艾滋病流行形势与防治对策课件.ppt

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1、LOGO主要内容主要内容海海 南南 概概 况况: Overview of HainanOverview of Hainan 海南全省陆地总面积3.54万平方公里,海域面积200多万平方公里,是中国陆地面积最小,海洋面积最大的省。 海南岛四周低平,中间高耸,以五指山、鹦歌岭为隆起核心,向外围逐级下降。山地、丘陵、台地、平原构成环形层状地貌,梯级结构明显.2008年末全省常住人口为864.7300万人,少数民族约140多万人。汉族、黎族、苗族、回族是世居民族。前海南乡亲及其后裔遍布五大洲,据估计应有500多万人。侨乡文昌海外人口比岛内还多Hainan has an area of 35.4 tho

2、usand square kilometers, and 2 million sq km of maritime waters. It is the province with the least land are and most maritime area in all of China. The center of the island is mountainous, and slopes down towards the coast in cascading ring-like plateau formations.In 2008 Hainan had a resident popul

3、ation of over 8.5 million people, of which ethnic minorities are nearly 1.5 million. Han, Li, Hui, Miao are all ethnic minorities native to Hainan. People from Hainan, and descendents from Hainan, are spread across 5 continents and likely total nearly 5 million worldwide. There are now more people f

4、rom Wenchang living abroad than in Hainan.海海 南南 概概 况况: Overview of Hainan海海 南南 概概 况况: Overview of Hainan 海南岛地处热带,与夏威夷纬度相近,长夏无冬。岛上终年气候宜人,四季鸟语花香。海洋、矿物、动植物资源丰富,尤其石油与天然气蕴藏量可观,洋浦开发区为中国南方最大的近海石油天然气加工、储存和出口基地。海南所孕育的热带雨林和红树林为中国少有的森林类型,海南丰富的生物在中国占有十分显著的地位,是开展科研、旅游和教学最理想的选择之地。Hainan has a tropical climate, an

5、d due to its latitude, has long summers and no winter. Hainan has abundant animal, marine, plant and mineral resources. It also has considerable reserves of natural gas and oil. The Yangpu development zone is southern Chinas largest offshore oil and gas processing, storage and export base. Hainans t

6、ropical rain and mangrove forests are rare in china. The rich ecology is of special importance to the nation, and creates an ideal environment for traveling and teaching. 一、海南省基本情况一、海南省基本情况: Overview of Hainan1、海南省是一个1988年新建立的省份,位于我国的最南端,北与广东、广西相连,南与马来西亚、印度尼西亚、文莱、新加坡,东与菲律宾、西与越南隔海相望。既是中国的南疆,又是中国与东南亚、

7、南亚、大洋州、非洲、欧洲等许多国家交往的海上交通要冲。2、海南省人口865万,陆地面积3.54万平方公里。设2个地级市、6个县级市、10个县。是我国最大的经济特区,也是我国著名的侨乡,累计有130万华侨分布在全球60多个国家和地区,其中在新、港、马、泰等东南亚分布着40多万。3、省会设在海口,位于海南岛北部的琼州海峡,是海南省的政治、经济和文化中心。海口在建省后,人口迅速增长,迄今,已发展成为180万人口的中等城市。 1. Hainan was established as a province in 1988, and is Chinas southernmost province. Gua

8、ngdong and Guangxi are to the north, to the south are Malaysia, Singapore, and Wencai, to the east Philippines and the west Vietnam. Hainan is an important port for South and Southeast Asia, Africa, Europe, and many other regions. 2. Hainan has a population of 8,650,000, and 354,000 sq km of land. I

9、t has 2 prefecture-level cities, and 10 counties. Hainan is Chinas largest free economic zone. It is also the origin of many overseas Chinese, with over 1300000 Hainanese people spread over 60 countries throughout the world. 400000 of those people are in Hong Kong, Thailand, and other Southeast Asia

10、n countries. 3. The provincial capital is Haikou, located on the Qiongzhou straight in northern Hainan. Haikou is Hainans cultural, political and social center. Haikou has experienced rapid population growth since Hainans establishment, with over 1,800,000 current residents. 一、海南省基本情况一、海南省基本情况: Over

