中国2010-2013年男男性行为人群艾滋病及相关行为变化趋势分析

Trend on HIV prevalence and risk behaviors among men who have sex with men in China from 2010 to 2013

目的：了解我国MSM人群HIV、梅毒感染状况、高危行为等变化趋势，为制定干预策略提供依据。方法2010-2013年，在哨点监测期内以重复横断面调查的方法对MSM人群进行监测，分析其人口学特征、高危行为状况、HIV和梅毒抗体阳性率水平及其变化趋势。结果2010-2013年共监测MSM 149848人。其中，12.3%来自浴池（A组）、30.1%来自网络招募（B组）、其他来源占57.5%（C组），历年样本来源构成相似。A组最近6个月肛交性行为时坚持使用安全套的比例最低，从2010年的30.2%上升至2013年的37.8%，B组从34.7%上升至42.9%，C组从35.3%上升至43.1%，趋势检验P＜0.01。HIV抗体阳性率A组最高，分别从2010年的7.8%上升至2013年的9.2%、B组从5.0%上升至6.8%、C组从5.6%上升至6.5%，趋势检验P＜0.01；梅毒抗体阳性率A组最高，分别从2010年的13.2%下降至2013年的9.5%、B组从6.1%下降至5.7%、C组从8.7%下降至6.2%，趋势检验P＜0.01。监测对象中，21～40岁年龄组占77.1%，41～50岁占9.4%，＞50岁占2.8%。＞50岁年龄组的HIV和梅毒抗体阳性率均最高，分别为10.1%和13.6%。结论近年来MSM人群HIV感染状况上升趋势明显。其中，来自浴池和高年龄组MSM的HIV感染状况更为严重，应重点对该两组MSM人群有效干预。

Objective To understand the trends on HIV and syphilis infections,as well as on risk behaviors and intervention among MSM in China from 2010 to 2013 so as to provide information for the development of intervention strategies for MSM. Methods Study population involved MSM who were recruited for the national HIV sentinel surveillance between 2010 and 2013. Demographic information,HIV related risk behaviors,and results on HIV and syphilis infections were described and trend analysis was performed. Results Between 2010 and 2013,the total number of MSM under survey was 149 848. As for sources of the studied population,12.3% of them were from public bathrooms （Group A）,30.1% from internet （Group B）,and 57.5% were others （Group C）. Proportions of three groups were similar between 2010 and 2013. The proportion of always using condom in the last six months increased from 30.2%to 37.8%,from 34.7%to 42.9%and from 35.3%to 43.1%in group A,B or C（ trend：P〈0.01）,from 2010 to 2013. The proportion of using condom in group A was the lowest among the three groups. The prevalence rate of HIV increased from 7.8%in 2010 to 9.2%in 2013 among group A,from 5.0%in 2010 to 6.8%in 2013 among group B,from 5.6%in 2010 to 6.5%in 2013 among group C（trend：P〈0.01）. The prevalence rate of syphilis decreased from 13.2% in 2010 to 9.5% in 2013 among group A,from 6.1% in 2010 to 5.7% in 2013 among group B,from 8.7% in 2010 to 6.2% in 2013 among group C （trend：P〈0.01）. In this MSM population,77.1%of them were at age 21-40,9.4%were at age 41-50 and 2.8%were older than 50 years of age. Both the prevalence rates of HIV and syphilis were the highest-10.1%and 13.6%,among age group of over 50s,respectively. Conclusion HIV prevalence among MSM increased rapidly in the last four years,especially in older age groups and from public bathrooms. More intervention efforts should be targeting on MSM with the above mentioned characters.