中国大陆MSM人群HIV/梅毒感染状况性行为特征和艾滋病知识知晓情况的Meta分析

HIV/syphilis infections,sexual behaviors and awareness of HIV/AIDS knowledge among men who have sex with men in the mainland of China: A Meta-analysis

目的了解2005-2011年中国大陆男男性行为人群(MSM)的艾滋病病毒(HIV)和梅毒感染状况、性行为特征、艾滋病知识知晓的总体及随时间和地区分布的情况。方法通过相应检索策略查找2005年至2011年期间针对该人群的HIV/梅毒感染率、性行为特征和艾滋病知识知晓率的调查文献,对其进行数据提取并建立数据库后进行Meta分析。结果共有82篇文献入选。2005-2011年,中国大陆MSM人群合并HIV感染率为4.4%[95%可信区间(CI):3.8%～5.0%],合并梅毒感染率11.1%(95%CI:9.7%～12.4%)。在各地区中,西南地区合并HIV感染率(12.1%)和合并梅毒感染率(10.6%)较高。近6个月性行为特征呈高肛交发生率(81.7%),高多性伴发生率(59.7%)和低肛交坚持使用安全套率(37.9%)。但是,该人群有较高的艾滋病知识知晓率(87.9%)。结论就现有发表文献而言,2006-2010年中国大陆MSM人群HIV和梅毒感染率较高,特别是在西南地区。该人群虽有较高的艾滋病知识知晓率,但是高危性行为仍普遍发生,亟需针对该高危人群将艾滋病防控与梅毒防控有机结合,并采取有效的综合干预措施。

Objective To explore the overall situation of HIV and syphilis infections,sexual behaviors,awareness of HIV/AIDS knowledge and the distribution of the infections in different time frames and regions among men who have sex with men（MSM） in the mainland of China in 2005-2011.Methods All the published data from surveys conducted among MSM in the mainland of China in 2005-2011 were searched and tabulated.Meta-analysis was performed to the obtained overall estimated variables on HIV/syphilis infections,sexual behaviors and awareness of HIV/AIDS knowledge.Results Eighty two studies were selected.Between 2005 and 2011,pooled infection rates of HIV and syphilis among MSM in the mainland of China were 4.4% [95% confidence interval（CI）： 3.8%-5.0%] and 11.1%（95%CI： 9.7%-12.4%）,respectively;pooled infection rates of HIV（12.1%） and syphilis（10.6%） in southwest regions were relatively higher;sexual behaviors in the past 6 months were characterized with high rates of anal sex（81.7%） and multiple sex partners（59.7%） and low rate of consistent condom use（37.9%）.However,high awareness rate of HIV/AIDS knowledge（87.9%） was found in this population group.Conclusion According to the published data,the prevalence of HIV and syphilis infections was high among MSM in the mainland of China in 2005-2011,especially in the southwest regions.Although with high rate of awareness of HIV/AIDS knowledge,risk sexual behaviors are still prevalent among this population group.Combining HIV/AIDS control with syphilis control,more efficient comprehensive interventions are required urgently to target this population group.