依托社区小组在男男性行为者中开展HIV抗体快速检测的效果分析

Result analysis of HIV antibody rapid testing supported by community-based organizations among men who have sex with men

目的 分析依托社区小组,在男男性行为者（MSM）中开展艾滋病病毒（HIV）抗体快速检测的结果,探讨其可行性。方法 培训社区小组MSM同伴教育志愿者,通过现场招募和网络招募,动员MSM进行HIV抗体唾液快速检测。收集受检者的一般人口学特征及性行为信息,对检测阳性者动员其到疾病预防控制中心（简称疾控中心）进行指尖血快速复检,指尖血快速复检阳性者由疾控中心艾滋病确证实验室进行确认检测。结果共为1861名MSM提供了HIV抗体唾液快速检测,检出阳性140例,唾液快检阳性率为7.5%。其中有110人成功动员到疾控中心进行指尖血复检,复检阳性者91人,复检阳性率为4.9%;复检阳性者经确认84人为HIV抗体阳性,确认阳性率为4.5%。HIV感染多因素Logistic回归分析显示,MSM的HIV感染与文化程度低[比值比（OR）=2.228,95%可信区间（CI）：1.353～3.670]、未婚（OR=1.949,95%CI：1.147～3.311）、最近6个月男男性行为安全套使用率低（OR=4.024,95%CI：2.421～6.689）和一年内未做过HIV抗体检测（OR=1.999,95%CI：1.079～3.702）等因素的联系有统计学意义。结论依托社区小组在MSM中开展HIV抗体快速检测,可以有效扩大MSM的HIV抗体检测覆盖面,有很强的实用性,接受性好,值得推广。

Objective To analyze the results of HIV antibody testing supported by community-based organiza- tions （CBO）among MSM and to explore the feasibility of CBO participation in HIV testing. Methods Trained MSM peer educators mobilized MSM to take rapid saliva HIV antibody tests through on-site and online recruitment. Social-demographic characteristics and sexual behavior information were collected. The HIV positives detected by saliva testing were referred to CDC for fingertip blood examination, and those screened HIV positives were followed by the laboratory tests for confirmation. Results 1 861 subjects recruited from MSM got saliva rapid HIV antibody testing, of whom 140 HIV positives were detected, with a rate of 7.5 %, and 110 cases were successfully referred to CDC for fingertip blood testing,with HIV positive rate of 4.9%. Finally, 84 cases were confirmed as HIV-positive with a rate of 4.5 %. Multivariate logistic regression analysis showed that factors associated with HIV infection in- cluded low education level（OR= 2. 228,95%CI： 1. 353-3. 670）, unmarried（OR= 1. 949,95%CI： 1. 147-3. 311）,low rate of condom use in anal sex in the past 6 months（OR=4. 024,95%CI：2. 421-6. 689）and never having HIV anti- body test in the last year（OR= 1. 999,95 %CI：1. 079-3. 702）. Conclusion Rapid HIV antibody testing supported by CBO can effectively expand the coverage of MSM. It will make the HIV testing more accessible, practical and ac- ceptable among MSM and it is worth promoting.