廊坊市部分MSM人群HIV检测咨询前后高危行为变化的分析

Impact of HIV counseling and testing on high risk behaviors among men who have sex with men in Langfang City

目的评价艾滋病病毒(HIV)检测咨询,对男男性行为人群(Men who have sex with men,MSM)艾滋病相关危险行为变化的影响。方法通过问卷调查,收集廊坊市200名MSM参加HIV检测咨询前后高危行为的变化,并进行艾滋病和主要性病的检查,比较艾滋病相关危险行为的变化。结果 200名MSM基线调查HIV抗体阳性率为7.3%,梅毒感染率为19.8%,淋球菌检出率为15.8%;三个月后的随访调查中,梅毒感染率为24.7%,淋球菌感染率为12.2%。随访调查中MSM中多性伴的比例、发生一夜情的比例、肛交以及性交中自己出血的比例,均有所下降(P<0.05)。按照性病感染状态分层后发现,感染了性病的MSM,被告知检测结果后,发生肛交的比例由73%下降到38%(P<0.01),群交和性交过程中的出血情况分别由19.2%和23.1%下降到5.8%和5.8%(P<0.05)。未感染性病的MSM,一夜情的比例从32.5%下降到17.2%(P=0.008),口交比例由57.0%上升到78.5%(P=0.001)。感染了性病的MSM发生肛交的比例要低于健康MSM(χ2=5.189,P=0.023)。结论 HIV检测咨询对MSM艾滋病相关危险行为的改变有积极意义,建议在该人群中推广HIV检测咨询服务,促进高危行为的改变。

Objective To evaluate the impact of HIV counseling testing on HIV related high risk behaviors among men who have sex with men （MSM）. Methods Face to face interview was employed to collect the high risk behavior information on MSM＇s visit to HIV counseling testing clinics and in three months later. HIV and sex transmitted infections （STIs） testing were also conducted by laboratory and clinical staff. Results The follow up study of 200 MSM revealed that HIV prevalence was 7.3%,syphilis prevalence was 19.8% and Neisseria Gonorrhoeae （NG） was detected among 15.8% of participants at baseline study. In the follow up interview,the prevalence of syphilis and NG was 24.7% and 12.2% respectively. After counseling testing,the proportion of multiple partners,one-night stand,anal sex as well as bleeding during intercourse dropped significantly. Stratified by STIs status,the proportion of having anal sex among MSM after they were informed of STI positive status reduced from 73% to 38%,group sex and bleeding during intercourse dropped from 19.2% and 23.1% to 5.8% and 5.8% respectively. Among healthy MSM the proportion of one-night stand fell from 32.5% to 17.2%,but the proportion of oral sex rose from 57.0% to 78.5%. STI positive MSM were likely to experience lower anal sex as compared to healthy MSM （χ2=5.189,P=0.023）. Conclusion HIV counseling testing have been proved to have positive impact on the change of HIV related high risk behaviors,and scaling up of HIV counseling and testing will be essential to promote the change of high risk behaviors among MSM.