绵阳市820名MSM HIV/梅毒感染现状及影响因素分析

An analysis of the influencing factors of HIV/syphilis infections among 820 MSM in Mianyang

目的进一步了解绵阳市男男性行为人群(MSM)艾滋病病毒(HIV)等相关性病的感染现状及影响因素。方法在绵阳市5县1市2区,经知情同意,在固定场所采用滚雪球抽样法招募MSM,进行自填式匿名问卷调查和HIV等血清学检测。结果在问卷调查合格的820人中,近1年报告被诊断过性病的占4.6%(38/820),HIV初筛阳性率7.4%(61/819),确证阳性率5.9%(48/819),既往阳性率1.0%(8/819)。初筛阳性追踪到位率78.7%,失访率21.3%;失访原因为不愿意复查和电话不通各占38.5%,外出占23.0%。单因素分析显示:婚姻状况、本地居住时间、近6个月肛交保护性、HIV知识知晓,近1年接受过安全套宣传和发放/艾滋病咨询与检测、接受过同伴教育、做过HIV检测、梅毒感染与HIV感染相关。多因素分析表明,最终HIV感染的独立影响因素有:婚姻状况[比值比(OR)=4.644]、近1年做过HIV检测(OR=5.228)、HIV知识知晓(OR=16.180)、近1周肛交次数(OR=2.322);梅毒的独立影响因素有:年龄(OR=0.449～0.337)、HIV知识知晓(OR=4.693)。离异/丧偶、近1年未做过HIV检测、近1周肛交次数≥2次、年龄较大、不知晓HIV知识者梅毒感染危险性较大。结论绵阳市MSM人群HIV感染率较高,受婚姻状况、知识知晓、HIV检测和性行为频次等的影响。

Objective To understand the current situation of human immunodeficiency virus （HIV） and related venereal disease infections among men who have sex with men （MSM） in Mianyang and analyze the influencing factors. Methods MSM were recruited from five counties, one county-level city and 2 districts of Mianyang through snowball sampling in fixed places, and anonymous self-administration questionnaire survey and blood testing were conducted. Results Eight hundred and twenty subjects were surveyed, of whom 4. 6%（38/820） were diagnosed as venereal diseases in the last year, 7.4 % （61/819） were positive in the first round of H IV blood testing, and 5.9 % （48/819） were finally confirmed positive. The follow up rate of the positive cases in the first round of HIV blood testing was 78. 7%, the rate of dropping out was 21.3%, and the cause of dropping out was unwillingness to take reexamination, failure to answer the phone （38.5% respectively）, and being out of town（23.0%）. Single factor analysis showed that marital status, time length of staying in Mianyang, having protected anal sex in the last six months, awareness of HIV knowledge, receiving condom use education and distributed condoms and taking HIV counseling and testing in the last year, availability to peer education and taking HIV blood tests were factors affecting syphilis/HIV infections. Multifactor analysis revealed that syphilis infections were related with age, education background, marital status and awareness of HIV knowledge （P〈0.05）. The final independent influencing factors of HIV infections included., marital status [odds ratio （OR） = 4. 644 ], taking HIV blood test in the last year（OR= 5. 228）, awareness of HIV knowledge（OR= 16. 180）, frequency of anal sex in the last week（OR=2. 322）, while the independent influencing factors of syphilis infections included： age （OR=0. 449-0. 337）, rate of awareness of HIV knowledge （OR=4. 693）, being divorced or widowed, not taking HIV blood test in the last year, unawareness of HIV knowledge, and having anal sex ≥2 times in the last week, and those who were older and lacked HIV knowledge were high risks to syphilis infections. Conclusion The infection rate of HIV among MSM in Mianyang is relatively high, which is influenced by marital status, HIV knowledge, HIV testing, and the frequency of sex activities.