西安市男男性行为人群艾滋病感染状况及影响因素分析

Prevalence and risk factors of HIV infection among MSM in Xi'an City

目的对2013年西安市男男性行为人群(men who have sex with men,MSM)专题流调数据进行分析,了解该人群艾滋病病毒(human immunodeficiency virus,HIV)、梅毒(syphilis)、丙型肝炎病毒(hepatitis C,HCV)感染状况,分析HIV感染危险因素,为制定有效干预策略提供依据。方法通过横断面调查的方法,对600名MSM进行行为学调查及血清学检测,通过单因素x2及多因素Logistic回归分析HIV感染危险因素。结果调查对象平均年龄(28.57±7.02)岁,以汉族为主;艾滋病(acquired immune deficiency syndrome,AIDS)知识知晓率77.67%;最近6个月发生同性肛交比例为78.33%,最近1次肛交安全套使用率为78.30%;最近6个月同性商业性行为比例为6.00%,最近1次同性商业性行为安全套使用率为88.89%;HIV检出率9.17%,HIV确证阳性率4.17%,梅毒检出率4.83%,丙肝检出率0.50%。单因素分析显示,样本来源、文化程度、最近1年是否患性病3个因素对MSM感染HIV的影响均有统计学意义(均有P<0.05);多因素分析显示,文化程度高是MSM感染HIV的保护因素,最近1年患性病感染HIV的风险是未患性病的2.53倍,梅毒检测结果为阳性感染HIV的风险是梅毒阴性的3.17倍。结论西安市MSM人群HIV感染情况相当严峻,应在各类MSM活动场所继续扩大宣传力度,推广安全套使用,加强完善性病诊疗服务,以控制HIV在该人群中的传播。

Objective To analyze the data of Xi＇an MSM HIV specific survey in 2013,to investigate the prevalence of HIV / Syphilis / HCV,and to explore the risk factors,so as to provide evidence for making effective prevention strategies. Methods Cross-sectional sentinel survey was performed among 600 MSM to collect behavior and serological test data. The risk factors were analyzed with single χ^2 test and multiple Logistic regressions. Results Average age of the MSM was（ 28. 57 ± 7. 02） years,mainly Han. Awareness rate of HIV / AIDS knowledge was 77. 67%. During the past 6months,78. 33% of the MSM had anal sex and 78. 30% used condom in the last anal sex,6. 00% had commercial sex with men and 88. 89% used condom in the last commercial sex with men. HIV / confirmatory HIV / Syphilis / HCV infection rate was 9. 17%,4. 17%,4. 83% and 0. 50%,respectively. Single factor analysis showed that sample source,education level and Venereal disease during the past year were risk factors of HIV infection. The results of multivariate analysis showed that education level was the protective factor. The risk of having venereal disease during the past year was 2. 53 times. And syphilis positive was 3. 17 times dangerous than negative. Conclusions HIV infection among MSM in Xi＇an is quite serious. Publicity and education should be expanded,and condom use should be promoted persistently. STD preventive services need to be strengthened to control the spread of HIV in the population.