中山市男男性行为人群的艾滋病感染状况及影响因素分析

HIV prevalence and its influence factors among men who have sex with men in Zhongshan City

目的了解中山市男男性行为人群（menwhohavesexwithnell，MSM）HIV感染率及其影响因素。方法2010年，采用同伴推动抽样法（respondent—drivensampling，RDS）招募在中山市生活或工作的、年龄在18岁以上、自我报告最近1年有过男男性行为（口交或肛交）的MSM进行面对面的问卷调查。调查内容包括人口学特征、艾滋病相关知识、艾滋病相关行为和流动性等；采集血样进行人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）和梅毒抗体检测；利用RDS分析软件（RDSAT）进行权重处理和双变量分析，多因素逐步非条件logistic回归分析艾滋病感染的影响因素。结果8名种子经过10周共招募127名下线。135名MSM中，平均年龄（28．24-6．9）岁。RDSAT校正后，未婚、外省户籍、高中及以上学历构成比分别为77．9％、63．9％和75．0％：艾滋病校正知晓率为91．3％；89．0％的MSM最近6个月与同性发生过肛交，其中53．6％每次使用安全套；20．7％的MSM自我报告最近6个月发生过异性性行为。血清学检测结果HIV抗体阳性18例（13．3％），HCV抗体阳性2例（1．5％），梅毒TRUST阳性11例（8．1％），经RDSAT校正后，中山市MSMHIV、HCV和梅毒TRUST阳性率分别为15．1％（95％叫：7．3％～25．6％）、3．0％（95％CI：0～4．2％）和8．9％（95％C／：3．3％～17．5％）。多因素logistic回归模型提示，最近6个月肛交非每次使用安全套（OR=10．19，95％CI：2．14～48．67）、最近1年未做过HIV检测（OR=15．09，95％CI：1．88～120．98）是HIV感染的危险因素。结论中山市受调查的MSMHIV感染率较高，高危行为普遍存在，亟需采取针对性的干预措施。

Objective To explore the prevalence of human immunodeficieney virus （HIV） and its influence factors among men who have sex with men （MSM） in Zhongshan City. Methods In 2010 respondent driven sampling （RDS） was applied to recruit MSM aged 18 years and over, living or working in Zhongshan, and having anal or oral sex with men in the last year by self report. A structured questionnaire was used for a face to face interview. The survey content included demographic characteristics, HIV/AIDS related knowledge, risk behaviors, and mobility. Intravenous blood samples were collected for the measurement of HIV, hepatitis C virus （HCV） and syphilis antibodies. RDS analysis tool （RDSAT） was applied for adjusting the estimates and bivariate analysis. HIV infection was analyzed by the unconditional muhivariable logistic regression model. Results Eight seeds recruited 127 MSM within 10 weeks. Among the 135 MSM, the average age was 28.2 years old. After adjusted by RDSAT, 77. 9% were unmarried; 63.9% were floating people who had no registered permanent residence in Guangdong Province; 75.0% were with senior high school or higher; the awareness rates on HIV/AIDS were 91.3% ; 89. 0% reported anal intercourse with men in the last 6 months, of whom, 53.6% reported condom use consistently. The crude prev- alence rates of HIV, HCV and syphilis were 13.3% （18/135）, 1.5% （2/135） and 8. 1% （11/135） ,respectively. The adjusted prevalence rates of HIV, HCV and syphilis were 15.1% （95% CI：7.3% - 25.6% ）, 3.0% （95% CI： 0 - 4. 2% ） and 8.9% （95% CI： 3.3% - 17. 5% ）, respectively. Multiple logistic regression indicated that those who reported inconsistent condom use during anal intercourse in the last 6 months （ OR = 10. 19, 95% CI： 2. 14 - 48.67）, and those who didn＇ t have HIV test （ OR = 15.09, 95% CI. 1.88 - 120. 98） in the last year were more likely to be HIV sero-positive. Conclusion A high HIV infection rate was observed among the recruited MSM in Zhongshan with high risk behaviors. Targeted interventions are necessary to prevent HIV spreading among MSM.