男男性行为人群同伴网络大小与艾滋病相关因素的关系

Relationship Between MSM Companion Network Sizes and AIDS-related Factors

目的了解男男性行为人群(MSM)同伴网络大小,分析与艾滋病相关因素的关系。方法 2014-4/10,以四川省绵阳市辖区9县(市、区)MSM为对象,在固定场所知情同意下,应用滚雪球抽样法,进行调查对象招募和自填式匿名行为学调查和血清学检测。结果共调查1 097例,同伴网络中位数7人,其中同伴网络较小52.4%(544/1 039)、较大47.6%(495/1 039),不同地区差异有统计学意义(P=0.000)。同伴网络较小、较大艾滋病病毒感染率分别为3.9%(21/544)、3.8%(19/495)(P=0.985),梅毒感染率分别为2.8%(10/353)、8.6%(29/339)(P=0.001)。多因素分析:年龄、性取向、接受预防服务、寻找性伴地方、寻找性伴场所、近6月肛交保护性是MSM同伴网络大小的独立影响因素(P均<0.05)。结论同伴网络大小既与艾滋病传播和流行相关,也是防治信息传递和预防服务的影响因素,在艾滋病防治中正负影响并存。应充分利用同伴网络强化同伴教育。

Objective To investigate sizes of companion networks of men who have sex with men（ MSM） and analyze the relationship with AIDS-related factors. Methods During the period from April to October 2014,MSM subjects were recruited from fixed places by snowball sampling with informed consent in nine counties（ cities,district） under the jurisdiction of Mianyang of Sichuan Province and surveyed by a self- administered anonymous questionnaire,and serological testing was conducted. Results 1 097 subjects were surveyed,and the median number of companions was 7; the companion network size was small in 52. 4%（ 544 / 1 039） and large in 47. 6%（ 495 / 1039） of surveyed subjects; differences in different regions were statistically significant（ P = 0. 000）. Of MSM withsmall and large companion networks,the HIV infection rates were 3. 9%（ 21 / 544） and 3. 8%（ 19 / 495）（ P =0. 985）,respectively; and the syphilis infection rates were 2. 8%（ 10 / 353） and 8. 6%（ 29 / 339）（ P = 0. 001）respectively. Multivariate analysis showed that age,sexual orientation,acceptance of preventive services,localities and places of seeking sexual partners and protective anal sex in recent 6 months are the independent influencing factors of companion network sizes of MSM（ P 0. 05）. Conclusion The companion networks size not only correlates to HIV transmission and prevalence but also is a factor influencing transmission of prevention and control information and prevention services and demonstrates both negative and positive influence in prevention and control of AIDS. Companion networks should be fully utilized to enhance companion education.