温州市主动求询男男性接触者人群HIV感染状况和影响因素分析

HIV infection and its influencing factors among MSM undergoing VCT in Wenzhou city

目的了解温州市主动到艾滋病自愿咨询检测门诊（voluntary counseling and testing,VCT）求询的男男性接触者（men who have sex with men,MSM）人群艾滋病病毒（human immunodeficiency virus,HIV）感染状况及其影响因素,为今后制定防控措施提供依据。方法对2011-2013年主动到温州市所有VCT门诊接受咨询检测的MSM人群的基本信息及检测情况进行统计分析,描述性分析MSM人群的人口学特征,高危行为特点及HIV感染情况,χ2检验、多因素非条件logistic回归分析不同人口学特征人群的HIV感染率差异,P〈0.05为差异有统计学意义。结果本研究中1 600名主动求询MSM中青壮年占85.38%（1 366/1 600）,未婚占65.19%（1 043/1 600）,高中及以上占67.00%（1 072/1 600）。近3年HIV抗体阳性检出率为8.69%,总体呈现出上升趋势;梅毒阳性检出率为4.31%。单因素分析显示,年龄（χ2=7.16,P=0.03）、婚姻状况（χ2=6.34,P=0.04）、文化程度（χ2=8.16,P〈0.01）、既往接受HIV检测（χ2=10.00,P〈0.01）、梅毒感染（χ2=12.24,P〈0.01）与HIV感染相关。多因素logistic回归分析显示,文化程度高中及以上HIV感染风险较初中及以下的低（OR=0.64,95%CI：0.45~0.91）;既往有接受过HIV检测比未接受过检测者感染HIV的风险高（OR=1.64,95%CI：1.15~2.34）;梅毒感染可以增加HIV感染的风险（OR=2.38,95%CI：1.27~4.45）。结论温州市主动求询MSM人群中HIV抗体阳性检出率较高,应该充分利用VCT点的窗口作用,对MSM人群开展有效、深入的咨询检测服务和人文关怀,降低MSM人群HIV感染的风险。

Objective To understand HIV infection and its influencing factors among men who have sex with men（MSM）undergoing HIV voluntary counseling and testing（VCT）in Wenzhou,and to provide evidence for developing future prevention and control strategies. Methods Data including basic information and laboratory testing information of MSM who underwent VCT services in VCT clinics in Wenzhou from 2011 to 2013were collected and analyzed.Chi-square test and multivariate logistic regression analysis were used for data statistical analysis. Results A total of 1 600 MSM were enrolled in the study and 85.38% were young adults,unmarried MSM accounted for 65.19%and 67.00% had high school and above diplomas.The positive rate of HIV antibody was 8.69%in recent three years with an upward trend in general.The positive rate of syphilis was 4.31%.Single factor analysis showed that age（χ2=7.16,P=0.03）,marital status（χ2=6.34,P=0.04）,education（χ2=8.16,P0.01）,HIV testing history（χ2=10.00,P0.01）and syphilis infection（χ2=12.24,P0.01）were associated with HIV infection.Multivariate logistic regression analysis revealed MSM with high school and above diplomas（OR=0.64,95%CI：0.45-0.91）and not receiving HIV testing（OR=1.64,95%CI：1.15-2.34）were less likely to get HIV infection.While,those with syphilis infection were at high risk（OR=2.38,95% CI：1.27-4.45）. Conclusions The positive rate of HIV antibody among MSM undergoing VCT is relatively high in Wenzhou.Therefore,VCT service should be expanded among MSM to decrease the risk of HIV infection.