深圳市男男性行为者婚姻状况及其对梅毒和HIV感染的影响

Marital status and its effect on syphilis/HIV infection among men who have sex with men in Shenzhen

目的了解深圳市男男性行为者(MSM)婚姻状况及其对梅毒和艾滋病病毒(HIV)感染的影响。方法于2009-2015年,应用滚雪球法和同伴推动抽样法,在深圳市招募5221名MSM为调查对象。采用一对一问卷调查方法,收集其社会人口学特征、性取向、性角色、最近半年内性伴数及安全套使用情况等信息;采集静脉血5mL进行梅毒螺旋体抗体和抗-HIV检测。定量资料采用单因素方差分析,分类资料采用χ2检验。结果 5221名MSM中,梅毒检出率为19.75%(1031例),HIV检出率为9.10%(475例),梅毒合并HIV检出率为4.86%(254例)。MSM中未婚者占70.02%(3656例),已婚25.30%(1321例),离异/丧偶4.67%(244例)。不同婚姻状况MSM间,近半年内女性性伴数、男性肛交性伴数、口交性伴数、安全套使用及HIV检出率差异均有统计学意义。已婚MSM梅毒检出率为19.23%(254/1321),HIV检出率为10.30%(136/1321),与女性伴性交时每次使用安全套比例仅为24.31%,与男性伴肛交时每次使用安全套比例仅为37.35%。结论深圳市已婚MSM梅毒和HIV检出率均较高,每次使用安全套比例低。应针对已婚MSM采取有效的干预措施,以阻断梅毒、HIV向普通人群传播。

Objective To investigate the marital status and its effect on syphilis/human immunodeficiency virus（HIV）infection among men who have sex with men（MSM）in Shenzhen.Methods Snowball sampling and respondent driven sampling were used to recruit MSM from 2009 to 2015in Shenzhen.Questionnaire-based interviews were conducted on a one-on-one basis to collect the data of socio-demographic information,self-identified sexual orientation,role in homosexual behavior,numbers of sexual partners in recent six months and condom use.5ml blood samples were taken and tested for treponema pallidum and HIV antibodies.Quantitative data were analyzed by oneway ANOVA and categorical data were analyzed by chi-square test.Results Among the total of 5221 MSM recruited,the prevalence of syphilis,HIV,and syphilis-HIV co-infection were 19.75%（1031/5221）,9.10%（475/5221）,and 4.86%（254/5221）respectively.70.02%（3656/5221）were unmarried,25.30%（1321/5221）married and 4.67%（244/5221）divorced or widowed.The numbers of female sexual partners,male sex partners with anal intercourse,oral sexual partners,condom use,and HIV infection among MSM of different marital status were significantly different.The infection rates of syphilis and HIV among married MSM were 19.23%（254/1321）and10.30%（136/1321）,respectively and the rate of condom use for every sex with female and for every anal sex were merely 24.31% and 37.35%,respectively.Conclusion Married MSM have the higher rate of syphilis/HIV infection and lower rate of condom use for every sex.Effective intervention should be targeted to married MSM to prevent syphilis/HIV transmission to general population.