河北省廊坊市MSM人群艾滋病相关危险行为研究

HIV/AIDS related high-risk behaviors among men who have sex with men(MSM) in Langfang,Hebei province

目的了解廊坊市男男性行为人群(MSM)艾滋病相关危险行为的暴露情况,分析该人群艾滋病病毒(HIV)和梅毒感染的主要危险因素。方法通过面对面的问卷调查,收集廊坊市区MSM的人口学资料、同性性行为、异性性行为以及艾滋病相关危险行为的暴露情况,并采集血液样本检测HIV和梅毒抗体,计算HIV和梅毒阳性率以及相关危险行为OR值。结果参加调查的233名MSM中,174人(74.6%)最近6个月发生过肛交性行为,肛交时坚持和经常使用安全套的人分别占46.6%和13.8%。该人群HIV和梅毒阳性率较高,检测195份血液样本,HIV抗体阳性13人,阳性率6.7%;梅毒抗体阳性41人,阳性率为21.0%。肛交不坚持使用安全套(OR=3.53,P=0.034)和性交过程中有自己出血经历(OR=9.967,P=0.003),是HIV感染的危险因素;而群交经历(OR=5.886,P<0.001)是梅毒感染的危险因素。结论廊坊市MSM人群有较高的HIV和梅毒阳性率,亟需在该人群中积极开展健康教育和行为干预,推广HIV和性病检测。

Objective To understand the exposure of HIV/AIDS related risk behaviors among MSM in Langfang, Hebei province and analyze the risk factors for HIV or syphilis infections; Methods Demographic information, homosexual and heterosexual contacts and HIV/AIDS related risk behaviors were collected by face to face interview. Blood sample and urethra specimen were taken for HIV and syphilis detection during their first visit to VCT clinics and out reach HIV testing service. HIV and syphilis prevalence were given by risk analysis. Results Survey of AIDS-related risk behaviors among 233 MSM found that 174 MSM （74.6 percent） had anal intercourses in past 6 months. In the case of anal intercourse, the rates of consistent condom use were 45 percent. Meanwhile, this specific population group had high prevalence of HIV or syphilis. The detection of 195 blood samples showed a 6.7% H IV- positive rate （13） and a 21 % syphilis prevalence （41）. Anal intercourse without using condoms （OR= 3.53, P=0. 034）, and self-bleeding during sex （OR= 9. 967, P=0. 003） were associated with HIV infection, group sex experiences （OR= 5. 886,P=0. 001） was a risk factor for syphilis infection. Conclusion MSM have a higher prevalence of HIV and syphilis in Langfang city. Health education and behavioral intervention should be implemented urgently and VCT services and HIV/STD testing should be promoted among them.