绵阳市男男性行为者性行为和HIV感染及影响因素分析

Investigation on the Sexual Behavior and HIV Infection Among MSM in Mianyang City and Analysis of the Influencing Factors

目的 了解绵阳市男男性行为者（MSM）性行为和艾滋病病毒（HIV）感染及影响因素. 方法 对2009年建立的MSM人群开放性研究队列在2010年随访调查基础上进行随访调查,对随访不足基线调查样本部分,采用滚雪球采样法,依据队列纳入条件,招募补足调查对象,进行相关行为学和血清学调查. 结果 共调查405人,近6月87.2％发生过男性肛交,平均（2.4±3.2）人次,3.5％发生过男性商业性性行为、16.3％发生过女性性行为.近1次/近6月男性、商业、女性性行为安全套每次使用率分别为83.1％/56.5％、92.9％/92.9％、46.2％/26.2％,差异有统计学意义（x2=45.221/72.183,P均=0.000）.血清学检测显示,HIV确证感染率6.4％,新发感染率5.8/100人年；梅毒累计感染率21.2％,现症感染率9.1％,新发感染率4.1/100人年；丙肝感染率0.5％,新发感染率0.4/100人年.多因素分析显示近1年接受预防性服务（OR=0.038）、微博获取防艾信息（OR=0.148）、近6月男性肛交人数（OR=4.152～～ 15.306）、感染梅毒（现症感染）（OR=9.709）是HIV感染独立影响因素,接受过预防性服务、通过微博获取防艾信息者感染风险较低,肛交数较多、梅毒感染者风险较高. 结论 绵阳市MSM人群性行为多样,高危行为较普遍,HIV感染率较高,与预防性服务、性行为和梅毒感染相关,应针对性加大防治力度.

Objective To learn the sexual behavior and HIV infection among MSM in Mianyang City and analyze the in- fluencing factors. Methods The follow- up investigation in 2010 was launched on the basis of the open- label study cohort of MSM which was established in 2009. For the follow - up with sample size less than that of the baseline survey, investigation objects were recruited for complement according to the queue inclusion criteria and by snowball sampling method. Related behav- ioral and serological surveys were launched. Results A total of 405 MSM were investigated. In the past six months, 87.2% of them had male anal sex, with an average of 2.4 _＋ 3.2 times per person. 3.5 % had commercial male sexual behavior, and 16.3 96 had female sexual behavior. The condom utilization rates for male, commercial and female sexual behavior in the last sex- ual behavior/past 6 months were respectively 83.1%/56.5 %, 92.9 %/92.9 % and 46.2 %/26.2 %. The differences were statis- tically significant （X2 = 45. 221/72. 183, P = 0. 000）. Serological tests showed that HIV confirmatory infection rate was 6.4 % and newfound infection rate was 5.8/100 person - year. Syphilis had an accumulative infection rate of 21.2 %, a present infection rate of 9.1%, and newfound infection rate of 4.1/100 person-year. The infection rate of hepatitis C was 0.5 % and the new- found infection rate were 0.4/100 person - year. Multivariate analysis indicated that receiving preventive services in the recent year （ OR = 0. 038）, getting AIDS prevention information by microblog（ OR = 0. 148）, the number of partners for male anal sex in recent six months （ OR = 4.152 - 15. 306）, present infection with syphilis （ OR = 9. 709 ） were independent influencing fac- tors of HIV infection. Those who had received preventive services in recent year and who got AIDS prevention information by mi- eroblog were at lower risk to get infected. However, those who had more anal sex and who got infected with syphilis were at higher risk. Conclusions Sexual behavior is diverse among MSM in Mianyang City. High - risk behavior is popular. The high HIV infection rate is associated with preventive services, sexual behavior and syphilis infection. Targeted prevention efforts should be strengthened.