南阳市MSM人群HIV新发感染情况研究

Study on incidence of new HIV infection among men who have sex with men in Nanyang

目的了解南阳市男男性行为(MSM)人群艾滋病病毒(HIV)新发感染情况及影响因素。方法采用动态队列研究的方法,于2010-2011年间建立MSM队列,对入组时HIV抗体阴性者每半年随访1次,收集HIV检测结果及其行为学信息。采用Cox比例风险模型进行HIV新发感染的单因素和多因素分析。结果南阳市429例MSM队列成员中,有20例新发HIV感染,2010-2011年总的HIV新发感染率(发病密度)为3.41/100人年。两年间4次随访的HIV新发感染率有所上升,依次为2.06/100人年、0.71/100人年、3.44/100人年和6.29/100人年。Cox回归多因素分析表明,少数民族[相对危险度(RR):4.91,95%可信区间(CI):1.04～23.17,P=0.04]、月收入≥2 000元(RR:7.99,95%CI:2.01～31.77,P<0.01)、性取向为同性(RR:3.16,95%CI:1.09～9.14,P=0.03)、近半年与男性发生肛交性行为从未使用安全套(RR:4.96,95%CI:1.10～22.42,P=0.04),是当地MSM人群HIV新发感染的影响因素。结论南阳市MSM人群HIV新发感染呈上升趋势,今后应考虑加强以关注同志场所和安全套使用为主的干预措施。

Objective To study the human immunodeficiency virus （HIV） incidence among men who have sex with men（MSM） in Nanyang. Methods A dynamic cohort of MSM was established from 2010 to 2011. During this period, the enrolled HIV negative respondents were followed up every six months for their HIV testing results and related behavioral information, and univariate and multivariate analysis associated with new HIV infections was con ducted by using Cox proportional hazard regression model. Results Among 429 MSM in Nanyang, 20 cases of new HIV infection were identified, with a total of HIV incidence density of 3.41 per 100 person years in 2010-2011. HIV incidence density of four follow-ups within the two years increased from 2.06, 0.71, 3.44 to 6.29 per 100 person-years. As was showed by multivariate Cox regression analysis, the following factors associated with new HIV infections among MSM in Nanyang were ethnic minorities （RR：4.91,95 %CI： 1.04-23.17, P = 0.04）, monthly income RMB≥2000 yuan （RR：7.99,95%CI：2.01-31. 77,P〈0.01）, self-identified gay （RR：3.16,95%CI;1.09--9.14, P=0.03）, never using a condom in anal sex with men in the past 6 months （RR：4.96,95 ~/ooCI：1.10-22.42, P=0.04）. Conclusion The trend of HIV new infection among MSM in Nanyang has been deteriorating, so HIV intervention measures directed towards gay venues and condom use promotion should be intensified.