11、view of Hainan行政区划:至1999年底,全省有2个地级市、6个县级市、4个县、6个民族自治县、5个市辖区,1个办事处(西南中沙群岛办事处、县级)和洋浦经济开发区管理局。行政管理体系:小政府大社会。省直接管理县。Administrative Divisions Administrative Systems: Small government big society. Directprovincial management of counties.海口世纪大桥远景 : View of Haikou Century Bridge海口市区远景图: View of Haikou City一

12、、海南省基本情况一、海南省基本情况: Overview of Hainan4、海南省作为一个旅游大省,近年来每年进出我省的国内外游客超过2000万人次,旅游业的发展促进了相关的服务行业的发展,成了我省的一项重要经济支柱。 5、三亚市是海南省第2大城市,市区人口26万,流动人口20 万人,每年到三亚旅游的人数超过1000万。随着人口的流动,也带来了一些公共卫生的问题,其中包括性病和艾滋病的流行问题。 4. Hainan is a travel destination, attracting more than 20 million Chinese tourists each year. The

13、tourist industry and related development have become the foundation of Hainans economy. 5. Sanya is the 2nd largest city in Hainan, with a population of 260, 000, and migrant population of 200, 000. Annual tourists to Sanya total more than 10,000,000. High population mobility (including migrant popu

14、lations and tourists) have fueled public health problems, including the spread of HIV/STIs. 三亚市区远景图: View of Sanya City三亚市鹿回头山顶公园: Luhuitou Mountain Park一、海南省基本情况一、海南省基本情况: Overview of Hainan 6、琼海市位于海南岛东部,人口44万人,闻名遐尔的万泉河从琼海市境内流入大海。琼海市博鳌镇是“亚洲论坛”永久会址所在地,论坛每年定期在博鳌召开年会。据统计,自2000年以来,各种会议及“黄金周”期间,接待游客、与会人

15、员约520万人次,平均每年有170万人次,会议及“黄金周”期间,各宾馆、酒店住房率达90%以上,比平时提高30%。 6. Qionghai is located in Eastern Hainan, has a population of 440,000, and is famous fro the Wanquan River that flows through the city into the sea. Bo Ao, near Qionghai, is “Asias Forum”, where many international meetings and conferences are

16、 held annually. The annual golden week, during which many conferences are held, has attracted over 5,200,000 visiting attendees and tourists, with an annual average of more than 1,700,000 attendees. During the conference season, hotels and guesthouses operate at more than 90% occupancy, more than 30

17、% increase over the remainder of the year. 博鳌亚洲论坛成立会址景区景观: View of Scenic Boao Asia Forum 博鳌水城博鳌水城: Boao 一、海南省基本情况一、海南省基本情况: Overview of Hainan 儋州市位于海南岛西北部,面积3265平方公里,有98万人口,是海南省土地面积最大、人口最多的市县,也是海南西部的经济、交通、通信和文化中心,洋浦经济开发区位于该市境内。 洋浦经济开发区是海南开发建设的“重中之重”。洋 浦发展以重化工业为重点,主要建设石油化工和浆纸制造 等工业项目。 2007年,这个开发区以不到

18、全省千分之一 的土地,创造出占全省以上的工业产值,进出口占 ,提供全省国税的一半。 Danzhou city, located in northwest Hainan, is 3265 sq meters, the area with most land and largest population in Hainan (98000 people). It is the economic, cultural, transportation and communications center of Western Hainan. Yangpu development zone is Hainan

19、s key economic development zone, with production of petrochemical pulp, paper manufacturing and other industrial projects.洋浦经济开发区洋浦经济开发区: Yangpu Economic Development Zone二、海南省艾滋病流行形势分析二、海南省艾滋病流行形势分析Analysis of Hainans AIDS Epidemic1、流行强度流行强度流行率流行率:1991年我省发现首例艾滋病病毒感染者。截止2011年6月30日,全省累计报告HIV/AIDS1080例

20、,其中AIDS 307例,死亡 346例。 2009年按国家艾滋病疫情方法估计,我省估计15-49岁年龄组感染人数有2500人。流行率约为2.89/万。二、海南省艾滋病流行形势分析二、海南省艾滋病流行形势分析Hainans AIDS Epidemic: Analysis and Trends 近两年我省HIV/AIDS疫情报告数在全国排序位于第25位,占全国报告数的0.22%。按照总人口患病率比较,我省排序位于第15位,处于中等水平。Of all Chinas provinces, Hainan ranks 25th for HIV/AIDS cases, accounting for .22

