重庆市男男性接触者艾滋病病毒感染率及其影响因素

HIV prevalence and its associated factors among men who have sex with men in Chongqing

目的了解重庆市男男性接触人群（MSM）艾滋病病毒（HIV）感染率及其影响因素。方法2007年7—9月在重庆市渝中区、九龙坡区和沙坪坝区通过滚雪球方式招募1044名MSM进行面对面的问卷调查，以HIV感染状况为应变量，人口学特征、艾滋病防治知识知晓水平、性行为状况、接受干预服务、梅毒感染状况等为自变量进行逐步向前法的logistic回归分析与HIV感染相关的因素。结果调查的1044名MSM中，艾滋病防治知识知晓率高（89．5％），近6个月与男性发生无保护性的肛交比例为63．8％；梅毒感染率为8．5％（89／1044），HIV感染率为12．5％（131／1044）。多因素回归分析发现，年龄较大（OR=1．69，95％CI：1．13—2．52）、文化程度在初中以下（OR=1．89，95％CI：1．17～3．05）、首次性行为年龄在18岁以下（OR=3．11，95％CI：1．20～8．02）、近6个月男性性伴数在10个以上（OR=2．24，95％CI：1．24—4．02）、近6个月与女性有性行为史（OR=2．40，95％C1：1．64—3．51）和梅毒感染（OR=4．52，95％CI：2．77～7．38）是HIV感染的独立危险因素。结论MSM人群无保护性性行为发生率、梅毒和HIV感染率均高。

Objective To examine HIV prevalence and its associated factors among men who have sex with men （MSM） and provide the evidence for the intervention program among MSM. Methods A faceto-face questionnaire interview was conducted among MSM recruited by snowball sampling method in Yuzhong,Jiulongpo and Shapingba district of Chongqing from July to September, 2007. Totally, 1044 MSM were recruited. Associated factors with HIV prevalence were analyzed using forward stepwise logistic regression that HIV status was the dependent variable and demographics, AIDS awareness, sexual behaviors and the status of the intervention were independent variables. Results A total of 1044 MSM were surveyed. The rate of AIDS awareness was 89. 5% among MSM. The rate of unprotected anal sex during the past 6 months was 63.8%. The prevalence of HIV and syphilis was 8.5% （89/1044） and 12. 5% （ 131/ 1044） respectively. The multivariate analysis identified that the older MSM （OR = 1.69,95% CI： 1.13 - 2.52） ,junior school education（ OR = 1.89,95% CI： 1.17 - 3.05 ） , younger than 18 years old of the first sex （ OR = 3.11,95 % CI： 1.20 - 8.02 ） , more than 10 sexual partners （ OR = 2. 24,95% CI： 1.24 - 4. 02 ） , the history of having sex with women （ OR = 2.40,95% CI： 1.64 - 3.51 ） and syphilis infection （ OR = 4. 52, 95% CI：2. 77 -7. 38 ）were independent risk factors associated with HIV infection. Conclusion The rate of unprotected anal sex was high, so were the prevalence of HIV and syphilis among MSM. It should be urgent to conduct the intervention to stop AIDS rapid transmission among MSM.