The incidence across 345 cities was stratified by gross domestic product (GDP). Between 2013 and 2021, there were 614 325 reported cases of HIV/AIDS, gonorrhea, and syphilis among children and adolescents aged 6-22, with an annual average incidence of 24.0967 per 100 000. The expansion of HIV/AIDS has halted, yet the surge in gonorrhea and syphilis remains notably pronounced. The ratio of male to female AIDS incidence increased from 2.75 (2.60, 2.90) to 7.13 (6.68, 7.62), but that of syphilis changed from 0.33 (0.32, 0.34) to 0.56 (0.55, 0.57). Students and out-of-school individuals aged 13-15 experienced a notably high increase in STI cases, surpassing other age groups, with an average annual percentage increase of 29.2% and 26.3%, respectively. Nonstudents consistently had a higher incidence rate than students, with an IRR reaching 31.80 (31.24, 32.37) in 2021. A noticeable clustering pattern of new cases emerged in the southeastern region of the Heihe-Tengchong line, extending inland from the coastal areas. Districts and counties with lower rates of puberty sexual health education tended to have higher average STI incidence rates. At the prefecture and city levels, there was a noticeable upward trend on average STI incidence rates in cities with per capita GDPs. Strategies to address those disparities include promoting equitable health education, and widespread sexual health education, particularly in areas with limited access to education and experiencing rapid economic development. The effectiveness of sexual health education intervention needs to be further evaluated in well-designed studies.
调查2013 - 2021年中国6至22岁儿童和青少年中人类免疫缺陷病毒/获得性免疫缺陷综合征（HIV/AIDS）、淋病和梅毒的差异变化情况。从中国传染病防控信息系统中提取了2013 - 2021年共614325例病例数据。青春期健康教育数据取自2021年的学生健康监测。采用描述性统计和Joinpoint回归分析中国性传播感染（STIs）发病率或新发病例的差异模式及年均变化百分比（AAPCs）。按国内生产总值（GDP）对345个城市的发病率进行分层。2013年至2021年，6至22岁儿童和青少年中报告的HIV/AIDS、淋病和梅毒病例有614325例，年均发病率为每10万人口24.096例。HIV/AIDS的增长已停止，但淋病和梅毒的激增仍十分显著。男性与女性艾滋病发病率之比从2.75（2.60，2.90）增至7.13（6.68，7.62），而梅毒的该比例则从0.33（0.32，0.34）变为0.56（0.55，0.57）。13 - 15岁的学生和校外人员的性传播感染病例增幅显著高于其他年龄组，年均增长率分别为29.2%和26.3%。非学生的发病率始终高于学生，2021年发病率比（IRR）达31.80（31.24，32.37）。在黑河 - 腾冲线东南部地区出现了明显的新发病例聚集模式，从沿海地区向内陆延伸。青春期性健康教育普及率较低的区县往往性传播感染平均发病率较高。在地市层面，人均GDP较低的城市性传播感染平均发病率呈明显上升趋势。解决这些差异的策略包括促进公平的健康教育以及广泛开展性健康教育，尤其是在教育机会有限且经济快速发展的地区。性健康教育干预的效果需要在精心设计的研究中进一步评估。
