辽宁省MSM HIV感染现状及其影响因素分析

HIV prevalence and its associated factors among 2074 men who have sex with men (MSM) in Liaoning province,China

目的了解辽宁省大、中城市男男性接触者(MSM)的HIV感染现状及其二代传播风险,为艾滋病防控提供参考信息。方法于2008年4-6月对辽宁省6个大中城市的MSM进行横断面调查,通过访谈式问卷调查MSM人群的高危行为等特征,采集静脉血检测HIV-1和梅毒螺旋体抗体。结果 2 074名MSM参加了调查,HIV和梅毒的感染率分别为4.8%(100/2 074)和8.9%(184/2 074);过去6个月中,其平均男性性伴数为5.8人,与固定性伴、商业性伴和偶遇性伴的安全套使用率依次为43.3%(899/2 074)、65.0%(286/440)和68.5%(1 421/2 074);51.6%(1071/2 074)的MSM曾与女性发生过性行为,其中与女性性伴最近一次性行为中安全套使用率为50.3%(294/585);多因素Logistic回归分析结果表明,梅毒感染(OR=4.6,95%CI=2.3～9.2)、被动肛交偶尔使用安全套(OR=2.8,95%CI=1.4～5.5)、最近6个月男性性伴数≥10个(OR=2.0,95%CI=1.0～3.8)和学历低(OR=1.8,95%CI=1.0～3.3)为HIV感染的独立危险因素。结论辽宁省MSM的HIV和梅毒感染率已达到较高水平;其异性性行为比例较高且安全套使用率较低,应及时采取措施降低HIV和梅毒经MSM向一般人群二代传播的风险。

Objective To examine HIV prevalence and risk of HIV secondary transmission among men who have sex with men in Liaoning province.Methods A face-to-face questionnaire interview was conducted among men who have sex with men（MSM） recruited wtih snowball sampling method in 6 main cities of Liaoning province from April to June,2008.Blood specimens were collected for HIV and syphilis testing.Results A total of 2 074 MSM were recruited for the survey.The prevalence of HIV and syphilis was 4.8%（100/2 074） and 8.9%（184/2 074）,respectively.Among the MSM,the average number of homosexual partners was 5.8 and the condom using rate during anal sex with regular male sexual partner,commercial sexual partner,and male casual sexual partner were 43.3%（899/2 074）,65.0%（286/440）,and 68.5%（1 421/2 074）,respectively.The proportion of MSM who had female sexual partner was 51.6%（1071/2 074）,in which 50.3%（294/585） used condom during intercourse with the last female sexual partner.Multivariate logistic analyses indicated that syphilis infection（odds ratio=4.6,95% confidence interval：2.3-9.2）,inconsistent condom use during receptive anal sex（OR=2.8,95%CI：1.4-5.5）,the munber of homosexual partners≥10（OR=2.0,95%CI：1.0-3.8）,and education（OR=1.8,95%CI：1.0-3.3） were independent risk factors for HIV infection.Conclusion The prevalence of HIV and syphilis among the MSM in Liaoning province has reached a high level.High proportion of MSM had heterosexual partners and low condom using rate during their heterosexual intercourse.Effective behavioral intervention program should be carried out among the MSM to decrease the risk of HIV secondary transmission to general population by unprotected sexual behavior.