绵阳市MSM队列研究梅毒新发感染及影响因素

New syphilis infection and its influencing factors among MSM in Mianyang city:a cohort study

目的了解四川省绵阳市男男性行为者（MSM）梅毒新发感染情况及影响因素。方法 2009年6—9月采用同伴推动招募法（RDS）在绵阳城区招募调查符合条件梅毒检测阴性的MSM建立开放性前瞻队列,每年随访1次,连续3年。随访中不足基线调查样本部分结合滚雪球抽查法,依据纳入条件补充调查对象。结果研究期间共纳入队列583人,随访535.5人年,梅毒阳转30例,新发感染率5.6/100人年（95%CI=3.7/100人年~7.6/100人年）,近2年明显下降。多因素分析显示,婚姻状况（RR=2.377,95%CI=1.035~5.459）、艾滋病知识知晓（RR=4.278,95%CI=1.941~9.431）,近1年接受过同伴教育（RR=2.281,95%CI=1.081~4.815）,近6月诊断过性病（RR=4.743,95%CI=1.829~12.302）是梅毒新发感染的独立影响因素。结论绵阳市MSM人群梅毒新发感染有所下降,但感染率仍较高,受婚姻状况、艾滋病知识知晓、同伴教育和性病感染影响。

Objective To examine new syphilis infection and its influencing factors among men who have sex with men（MSM） in Mianyang city. Methods Respondent driven sampling was used to recruit MSM in Mianyang city from June to September 2009 and an open prospective cohort was established. Serological follow-up survey was conducted once a year for three consecutive years. Snowball sampling method was adopted to recruit MSM for the supplement of partici- pants lost to follow-up. Results During the study period,583 MSM were included in the cohort, with a total of 535.5 person-years of follow-up. Totally 30 new-syphilis infections were diagnosed and the new infection rate was 5.6/100 person-years（95% confidence interval[95% CI] ：3.7 -7.6/100 person-years）. Multivariate analyses showed that the influencing factors of new syphilis infection included marital status （ relative risk [ RR ] = 2. 377,95 % CI ： 1. 035 - 5. 459 ）, knowledge about AIDS （ RR = 4. 278,95 % CI： 1.941 - 9.431 ）, with peer education during last one year （ RR = 2. 281, 95 % CI： 1. 081 -4. 815 ）, and being diagnosed with sexually transmitted diseases （RR = 4. 743,95 % CI：1. 829 - 12. 302 ）. Conclusion New syphilis infection is relatively stable in local MSM population but still higher and affected by marital status,knowledge about AIDS,peer education and infections of KSTDs.