中山市2010-2014年男男性行为人群HIV感染率及相关因素

Analysis of the HIV infection and its related behaviors among men who have sex with men in Zhongshan City( 2010-2014)

目的获得中山市男男性行为人群HIV感染率,影响因素及流行趋势,为制定有针对性的干预策略提供依据。方法采用滚雪球抽样法招募MSM进行调查及HIV、梅毒血清学检测。采用SPSS分析数据。结果中山市2010-2014年MSM的HIV感染率分别为10.00%（21/210）、12.56%（27/215）、15.71%（44/280）、11.93%（34/285）和12.35%（31/251）;梅毒TRUST阳性者的HIV感染率为20.41%（30/147）,是梅毒阴性者HIV感染率11.61%（127/1 094）的1.76倍（95%CI：1.23~2.52）;艾滋病知晓率为83.58%~90.95%;最近半年与同性肛交每次均使用安全套的比例为43.58%~57.42%。多因素Logistic回归模型提示,初中及以下文化程度、本地居住时间〈3个月者具有更高的HIV感染率（AOR分别为2.51和1.72,95%CI分别为：1.52~4.13和1.03~2.89）;知晓艾滋病知识、最近一年接受过HIV检测者具有更低的HIV感染率（AOR分别为0.62和0.54,95%CI分别为0.40~0.97和0.37~0.78）。结论中山市MSM艾滋病流行形势严峻,人口流动对其流行具有重要影响。应加强低文化程度者的综合干预,推动更多的MSM接受HIV检测。

Objective To understand the HIV infection rate, its influencing factors and epidemic trends among men who have sex with men （MSM） in Zhongshan City. Methods MSM were recruited through snowball sampling for questionnaire surveys and serologic testing of HIV and syphilis. Results From 2010 to 2014, the HIV infection rates among MSM were 10. 00% （21/210）, 12. 56% （27/215） , 15.71% （44/280） , 11.93% （34/285） , and 12. 35% （31/251） respectively. The HIV infection rates among those with syphilis sero-positive tests were 20. 41% （30/147）, which was 1.76 times （RR = 1.76, 95% CI： 1.23 -2. 52） higher than those with syphilis sero-negative tests （11.61%, 127/1 094）; the HIV awareness rate among MSM ranged from 83.58% to 90. 95% ; for those who had anal sex during the last 6 months, the proportion of consistent condom use ranged from 43.58% to 57. 42%. Multivariate analysis indicated that the risk of HIV infection was higher in subjects with a middle school education or less （AOR =2. 51, 95% CI： 1.90 -5.70）. Those who lived in Zhongshan for less than 3 months were more likely to be HIV sero-positive （AOR = 1.72, 95% CI： 1.03 -2. 89）. MSM who were aware of HIV were less likely to be HIV sero-positive （AOR =0. 62, 95% CI： O. 40 -0. 97） , and those with HIV test history in the last year were also less likely to be HIV sero-positive （AOR = 0. 54,95% CI： O. 37- 0. 78 ）. Conclusion The HIV epidemic among MSM in Zhongshan was serious, and migration played an important role. Comprehensive intervention should be strengthened among those with lower education levels and HIV testing should be promoted to more MSM.