苏州市MSM人群艾滋病高危行为特征、感染状况及影响因素分析

Analysis of the High Risk Behaviors,HIV Infection and Related Factors among Men who Have Sex with Men in Yangzhou, Jiangsu

目的了解苏州市男男性行为者(MSM)艾滋病高危行为特征、感染情况及其影响因素。方法采用横断面调查,采取分类滚雪球抽样的方法于2008年5月起,对苏州市范围内的MSM人群就艾滋病(AIDS)知识态度、高危行为特征的面对面问卷调查结果 ,以及血样的艾滋病病毒(HIV)及其他性传播疾病(STD)感染的实验室检测数据进行统计分析。结果所调查280名MSM中,82.7%最近六个月发生过同性性行为,其中79.4%有多个同性性伴;48.7%曾与异性发生过性行为,其中21.2%有多个异性性伴;最近六个月与同性发生肛交性行为时坚持使用安全套的比例为52.0%,与异性发生性行为时该比例为21.2%。300名被调查者均采集血样进行了血清学检测,确证HIV阳性人数22人,阳性率为7.3%;确证梅毒抗体阳性人数为66人,阳性率为22.0%。在多因素logistic回归模型中,常通过互联网寻找性伴(OR=1.93,95%CI=1.01～3.67)、最近六个月曾与固定性伴发生性行为(OR=0.45,95%CI=0.25～0.79)与最近六个月同性性行为时安全套坚持使用率的关系有统计学意义;梅毒感染(OR=3.17,95%CI=1.25～7.99)与HIV感染的关系具有统计学意义。结论苏州市MSM人群无保护性性行为及多性伴现象较为普遍,HIV和梅毒感染率较高,需要进一步加强对该人群的行为干预以防止艾滋病在该人群中的蔓延以及传播至一般人群。

Objective To investigate the behaviors at high risk,HIV infections and related factors among men who have sex with men （ MSM） in Yangzhou. Methods A cross-sectional study with snowball sampling method was conducted from May 2008,the researchers carried out face to face questionnaire about the knowledge attitude and behavior on acquired immune deficiency syndrome（ AIDS ） among MSM ,blood samples were collected for test of human immunodeficiency virus（ HIV） and other sexually transmitted diseases（ STD ） infection. Results Among 300 respondents,82. 7% of them had homosexual acts in the past six months and 79. 4% had multiple homosexual partners; 48. 7% had heterosexual sex in the past six months and 21. 2% had multiple heterosexual partners. The pro- portion of condom continued use in homosexual sex in the past six months was 52. 0% ,while the proportion in heterosexual sex was 21. 2% . Laboratory test results showed that the prevalence of HIV infection was 7. 3% （ 22/300） and the prevalence of syphilis was 22. 0%（ 66/300） . In multiva- riate logistic regression model,looking for sex partners through the internet （ OR =1. 93,95%CI =1. 01 -3. 67） and having homosexual sex with regular partners（ OR = 0. 45,95% CI = 0. 25 - 0. 79） were significantly associated with the condom continued use in homosexual sex in the past six months; the infection of syphilis（ OR = 3. 17,95% CI = 1. 25 - 7. 99 ） was significantly associated with the HIV infection. Conclusion The unprotected sex and multiple sexual partners are more common among MSM in Yangzhou,furthermore,the prevalence of HIV infection and syphilis was relatively high,intervention of behavior on the target population must be strengthened to reduce the HIV spread in such population and to generalpopulation.