21、% of the nations total infections. HIV/AIDS cases in proportion to the population rank Hainan the 15th province in HIV/AIDS prevalence. 2 2、流行的时间分布、流行的时间分布: : Epidemic Phases 我省已经完成了原始的传染源输入传染源输入和传染源积蓄传染源积蓄两个历史阶段,现在开始进入增长阶段增长阶段。Hainan has completed the introduction and spreading phases of the epidem

22、ic, and has already entered the expansion phase. 三个流行时期:三个流行时期:3 Epidemic PhasesY 1991 199119931993年为传入期。这期间感染的主要原因是经境外传入,共发现年为传入期。这期间感染的主要原因是经境外传入,共发现1111例感例感染者。均是经境外感染后返回国内时监测被发现的。染者。均是经境外感染后返回国内时监测被发现的。* Phase 1: 1991 to 1993. Initial introduction of the disease. During this phase, 11 total cases

23、 were discovered. Carriers not local to Hainan were returned to their province of origin for treatment. X 1994 199420012001年为散发期,这期间主要是外省传入的有偿供血感染者明显增加,年为散发期,这期间主要是外省传入的有偿供血感染者明显增加,境内由性接触传播也跟着增长,感染的原因由境外感染为主转为以境内感染为主。境内由性接触传播也跟着增长,感染的原因由境外感染为主转为以境内感染为主。* Phase 2: 1994 to 2001. Spreading phase. Durin

24、g this phase the epidemic was fueled by migration of carriers to Hainan, who had been infected while selling plasma. There was an increase in sexual transmissions during this time, and establishment the disease among local populations. X 2002 2002年年至今为增长期,这期间由于吸毒人群中共用注射器而引起局部地区的至今为增长期,这期间由于吸毒人群中共用注射

25、器而引起局部地区的吸毒人群中流行。吸毒人群中流行。* Phase 3: 2002- present. Expansion phase. An increase in rates of new infections amongst IV drug users sharing syringes. (2)海南省艾滋病流行的三个时期: 3 Phases of the AIDS Epidemic in Hainan050100150200250年份1991-2011年6月全省HIV/AIDS年度报告情况AIDS人数HIV/AIDS人数AIDS人数0000102230232416153926203520H

26、IV/AIDS人数2450634562136082547990108 118 139 220 1129192939495969798990001020304050607080910111991-94年 传入期Introduction1995-2001年 散发期Spreading2002-PresentExpansionAnnual June Complitation of Hainans HIV/AIDS CasesPhases:1991海口市海口市海口市海口市1995001-101-1011-5011-5051-100 51-100101-200101-200Hainan Geographi

27、cal Distribution of HIV/AIDS: Changes Over Time海南省艾滋病地区分布与时间变化的关系海南省艾滋病地区分布与时间变化的关系Hainan HIV/AIDS epidemic geographical distributionHainan HIV/AIDS epidemic geographical distribution海口市海口市001-101-1011-5011-5051-10051-100101-200101-200海口市海口市Hainan Geographical Distribution of HIV/AIDS: Changes Over

28、Time海南省艾滋病地区分布与时间变化的关系海南省艾滋病地区分布与时间变化的关系Hainan Geographical Distribution of HIV/AIDS: Changes Over TimeHainan AIDS epidemic geographical distribution: 2010海口市海口市01-1011-5051-100101-200海南省艾滋病地区分布与时间变化的关系海南省艾滋病地区分布与时间变化的关系4、我省累计报告病例数居前五位的市县依次为:三亚184例、儋州177例、海口125例、乐东117例和东方109例。(按现住址统计)4. The 5 cities

29、 and counties with the most reported cases of HIV/AIDS in Hainan are: Sanya, 184; Danzhou, 177; Haikou, 125; Ledong 117; Dongfang, 109. Geographical Distribution of AIDS in Hainan海南省艾滋病地区分布情况海南省艾滋病地区分布情况: :海南省艾滋病地区分布情况海南省艾滋病地区分布情况 Geographical Distribution of HIV/AIDS in Hainan2010年全省各市县HIV/AIDS地区分布

30、情况1841771171251092621151883915710321253020406080100120140160180200三亚 儋州乐东 海口东方 万宁陵水 澄迈琼海定安 文昌临高 屯昌琼中 保亭五指山不详昌江 白沙HIV/AIDS人数海南省艾滋病性别分布情况海南省艾滋病性别分布情况: Age & Gender Distribution of HIV/AIDS in Hainan全省1080例HIV/AIDS的年龄性别分布924390248471615817574399400005010015020025030035040045014岁及以下15-19岁20-29岁30-39岁40-

