上海市男男同性性传播AIDS病人的临床流行病学研究

Study on clinical epidemiology of HIV/AIDS patients among MSM in the past five years in Shanghai

目的通过对上海艾滋病(AIDS)抗反转录病毒治疗(ART)病人的流行病学研究,为国家艾滋病防治专家提供基本信息,针对不同地区因地制宜采取侧重点不同的防控措施。方法采集662例男性病人的相关信息,分为同性性传播组和非同性性传播组进行相关数据的统计学分析。结果通过同性性传播感染的男性病人为318例(48.04%),且占男性病人的比例由2005年的38.71%上升至2010年的57.14%。开始ART时的年龄分别为同性性传播组(36.14±11.05)岁,非同性性传播组(45.80±11.08)岁,差异有统计学意义(P<0.01)。婚姻状况方面前者未婚为198例(62.26%),后者为56例(16.28%),差异有统计学意义(P<0.01)。两组已婚的病人中均有配偶感染的情况。在学历方面,两组差异有统计学意义(P<0.01),具有大专及以上学历的病人前者137例(43.08%),后者36例(10.47%)。在病人发现感染至治疗时间间隔方面,两组分别为(10.43±15.83)个月和(10.76±17.80)个月,差异无统计学意义(P=0.802)。结论因同性性传播途径感染的病人的比例迅速上升,均为年轻且具有较高学历的国家有用人才,应引起各参与防治工作人员的重视,采取更有效的方式和模式来减少未采取保护措施的肛交(UAI)的发生。男男同性恋尚不能得到社会的承认,有些人不得不结婚生子,因此在关注男男同性恋的同时,也应该关注其婚姻状况,以及其配偶可能感染的问题。

Objective The ratio of homosexual sexual transmission of HIV/AIDS among men who have sex with men（MSM） was raised and their age became younger and younger.The epidemiological study of HIV/AIDS patients among MSM treated with ART in Shanghai aimed to provide useful information for AIDS prevention and treatment and to develop prevention and control measures tailored to fit the local situations.Methods The clinical data of 662 male HIV/AIDS cases were collected and statistical analysis was made in two groups： homosexual transmission group and heterosexual transmission group.Results Among 662 male HIV/AIDS cases,318 were infected through homosexual sexual behavior（48.04%）,and the rate was raised from 38.71% in 2005 to 57.14% in 2010.The age when ART began was 36.14±11.05 years in the homosexual transmission group and was 45.80±11.08 years in the heterosexual transmission group.There was significant difference between the two groups（P〈0.01）.In addition,there were 198 unmarried cases in the homosexual group（62.26%）and 56 in the heterosexual group（16.28%）,with statistically significant difference（P〈0.01）.A large proportion of their spouse were also infected in either homosexual or heterosexual cases.In terms of the educational background,there were 137 cases with college education（43.08%） in the homosexual group and 36 cases with college education（10.47%）in the heterosexual group.The difference was also significant（P〈0.01）.The time interval to start ART after HIV infection was 10.43±15.83 months and 10.76±17.80 months respectively in the two groups,but the difference was not significant（P=0.802）.Conclusion In China,specially in some economically developed areas such as Shanghai,more and more HIV infections are transmitted through homosexual sexual behavior.A large proportion of the infectors are young talents with a higher education.So this situation should be concerned with and some more effective ways and modes of sexual intercourse should be promoted to reduce the incidence of unprotected anal intercourse（UAI）,which could reduce the risk of HIV infection in MSM.Although MSM have not been socially recognized,some of HIV infected MSM will get married and will have children.While homosexual behaviors among MSM have aroused social concern,their marital status and possible infection among their spouses should be given serious attention.