昆明市HIV阳性MSM感染者性伴HIV感染及影响因素分析

Analysis on HIV infection and influencing factors among sex partners of HIV-positive MSM in Kunming

目的了解昆明市HIV阳性的MSM人群动员其性伴接受HIV检测情况及感染影响因素,提高MSM人群阳性发现率。方法将研究期间以方便抽样纳入的HIV阳性MSM者作为种子进行性伴HIV检测动员招募,动员阳性MSM种子近一年内的同性性伴接受HIV抗体检测,收集接受检测的性伴种子的人口学特征、性伴自身的人口学特征和性行为情况,对性伴HIV感染影响因素分析采用单、多因素Logistic回归分析。结果此研究纳入的阳性MSM种子71例,种子成功动员的比例为69.0%（49/71）。成功动员同性性伴53名接受HIV抗体检测,阳性检出率为18.9%（10/53）。多因素Logistic回归结果显示：性伴既往做过HIV检测[5.7%（2/35）;OR（95%CI）：0.105（0.017~0.646）],性伴近6个月坚持使用安全套[3.4%（1/29）;OR（95%CI）：0.083（0.009~0.795）]HIV感染风险较低。结论在MSM人群中,相较VCT检测方式HIV阳性者的性伴动员方式的性伴阳性发现效率较高,性伴既往没有做过HIV检测,近6个月没有坚持使用安全套可能是性伴感染HIV的危险因素。建议在MSM人群的社区文化建设中加强性伴检测宣传教育工作,指导更多的MSM感染者动员性伴接受HIV检测。

Objective To investigate the situation about HIV-positive MSM to mobilize their sex partners for HIV testing and influencing factors in Kunming and increase the rate of positive findings in MSM population. Methods This study was conducted among HIV-positive MSM（index-case） to mobilize their nearly a year of sex partners for HIV testing.Demographic, sexual behaviors of sex partners were collected for HIV testing.Single and multiple Logistic regression analysis were used to analyze the influencing factors of sex partners of HIV-positive. Results In this survey, there were 71 index caeses voluntarily participated in it, and 53 sex partners received HIV counseling and testing successfully, the success rate of mobilization was 69.0%（49/71）, the rate of HIV-positive findings was 18.9%（10/53）. In multivariate logistic regression analysis, the partners who received the previously HIV testing [5.7%（2/35）;OR（95% CI）： 0.105（0.017 ~0.646）] and insisted on using condoms in recent 6 months [3.4%（1/29）;OR（95%CI）： 0.083（0.009~0.795）] were low risk of HIV infection. Conclusion It is high that the rate of positive findings in MSM population compared with VCT, the partners who had no the previously HIV testing and not insist on using condoms in recent 6 months probably are the risk factors for HIV infection in male sex partners. Proposed to strengthen publicity and education partner testing in the community cultural construction in the MSM population and encourage more participation in the partner mobilization and testing.