31、49岁50-59岁60-69岁70-79岁80岁及以上女性男性 F M全省全省1080例例HIV/AIDS感染途径构成比感染途径构成比: Modes of transmission of Hainans 1080 HIV/AIDS Cases50.65%28.98%8.80%0.93%1.48%9.17%注射吸毒异性接触同性接触输血/血制品母婴传播其他/不详 Blood transfusion/medical Mother to child Other/unknown Injection drug use Heterosexual sex Homosexual sex 全省各年度HIV感染途径

32、构成比分析: Analysis of HIV transmission modes by year0%10%20%30%40%50%60%70%80%90%100%9193959799010305070911.6不详母婴传播供血/使用血液制品同性性接触异性性接触注射吸毒 UnknownMother-Infant transmissionBlood transfusion/ use of infected injection toolsHomosexual transmissionHeterosexual transmissionInjection Drug use我省不同年份我省不同年份MSM

33、人群人群HIV感染趋势变化情况感染趋势变化情况: Yearly trends and changes in infection rates among MSMYear/Time Infection Rate (%) 2008 1.75 2009 1.97 2010 3.23 June 2011 6.19各市县各市县HIV感染途径分析感染途径分析 Modes of HIV Transmission by Cities and Regions0%20%40%60%80%100%三亚儋州海口乐东东方文昌万宁陵水澄迈临高琼海琼中定安屯昌昌江五指山白沙保亭不详母婴传播供血和使用血液/血液制品同性性接触异

34、性性接触注射吸毒 Unknown Mother-Infant Blood transfusion/ medical Homosexual transmission Heterosexual transmission Injection Drug use海南省艾滋病流行特征海南省艾滋病流行特征: Characteristics of HIV Transmission in Hainan1、从HIV传播途径来看,我省已经从“以共用注射器吸毒传播为主的模式”,发展为“以性接触传播和共用注射器吸毒传播并重的模式”,近两年经性接触传播构成比已超过经注射吸毒传播所占比例。2、从地区分布来看,就全国范围比较

35、,海南省属低发地区,但HIV感染者和病人的数量呈逐年上升趋势;从本省各市县来看,艾滋病疫情分布地区差异较大。3、男男性接触呈现较快增长态势;可能成为我省下一波艾滋病流行的主要因素,必须引起高度重视。1. The primary mode of HIV transmissions in Hainan has evolved from injection drug use and sharing of contaminated syringes, to sexual transmission. In the past 2 years, new sexually transmitted cases

36、have exceeded new IDU related infections. 2. Compared with the rest of the nation, Hainan still has low HIV/AIDS prevalence. However, rates of new infections are increasing. There are significant regional differences in HIV/AIDS distribution throughout the province.3. Rates of infection through homo

37、sexual transmission are increasing, and with continued growth could become a primary means of infection in Hainan, requiring special focus and attention. 三、海南省艾滋病防治对策与措施三、海南省艾滋病防治对策与措施1 1、建立健全监测检测体系、建立健全监测检测体系(1)在全省设立艾滋病监测哨点,2010年我省共设了19个艾滋病丙肝监测哨点,开展对吸毒人群、暗娼人群、男男性行为人群、性病门诊男性就诊者、流动人口、孕产妇、青年学生、无偿献血人群等

38、8类人群的监测。(2)以县为单位,每年搜索各类高危人群(女性性服务者、吸毒者、男男性行为者、性病门诊就诊者)样本进行血清学HIV抗体检测。(3),包括HIV阳性者性伴追踪、自愿咨询检测、孕产妇检测、术前检测、无偿献血人群检测等数据,全面分析各类人群HIV感染动态。(4)加强对公安司法监管场所羁押人员开展HIV抗体常规筛查,让感染者浮出水面,以便加强管理,减少二代传播的发生。 Establish Improved Surveillance and Testing Systems In 2010 Hainan had 19 surveillance centers to test for AIDS

39、 and hepatitis C among female sex workers, MSM, male STD clinic patients, migrant populations, pregnant women, young students, unpaid blood donors, etc in 8 categories of population monitoring. Collect samples for HIV testing among high-risk populations (female sex workers, drug users, MSM, STD clin

