厦门市男男性行为人群HIV抗体阳性率增高原因的探讨

Analysis of the factors related to an HIV-positive rate climb in MSM in Xiamen city,China

目的探讨厦门市在男男性行为人群(MSM)疫情调查中,出现艾滋病病毒(HIV)抗体阳性率增高的原因。方法采用回顾性核查现场调查与实验室检测、分析调查数据、对HIV阳性者追踪调查,以及在MSM人群中进行深入访谈等方法,分析可能导致HIV阳性率增高的因素。结果 (1)不同调查之间的实验室HIV检测判定标准出现了调整,前三轮调查没有HIV阳性者采用替代策略I判断标准,而最后一轮调查中则有3例阳性采用了这一判断标准;(2)调查对象的构成也发生了变化,第四轮调查对象的平均年龄大于前三轮(27.1±6.5岁vs 25.7±6.0岁,P<0.05),汉族所占的比例也高于前三轮(97.4%vs 91.6%,P<0.01);在MSM中进行的访谈提示,第四轮调查中来自会所的对象的比例可能出现了增加;(3)不能排除HIV在MSM人群中流行加剧的可能。结论 MSM人群HIV阳性率的增高可能是上述一个或几个因素单独或共同作用的结果。

Objective To explore why the HIV-positive rate climbed so rapidly in men who have sex with men （MSM）in Xiamen city. Methods Guidelines for field survey and laboratorystandards of human immunodefieiency virus（HIV）test among different surveys were checked and compared; survey data were analyzed; the H IV-positive cases were traced and inquired; and an in depth interview in MSM was Carried out. Results （1） The laboratory standard of HIV test was adjusted in different surveys. There were three HiV-positive eases diagnosed by alterna tire strategy I in the last survey while none in the first three surveys. （2） The study subjects＇ constitute varied. The average age in the last survey was older than that in the first three suryeys （27.1±6.5 years vs 25.7!6.0 years, P〈0.05）. The percent age of Han （nationality） in the last survey was also higher than that in the first three surveys （97.4% vs 91.6%, P〈0.01）. An interview conducted in MSMs hinted that the percent age of subjects from homosexual clubs might rise in the last survey. （3） The prevalence of H IV infection might also speed up. Conclusion It seemed that one or more of these factors contributed to the climb of HIV positive rate.