北京市男男性行为者HIV新发感染率及影响因素研究

Study on the incidence of HIV and associated risk factors through a prospective cohort among men who have sex with men in Beijing, China

目的了解北京市男男性行为者（MSM）H1V血清抗体阳转率的动态变化情况及影响因素。方法2009年8—12月在北京市招募962名MSM，其中809名HIV阴性进入队列，每6个月随访检测HIV抗体，并进行体检和行为学问卷调查。结果在招募的962名MSM中，HIV感染率为6．34％（61／962）。对809名HIV阴性者在第6、12和18个月随访时，队列保持率分别为95．1％（769／809）、85．5％（692／809）、71．0％（574／809）；HIV血清抗体阳转者分别为19、29和17例；HIV新发感染率分别为5．47／100人年、12．37／100人年、6．86／100人年。18个月随访期间的HIV新发感染率为7．59／100人年。多因素Cox回归模型分析显示，年龄≤25岁（HR=2．32，95％CI：1．39—3．87）、认识圈内的朋友数〉8个（朋=2．50，95％CI：1．49～4．20）、月经济收入〈2000元（HR=1．76，95％CI：1．06～2．95）、最近6个月男男性行为人数〉4人（HR／3．50，95％CI：2．11～5．81）、体检包皮为包茎或包皮过长或较长者（HR=2．47，95％CI：1．50—4．07）和梅毒检测结果阳性（HR=2．62，95％CI：1．53～4．49）同HIV新发感染的差异有统计学意义。结论北京市MSM中HIV新发感染率较高，提示该人群中HIV在快速传播。

Objective To investigate the dynamic change and associated risk factors of HIV sero-conversion rate in Beijing. Methods 809 sero-negative men who have sex with men （MSM） were recruited in the cohort from August to December in 2009. HIV sero-antibody, medicinal examination and behavior questionnaire interview were carried out every six months. Results 962 MSM with overall baseline prevalence of HW infection as 6.34% （61/962） together with 809 sero- negative MSM, were enrolled in the cohort. Of the 809 sero-negative participants, 95.1% （769/809）, 85.5%（692/809） and 71.0%（574/809） of them were retained in the 6-month, 12-month and 18- month follow-up visits, with 19,29 and 17 of them became HW sero-conversion at 6-month, 12-month, and 18-month follow-up visits and the HIV incidence rates appeared to be 5.47, 12.37 and 6.86 per 100 person-years respectively. The HIV incidence was 7.59 per 100 person-years in the 18 months follow-up visit. Factors including：younger than 25-years old （HR=2.32,95%C1： 1.39-3.87）, having more than 8 MSM partners （HR=2.50, 95%CI： 1.49-4.20）, less than RMB 2000 Yuan every month income （HR----- 1.76,95%CI： 1.06-2.95）, having more than 4 homosexual partners in the last six months （HR=3.50, 95%CI： 2.11-5.81 ）, showing phimosis and redundant prepuce （HR=2.47,95%CI： 1.50-4.07） as well as positive syphilis test （HR=2.62, 95% CI： 1.53-4.49） etc., were significantly associated with HIV incidence. Conclusion High HIV incidence was shown among MSM in Beijing and had spread fast in this population, calling for more favorable prevention measures to be taken.