2010—2013年云南省曲靖市男男性行为人群艾滋病哨点监测分析

Sentinel surveillance for AIDS in men who have sex with men in Qujing,Yunnan,2010-2013

目的分析云南省曲靖市男男性行为者（MSM）艾滋病性病流行趋势、干预服务及相关行为变化情况。方法 2010—2013年,采用滚雪球的方法招募样本,对招募到的MSM开展行为学问卷调查,并进行艾滋病病毒（HIV）、丙型病毒性肝炎病毒（HCV）和梅毒抗体检测。结果共监测400人,艾滋病知晓率为72.0%-76.0%;HCV阳性率为0-1.0%;HIV阳性率为1.0%-10.0%,各年度差异有统计学意义（χ^217.447,P=0.039）;梅毒阳性率为0-6.0%,各年度差异有统计学意义（χ^2108.00,P〈0.01）;最近一次同性商业性行为安全套使用率为50.0%-80.0%;最近一次同性肛交安全套使用率（86.0%-100.0%）和最近一次异性性行为安全套使用率（31.9%-95.2%）各年度差异有统计学意义（χ^228.999,P〈0.01;χ^223.451,P〈0.01）。干预服务接受率（89.0%-100.0%）和同伴教育接受率（77.0%-99.6%）各年度差异有统计学意义（χ^225.681,P〈0.01;χ^236.779,P〈0.01）。结论曲靖市MSM艾滋病知晓率较低,HIV和梅毒阳性率较高,应继续加强健康教育和干预服务。

Objective To understand the prevalence of AIDS and related risk behaviors in men w ho have sex w ith men（ MSM） in Qujing,Yunnan province. Methods During 2010-2013,MSM were recruited by snowball sampling,and a questionnaire survey w as conducted among them. Blood samples w ere taken from them for HIV,HCV and syphilis tests. Results A total of 400 M SM w ere surveyed. The aw areness rate of AIDS related know ledge ranged from 72% to76%. The HCV positive rate ranged from 0 to 1%. The HIV positive rate ranged from 1% to 10%,the differences in annual positive rate w ere significant（ χ^2 17. 447,P = 0. 039）; The syphilis positive rate ranged from 0 to 6%,the differences in annual positive rate w ere significant [Var（ lnRR） = 108. 00,P〈0. 01]. The condom use rate ranged from50% to 80% in recent commercial homosexual behavior. The condom use rate ranged from 86% to 100% in recent anal homosexual behavior and ranged from 31. 9% to 95. 2% in recent heterosexual behavior,the differences in annual condom use rate w ere significant（ χ^2 28. 999,P〈0. 01; χ^2 23. 451,P〈0. 01）. The acceptance rates of intervention services and peer education ranged from 89% to 100% and from 77. 0% to 99. 6% respectively,the differences in annual acceptance rate w ere significant（ χ^2 25. 681,P〈0. 01; χ^2 36. 779,P〈0. 01）. Conclusion It is necessary to strengthen the health education and intervention services among M SM to increase the AIDS related know ledge aw areness and reduce the HIV infection and syphilis prevalence among them.