深圳市MSM人群的HIV感染状况及相关危险因素

Prevalence of HIV infection and related risk factors of MSM by RDS survey in Shenzhen city

目的了解深圳市男男性行为人群（MSM）艾滋病病毒（HIV）感染状况及其行为特征，分析其影响因素，为制定针对性干预策略提供建议。方法应用同伴推动抽样法招募MSM，采用电脑辅助自填问卷形式进行调查，采血检测HIV和梅毒抗体。使用RDSAT软件进行统计分析。结果调查的492名MSM，HIV阳性率为4．6％[95％可信区间（CI）：2．59％～6．7％]，梅毒患病率为16．4％（95％CI：11．9％～21．0％）。平均年龄为（27．2±6．3）岁，初中以上文化占98．4％，该市户籍占8．5％，60％以上通过互联网寻找性伴，最近半年内平均男男性伴数为2．37个，32．2％的调查对象最近6个月男男性行为时未能使用安全套。艾滋病基本知识知晓率仅为61．1％，安全套使用知识知晓情况也较差，仅为55．7％。Logistic回归分析结果显示，在深圳居住小于3个月、已婚、来自HIV高流行地区、有超过一个非商业男性性伴，是MSM感染HIV的危险因素；最近6个月内获得过艾滋病相关服务，是感染HIV的保护因素。结论需进一步加强MSM中HIV监测和干预工作，有效阻断HIV传播和蔓延。

Objective To understand the characteristics of high-risk behavior and human immunodeficiency virus （HIV） infection among men who have sex with men （MSM） in Shenzhen city, analyze related risk factors and pro- vide information for further intervention. Methods A computer-assist personal interview was conducted among MSM recruited by using respondent driven sampling （RDS）. HIV and syphilis antibodies in serum were tested. Da- ta were analyzed by software RDSAT. Results Of 492 MSM subjects, the positive rates of HIV and syphilis were 4.6%（95%CI 2.59%-6.7%） and 16.4% （95%CI 11.9%-21.0%）, respectively. The average age of the sub- jects was 27.2±6.3 years. Nearly all of the MSM （98.4%） had received at least a junior high school education 8.5% of the participants were native residents of Shenzhen. More than 60% of participants typically met their sex partners through internet. The average number of male sex partners within the previous 6 months was 2.37. 32.2% reported that they had male-to-male anal sex without using condom within the past 6 months. The awareness rate of AIDS-related knowledge was only 61.1%. Their knowledge rate of using condom was also low, 55.7%. The re- sults of multivariate logistic regression analysis showed that staying in Shenzhen for less than 3 months, being mar- ried, coming from high HIV prevalence areas, having more than one non-commercial male sex partners were risk factors for HIV infection, while receiving HIV-related services in the previous 6 months was a protective factor. Conclusion Further countermeasures for HIV/STD monitoring and prevention should be explored to prevent HIV spreading in MSM.