苏州市男男性行为人群HIV感染及相关因素研究

Sero-prevalence and correlates of HIV infection among men who have sex with men in Suzhou

目的了解苏州市男男性行为人群（men who have sex with men,MSM）HIV感染率及HIV感染相关因素。方法 2008-2009年间,通过场所招募、艾滋病自愿咨询检测（voluntary counseling and testing,VCT）门诊、同伴转介等方法,招募MSM进行问卷调查,收集人口学、行为学信息,并检测其HIV和梅毒感染情况。结果纳入MSM研究对象717人,研究对象的年龄中位数为26岁,69.7%未婚。58人检测为HIV抗体阳性,HIV感染率为8.1%;105人检测为梅毒阳性,梅毒感染率为14.6%。多因素Logistic分析显示,大专及以上文化程度者HIV感染风险是大专以下者的0.40倍（OR=0.40,95%CI：0.19~0.87）;来自本省其他地区的MSM感染HIV风险是本市MSM的2.70倍（OR=2.70,95%CI：1.19~6.12）;最近6个月同性性行为时做过＂0＂者,感染风险是未做过＂0＂者的2.85倍（OR=2.85,95%CI：1.27~6.38）;最近6个月内有≥2个同性性伴者的感染风险是只有1个同性性伴者的3.48倍（OR=3.48,95%CI：1.01~11.96）;最近6个月内肛交时偶尔使用安全套者的感染风险是经常使用者的9.57倍（OR=9.57,95%CI：3.30~27.78）,从不使用者感染风险是经常使用者的9.13倍（OR=9.13,95%CI：2.18~38.28）。结论苏州地区MSM人群HIV感染率较高,文化程度高者感染风险低,来自本省其他地区者感染风险高,同性性行为时做过＂0＂,同性多性伴和不使用安全套等因素是HIV感染的相关因素,迫切需要针对该人群开展行为干预工作,降低HIV的传播风险。

Objective To study the sero-prevalence and correlates of HIV infection among men who have sex with men（MSM） in Suzhou.Methods A cross-sectional study was conducted among MSM in Suzhou.A face-to-face interview was administered to each MSM under informed consent.Socio-demographic factors and HIV-related behavior characteristics were evaluated by means of questionnaires,and venous blood samples were collected for HIV and syphilis antibody test.Results 717 MSM participated in the study.The median age was 26 years with 69.7% as unmarried MSM.The sero-prevalence of HIV was 8.1%（58/717）,and the sero-positivity of syphilis was 14.6%（105/717）.Multivariate Logistic regression analysis indicated that college or above educated MSM were less likely to be HIV infected than those less than college educated（OR=0.40,95% CI：0.19~0.87）,MSM from other cities of Jiangsu Province were more likely to be HIV infected than Suzhou local MSM（OR=2.70,95% CI：1.19~6.12）.MSM who had receptive anal sex in the recent 6 months were more likely to be HIV infected（OR=2.85,95% CI：1.27~6.38）,those having had two or more homosexual partners（OR=3.48,95% CI：1.01~11.96）,MSM rarely using condoms in anal sex（OR=9.57,95% CI：3.30~27.78） or never using condoms（OR=9.13,95% CI：2.18~38.28） in the recent 6 months sex were more likely to be HIV infected.Conclusions HIV infection was highly prevalent among MSM in Suzhou,especially in those who were less than college educated and migrated from other cities of Jiangsu Province.Receptive anal sex,multiple sexual partners and rarely using condoms were correlated to HIV infection.Behavioral interventions among MSM should be a high priority in local HIV prevention and control programs.