常州市不同样本来源男男性行为者哨点监测结果分析

Analysis of samples from different sources in sentinel surveillance among men who have sex with men in Changzhou

目的了解常州市不同样本来源男男性行为者(MSM)艾滋病感染状况和高危行为特征,为制定艾滋病防治策略提供参考依据。方法根据《全国艾滋病哨点监测方案》要求,对常州市酒吧招募的264名MSM和自愿咨询检测门诊(VCT)招募的224名MSM进行问卷调查和血清学检测。结果门诊组最近6个月与同性肛交比例高于酒吧组(χ2=15.958,P<0.000),但最近1次肛交使用安全套的比例低于酒吧组(χ2=4.189,P=0.041);两组同性肛交和异性性行为使用安全套频率的差异有统计学意义(χ2=14.988,P<0.001;χ2=7.408,P=0.025)。门诊组接受同伴教育的比例低于酒吧组(χ2=7.197,P=0.007),最近1年患性病比例和HIV阳性比例高于酒吧组(χ2=6.019,P=0.014;χ2=6.175,P=0.013)。结论主动检测的MSM中高危行为更普遍,感染HIV的风险更高,应针对性制定策略,加强MSM人群的高危行为干预。

Objective To investigate current AIDS prevalence and high risk behavior characteristics among men who have sex with men （MSM） of different sample sources in Changzhou; to provide scientific basis for making AIDS prevention strate- gies. Methods According to Manual of National AIDS Sentinel Surveillance Protocol, 264 MSM recruited in bars and 224 MSM recruited in voluntary counseling and test （VCT） clinics were subjected to questionnaire-based survey and serological tests. Results For MSM recruited in VCT clinics, proportion of MSM having homosexual anal intercourse in past 6 months was higher than that of MSM recruited in bars （x^2 =15. 958,P〈0.01）. However, compared to MSM recruited in bars, MSM recruited in VCT clinics had lower rate for using condoms in last homosexual anal intercourse （x^2= 4. 189, P： 0. 041）. Rates for using condoms in homosexual and heterosexual intercourses were statistically different between MSM recruited in bars and VCT clinics （x^214. 988, P〈0. 001; x^2 7. 408,P=0. 025）. Compared to MSM recruited in bars, MSM recruited in VCT clinics had lower rate for accepting peer education （x^27. 197,P=0. 007）, while STD incidence and HIV positive rate were higher （x^26. 019,P=0. 014 ; x^26.175,P=0.013） in past year. Conclusion High risk behavior was much more common and HIV infection was higher for MSM recruited in VCT clinics. Targeted strategies should be made to strengthen high risk behavior intervention among MSM.