浙江省杭州市男男性行为者HIV感染状况及影响因素分析

HIV infection status and associated risk factors among men who have sex with men in Hangzhou,Zhejiang

目的分析杭州市男男性行为人群（MSM）艾滋病哨点监测结果,了解人类免疫缺陷病毒（HIV）感染现状及传播的危险因素,为实施有效的干预措施和防治策略提供依据。方法 2009 2014年,通过社会组织的积极动员,以滚雪球抽样、MSM人群活动场所招募及网络招募的方式获得监测对象,进行面对面问卷调查,采集静脉血进行HIV和梅毒检测。结果共纳入2892名MSM,HIV抗体阳性率从2009年的7.75%增长到2014年的13.10%,上升趋势明显（Z=3.610,P=0.0003）。艾滋病知识知晓率为92.53%。多因素logistic回归分析表明,高中以下文化程度（OR=1.903,95%CI：1.471~2.462）、最近6个月与同性性伴发生肛交性行为（OR=1.838,95%CI：1.263~2.676）、最近一年患过性病（OR=1.572,95%CI：1.057~2.336）、梅毒感染（OR=2.802,95%CI：2.055~3.819）为HIV感染的独立危险因素。结论杭州市MSM的HIV感染率已达到较高水平,尽管艾滋病知识知晓率较高,但高危行为普遍存在,急需寻求更有效的干预措施遏制HIV传播。

Objective To understand the HIV infection status and associated risk factors among men who have sex with men（ MSM） in Hangzhou,Zhejiang province,and provide evidence for effective HIV prevention and control.Methods Face to face questionnaire survey was conducted among the MSMrecruited by snowballing method in the communities in Hangzhou from 2009 to 2014. Blood specimens were collected from them for the detection of HIV and syphilis antibodies. Results A total of 2892 MSMwere enrolled in the study. The HIV infection rate was 7. 75% in2009 and 13. 10% in 2014,which showed a statistically significant increase（ Z = 3. 610,P = 0. 0003）. The overall awareness rate of AIDS related knowledge was 92. 53%. The results of multivariate logistic regression analysis showed that the educational level of senior high school（ OR = 1. 903,95% CI： 1. 471- 2. 462）,anal sex with homosexual partners（ OR = 1. 838,95% CI： 1. 263- 2. 676）,sexually transmitted disease（ OR = 1. 572,95% CI： 1. 057- 2. 336）,syphilis（ OR = 2. 802,95% CI： 2. 055- 3. 819） were the independent risk factors for HIV infection. Conclusion The positive rate of HIV had reached a high level among MSMin Hangzhou. Although the MSMhad high awareness of AIDS related knowledge,high risk sex behaviors were still common. It is necessary to conducted effective intervention among MSMto prevent HIV transmission.