成都市感染HIV的男男性行为者的高危行为及其影响因素分析

Study on HIV related high risk factors among MSM infected with HIV/AIDS in Chengdu

目的了解成都市感染艾滋病病毒(HIV)男男性行为者(MSM)的梅毒感染状况及高危行为特征,探索影响感染HIV MSM的高危行为的相关因素,为感染者的管理与行为干预提供指导。方法采用横断面调查,通过MSM社区组织,采用方便抽样招募调查对象,所有受访对象接受一对一定量调查,并现场采血完成梅毒抗体检测。结果共招募调查对象433人,平均年龄(33.45±10.27)岁。55.42%受访者表示,目前在寻找性伴时会主动考虑选择HIV感染者。62.36%的调查对象最近6个月内发生过男男肛交性行为,其中安全套坚持使用率为54.81%。梅毒感染率为15.01%。多因素Logistic回归分析表明,影响该人群高危行为的因素为获知感染的时间[比值比(OR)=2.06,P<0.01]和告知他人自己的感染状况(OR=0.59,P<0.05)。结论应重视成都市感染HIV MSM的高危行为,获知感染时间的长短和是否告知他人自己的感染状况,是其高危行为可能的影响因素。应促进MSM尽早进行HIV和梅毒检测及治疗,并在随访管理中重视性伴告知以取得性伴的支持,促进感染者采取安全性行为。

Objective To understand syphilis infection of men who have sex with men（MSM） infected with HIV in Chengdu city,and to estimate the high risk behaviors and risk factors.Methods A cross-sectional survey was made by the MSM community-based organizations（CBO）.433 MSM infected with HIV/AIDS were recruited by a convenience sampling method and received questionnaire investigation and syphilis serological test.Results The average age of respondents was 33.45±10.27,and 55.42%of them reported that they would actively seek homosexual partners living with HIV/AIDS.62.36%reported that they had anal sex the last six months and among them54.81%used condom consistently.Syphilis prevalence was 15.01%among the respondents.The multivariate logistic regression analysis showed that the factors influencing their behaviors were the duration being aware of their HIV infection status（OR= 2.06,P〈0.01） and their HIV infection were disclosed to others（OR= 0.59,P〈0.05）.Conclusion The risk factors include the duration of their awareness of HIV status,and disclosure of their HIV status to others.The high risk behaviors among MSM living with HIV should be paid attention.It is necessary to strengthen HIV and syphilis test and treatment.Partner notification is also vital to provide support and improve protected sex behaviors.