40、ic patients). Collect and comprehensively review HIV testing results compiled by all various testing agencies. Conduct comprehensive analysis of dynamics of HIV infections among all populations including pregnant women, unpaid blood donors, partners of HIV-positive patients.Increase testing among im

41、prisoned and detained populations, and improve care of any skin wounds among them, to reduce risks of secondary transmissions. 三、海南省艾滋病防治对策与措施三、海南省艾滋病防治对策与措施 Hainans AIDS Prevention and Intervention Measures2、开展对高危人群的行为干预(1)针对失足妇女的干预:外展干预、同伴教育、安全套自动销售机和免费发放网络、妇女健康中心、发放宣传材料和安全套(2)针对嫖客人群的干预:在全省的宾馆、旅馆以

42、及桑拿、按摩等可能有提供性服务的公共娱乐场所推行100%使用安全套干预措施。预防艾滋病通过性乱行为传播。在性病门诊提供“4个C”的服务。(3)针对男男性行为人群:草根组织、同伴教育、志愿者外展(4)针对吸毒人群:在吸毒严重的地区设立美沙酮维持治疗门诊,全省共设立29家美沙酮门诊。覆盖2600人,约占静脉注射吸毒人群的25%。在吸毒人群当中推行清洁针具交换措施,全省共建立了20个针具交换点,覆盖约12%的吸毒人群。收戒措施:约占吸毒者的40%。(5)鼓励各部门、各机构开展艾滋病防控工作:妇联组织、建设工地、大中学校等。 2. Improving interventions for high-ri

43、sk populations1. Sex workers: outreach intervention, partner education, condom vending machines and free condom distribution networks, womens health centers, distribution of health information and condoms. 2. Clients of sex workers: in all hotels, motels, saunas, massage parlors (any entertainment v

44、enues where sex service is provided) instate measures for promoting 100% condom use. Educate about, and prevent risks of infection through sexual promiscuity. In STI clinics provide4 Cs of service and care.3. Men who have sex with men (MSM): support grassroots organizing, partner education and volun

45、teer outreach. 4. Drug using populations: Establish methadone treatment clinics in regions with serious drug abuse problems. Hainan already has 29 methadone clinics which treat 2600 people, about 25% of IV drug users. Increase promotion of safe needle exchange, expand beyond 20 existing needle excha

46、nge centers, which current reach 12% of Hainans IV drug users. 5. Encourage all departments and agencies to carry out HIV/AIDS education and prevention, including construction sites, womens organizations, schools, etc. 省预防医学会指导外展干预省预防医学会指导外展干预: : Hainans medical and prevention teams leading outreach

47、 intervention培训社会小组外展活动能力Social Outreach Skills Building and Training Activities社区关怀小组培训活动 Community Care Group Training Activities把我们的心连成海,做相亲相爱的一家人把我们的心连成海,做相亲相爱的一家人Connect our hearts, love and care for each other like a family三亚市外展人员到公园开展外展干预三亚市外展人员到公园开展外展干预: : Sanya city outreach staff conductin

48、g intervention in a park 烛光纪念 Candlelight Commemoration三、海南省艾滋病防治对策与措施三、海南省艾滋病防治对策与措施3 3、开展免费自愿咨询检测服务开展免费自愿咨询检测服务 设立自愿咨询检测服务点,在全省县以上的疾病预防控制中心、皮肤性病防治所、妇幼保健院、以及综合性医院建立艾滋病抗体筛查实验室,并依托实验室开展免费艾滋病自愿咨询检测服务。 Implementation of free voluntary testing and counseling services At all of Hainans county level (and

49、above) CDC stations, skin and STI clinics, and hospitals should establish AIDS antibody screening labs, along with free voluntary testing and counseling services. 三、海南省艾滋病防治对策与措施三、海南省艾滋病防治对策与措施4 4、加强艾滋病感染者、加强艾滋病感染者/ /病人的随访管理病人的随访管理对新报告的艾滋病病毒感染者/病人开展流调,加强随访管理,对感染者/病人进行宣传教育和提供随访关怀服务,以控制二代传播的发生及艾滋病的流行蔓

50、延。随访频次为感染者每6个月随访一次、病人每3个月随访一次。Improve care and services for HIV/AIDS carriersImprove epidemiological surveillance and follow up care for newly reported HIV/AIDS patients. Improve education and resources for continued comprehensive follow-up care for patients, be proactive in curbing the spread of Ha

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