上海市MSM人群HIV和梅毒的感染率及其影响因素

HIV and syphilis prevalence among MSM in Shanghai and the associated risk factors

目的了解上海市男男性行为(Men who have sex with men,MSM)人群艾滋病病毒(Human immuno-deficiency virus,HIV)和梅毒的感染率及其影响因素。方法 2011年3-12月,对MSM人群开展一次大规模的横断面调查,调查内容包括人口学特征、艾滋病知识、性行为状况、既往性病史及接受HIV有关干预措施,采集血样标本进行HIV和梅毒抗体检测。结果对招募到的790名MSM进行问卷调查、HIV和梅毒抗体检测。HIV、梅毒及HIV和梅毒双重感染的感染率及95%可信区间(Confidence interval,CI)分别为7.59%(95%CI:5.74～9.44)、18.35%(95%CI:15.65～21.05)、2.15%(95%CI:1.14～3.16)。多因素Logistic回归显示,HIV感染的独立危险因素为:外地户籍、月收入<2 000元者、性伴数>3个、肛交时肛门或阴茎破损出血、既往有性病史、未接受过艾滋病自愿咨询检测、未检测过HIV抗体。结论上海市MSM人群的HIV及梅毒感染率较高,建议今后HIV预防控制工作中应强调同性和异性性行为时都坚持使用安全套,降低性伴数,推广艾滋病自愿咨询检测和HIV抗体检测,以控制性病在MSM人群中的传播。

Objective To assess the prevalence of HIV （human immunodeficiency virus） and syphilis infections among MSM （men who have sex with men） in Shanghai and the associated risk factors. Methods A cross-sectional study using non-probability sampling was conducted from March to December 2011. Participants were asked to complete a questionnaire with information of demographic characteristics, AIDS related knowledge, sexual behavior, f. history of STD （sexually transmitted diseases） and HIV prevention intervention received. Blood samples were taken for antibody testing for HIV and syphilis. Results A total of 790 MSIV were recruited and completed the questionnaire and sera test. The prevalence of HIV, syphilis,and both HIV and syphilis with 95% confidence interval （CI） were 7.59%（95% CI： 5.74-9.44）, 18.35% （95% CI： 15.65-21.0%） and 2.15% （95G CI： 1.14-3.16）,respectively. The multivariate logistics regression revealed that the independent risk factors associated with HIV infec tion were： non Shanghai residence, monthly income 〈2 000, sex partners 〉3, anus or penis lesion during anal sex, STD history, not seeking HIV voluntary counseling and testing （VCT）, and no HIV testing. Conclusion The prevalence of HIV and syphilis is high among MSM in Shanghai. It is suggested to promote condom use when hav ing sex with men and women, to decrease the number of sex partners, boost VCT and HIV test, and control STD transmission among MSM.