天津市2008-2011年MSM人群HIV流行趋势分析

An analysis of epidemic trend of HIV infection among MSM from 2008 to 2011 in Tianjin

目的了解天津市2008-2011年男男性行为人群(MSM)艾滋病病毒(HIV)的流行趋势,为在该人群中开展相关控制措施提供依据。方法分析2008-2011年天津市监测中新发现的MSM中的HIV/艾滋病(AIDS)病例情况、MSM人群血清学监测的数据以及横断面调查数据。结果新发现HIV/AIDS病例中,MSM病例所占比例最高,2008-2011年病例报告显示的构成比及报告数量增长最快的传播途径是男男性传播。MSM病例中流动人口占53.3%,未婚占61.0%,高中及以上文化程度占69.6%,15～29岁占47.2%。无偿献血及自愿咨询和检测发现的阳性病例中,MSM所占的比例最高。血清学监测结果显示,天津市MSM人群HIV感染率维持在稳定水平。横断面调查结果显示,MSM近6个月发生同性性行为时每次都使用安全套构成的中位数为35.85%,近6个月中最近1次发生同性性行为时安全套使用率中位数为59.55%,近6个月与异性发生性行为比例的中位数为18.05%,梅毒检出的中位数为18.25%,HIV检出的中位数为6.25%。结论 MSM人群为天津市HIV/AIDS感染的主要人群,艾滋病流行趋势严重,危险行为普遍存在,急需采取有效措施控制HIV通过其传播及扩散。

Objective To analyze the epidemic characteristics of HIV/AIDS among men who have sex with men （MSM） from 2008 to 2011 in Tianjin,so as to provide evidence for the development of prevention and control measures. Methods The data of the newly reported cases of HIV/AIDS, serological surveillance among MSM and the cross-sectional surveys of MSM from 2008 to 2011 were analyzed. Results The cases of MSM accounted for the highest proportion among the newly reported cases of HIV/AIDS from 2008 to 2011. The proportion of MSM transmission was high and the increase of cases of MSM transmission was the fastest in comparison with that of other routes of transmission. Among the cases of MSM transmission, the floating population accounted for 53.30%, unmarried individuals accounted for 61.0%, those with high middle schooling or above accounted for 69.6%, and those aged 15-9 years accounted for 47.2%. Among the newly reported cases detected from unpaid blood donors and VCT services, those of MSM transmission accounted the highest proportion. Serological surveillance showed that the rate of HIV infection remained at a high level among MSM in Tianjin. Meanwhile, cross-sectional surveys showed that among the MSM 35.85 % （median） used condom consistently when having sex with men in the last six months, and 59.55% （median） used condom in the last sexual behavior with men, and 18.05% （median） had heterosexual behaviors in the past 6 months. The detection rate of syphilis was 18.25M （median）, while that of HIV infection was 6.25% （median）. Conclusion MSM is the main population of HIV/AIDS infection in Tianjin, and the epidemic of HIV/AIDS among them is becoming serious. The HIV infection related risk behavior is common a- mong MSM, therefore, effective measures should be taken to control and prevent HIV/AIDS spreading.