药物滥用对男男性行为者高危行为及梅毒/HIV感染的影响

Drug abuse and syphilis/HIV infection among men who have sex with men in Shenzhen

目的了解药物滥用对男男性行为者(MSM)高危行为及梅毒/艾滋病病毒(HIV)感染的影响。方法于2010-2015年采用滚雪球法和同伴推动抽样方法,在深圳市共招募3803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、近二年内药物滥用史、性取向、性角色、性伴数量、安全套使用情况等,采集静脉血5mL进行梅毒螺旋体抗体和抗-HIV检测。趋势检验采用Cochran-Armitage法,分类资料采用卡方检验。结果175名(4.60%)MSM近二年内有药物滥用史,719例(18.91%)梅毒确认阳性,343例(9.02%)HIV确认阳性,179例(4.71%)梅毒合并HIV感染。与无药物滥用者相比,深圳市MSM药物滥用者最近半年内女性性伴数≥2个、肛交性伴数≥5个、口交性伴数≥5个的比例较高,梅毒感染率、HIV感染率以及梅毒合并HIV感染率分别为前者的1.7692倍、1.8226倍和1.9802倍。结论 MSM药物滥用者易发生多性伴、不使用安全套等高危行为,梅毒/HIV感染率高,应开展有针对性的行为干预。

Objective To investigate the drug abuse and syphilis/HIV infection among men who have sex with men（MSM）in Shenzhen.Methods A total of 3803 MSM were recruited with the methods of snowball sampling and respondent driven sampling from 2010 to 2015in Shenzhen.Questionnaire-based interviews were conducted on a one-on-one basis.Data were collected including socio-demographic information,drug abuse in recent two years,selfidentified sexual orientation,roles in homosexual behavior,numbers of sexual partners and condom use in the past six months.5ml blood samples were taken and tested for treponema pallidum and HIV antibodies.Trend test were done by the Cochran-Armitage method and categorical data by Chi-square test.Results Of the 3803 participants,175（4.60%）reported that they used club drugs in recent 2years.The prevalence of syphilis,HIV,and syphilisHIV co-infection were 18.91%,9.02% and 4.71%,respectively.Compared with non-drug users,drug users had frequently more than 2female sexual partners and more than 5anal and oral sexual partners in the past 6months.The rates of syphilis,HIV infection and syphilis-HIV co-infection among drug users were 1.7692,1.8226,1.9802 times as high as those among non-drug users,respectively.Conclusion Risk behaviors happen more frequently such as multiple sex partners and no use of condoms for every act,and the prevalence of syphilis and HIV is higher among drug users.It is necessary to carry out behavior intervention targeted to drug users among MSM.