男男性接触者艾滋病性病感染状况及行为特征和干预策略

Prevalence of sexually transmitted infections and the behavior characteristics of men who have sex with men in Jiangsu province

目的分析男男性接触者（MSM）最高危人群及最危险的行为因素,提出更具针对性的干预措施。方法采用滚雪球法对江苏省三市2008年5月~2009年7月国家试点调查期间招募的MSM进行问卷调查和血样本采集。结果共调查符合招募条件的MSM 2 241例,自我认同同性恋者占47.66%,双性恋者占44.85%。最近6个月59.65%的MSM有过无保护肛交,36.77%与女性发生过性关系,且最近一次安全套使用率为35.19%。最近一年15.89%的MSM出现过性病相关症状,仅57.69%到综合医院/性病专科门诊求诊。53.27%的HIV阳性MSM为双性恋,39.02%在婚。三市平均HIV感染率为7.10%,梅毒感染率为17.63%,HIV合并梅毒感染率为2.72%。浴室型MSMHIV和梅毒感染率最高,分别为12.30%和27.34%。结论浴池型MSM和MSM感染者是干预重点人群,应尽快采取有效措施来遏制艾滋病在MSM人群以及通过该人群向一般人群中的传播。

Objective To investigate the risk behaviors and the prevalence of HIV and other sexually transmitted infections（STIs） in the population of men who have sex with men（MSM）.Methods A snow-ball sampling method was applied to recruit MSM from May 2008 to July 2009 in three cities of Jiangsu province under a national survey pilot project.A structured questionnaire survey and the blood collection of participants were carried out simultaneously.Results 2 241 MSM eligible for the study were recruited.47.66% and 44.84% of the respondents identified themselves as gay men and male bisexual,respectively.In the most recent six months,59.65% and 36.77% MSM had unprotected anal sex and intercourse with women,respectively.The rate of condom use was 35.16% for the last sex episode.16.24% MSM had the symptoms of STIs and 57.69% of them went to STIs clinics or hospitals for regularly treatment in the most recent one year.53.27% and 39.02% HIV positive MSM were bisexual and married,respectively.The prevalence rates of HIV and syphilis in three cities were 7.10% and 17.63% on average,respectively.The co-infection rate of HIV and syphilis was 2.72%.Gay bathhouse attendees had the highest infection rates of HIV（12.30%） and syphilis（27.34%）.Conclusion Gay bathhouse attendees and HIV positive MSM are high risk populations for HIV infection and transmission.The urgent and comprehensive measures of HIV prevention and control should be implemented for the population.