江苏省部分城市男男性行为者HIV/STD感染情况研究

Study on HIV/STD infections among men who have sex with men in selected cities of Jiangsu Province

目的了解男男性行为者(MSM)群体的艾滋病病毒/性病(HIV/STD)感染水平。方法在MSM聚集的酒吧,在知情同意下,匿名填写问卷,自愿选择检查项目,在现场开展体检和实验室标本采集,标本按要求冷藏转送至实验室。结果共检测了144人,平均年龄32.68岁,未婚者占59.03%,各种文化层次和职业者均有。他们中只有同性性行为者占38.64%,其他人均与异性有性行为。首次性行为的平均年龄为20.82岁。近3个月内被调查者有与异性的性行为及各种方式的性行为,且每次使用安全套者仅13.77%。其中11.11%的人报告曾被诊断有性病。现场体检发现尖锐湿疣患病率13.21%(14/106)。尿道分泌物检查淋球菌阳性率2.68%(3/112),沙眼衣原体8.04%(9/112),解脲脲原体25.00%(28/112),生殖支原体4.46%(5/112)。血清学检查HIV抗体全部阴性,梅毒螺旋体明胶凝集试验(TPPA)阳性率18.75%(27/144),快速血浆反应素试验(RPR)阳性率9.72%(14/144),疱疹病毒抗体(HSV-2-IgG)阳性率7.78%(7/90),乙型肝炎病毒表面抗原(HBsAg)阳性率9.68%(9/93),丙型肝炎病毒抗体(抗-HCV)阳性率0(0/93),戊型肝炎病毒抗体(抗-HEV)阳性率16.13%(15/93)。结论MSM人群的性生活状态复杂并且缺乏安全性意识,成为HIV/STD传播的桥梁人群。他们中STD的感染水平较一般人群高,个别感染甚至接近性病门诊的感染水平,应该引起关注。

Objective To investigate HIV/STD infections among men who have sex with men （MSM）. Methods An self-designed anonymous quesitonnaire was used for members taking part in health education about HIV/STD in gay bar with informed consent and related tests were performed selectively in accordance with their personal wishes. The physi- cal examination and collection of samples were taken on the site, and the samples were delivered to the STD research laboratory for testing. Results A total of 144 subjects（mean age 32.68 years） were recruited,with unmarried men accounting for 59.03 96. They had various levels of education and engaged in different professions. Among them 38.64 96 had only homosexual behavior and the others had heterosexual behavior as well.The mean age of having initial sex was 20.82 years. They report having heterosexual intercourse of all kinds of sexual behaviors in the last three months. Condoms were consistently used in 13.7796 of them in their sexual activities.Of them 11.1196 （16/144） reported that they had contracted STD,and 13.21% （14/106） were infected with condyloma acuminatum by physical examination. In the test with urethral samples, positive rate of Neisseria gonorrhoeae was 2.68 96 （ 3/112 ）, Chlamydia tracbomatis 8.04 96 （ 9/112 ）, Ureaplasma urealyticum 25.00 96 （ 28/112 ） and Mycoplasma genitalium 4.46 96 （ 5/112 ）. In the detection of blood serum samples no HIV antibody was found. TPPA was positive in 18.75 96 （27/144） of the subjects, RPR（ ＋ ） in 9.72 96 （ 14/ 144）,HSV- Ⅱ -IgG（ ＋ ）in 7.78% （7/90） ,HbsAg（ ＋ ） in 9.68% （9/93） ,HCV-Ab（ - ）,and HEV-Ab（ ＋ ） in 16.13% （15/93 ）. Conclusion Because of the complicated sexual activities and lacking of safe-sex consciousness in MSM population they become a bridge of HIV/STD transmission. The infection of STD in MSM is higher than that in the general population, and rates of some infections are similar to those in patients attending STD clinics. Much attention should be paid to this situation.