深圳市MSM梅毒/HIV感染变化趋势的Joinpoint回归分析

Joinpoint regression analysis on trends of syphilis/HIV prevalence among men who have sex with men in Shenzhen

目的探讨深圳市男男性行为者(MSM)梅毒/HIV感染变化趋势,为政府制订预防控制策略提供参考依据。方法于2005-2015年应用滚雪球法和同伴推动抽样法,在深圳市招募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及性取向、性角色等;采集静脉血5mL检测梅毒螺旋体抗体和抗-HIV。采用Joinpoint Regression Program软件计算年度变化百分比并进行趋势检验。结果共招募7 510名MSM接受自愿咨询检测。2005-2007年,深圳市MSM梅毒阳性率以每年56.36%的平均速率上升(Z=9.02,P<0.01),2007-2011年,以每年-8.17%的平均速率下降(Z=-3.44,P=0.04),2011-2015年无显著变化(Z=0.14,P=0.90)。2005-2008年,深圳市MSM HIV阳性率以每年65.73%的平均速率上升(Z=3.95,P=0.01),2008-2015年以每年6.47%的平均速率上升(Z=1.83,P=0.12),但变化不明显。结论深圳市MSM梅毒阳性率上升趋缓,HIV阳性率上升趋势明显,应加大对MSM的艾滋病健康教育和行为干预力度,扩大梅毒/HIV感染免费治疗范围。

Objective To explore trends of syphilis/HIV prevalence among men who have sex with men（MSM）in Shenzhen and provide scientific reference for control and prevention policy by the government.Methods Snowball sampling and respondent driven sampling were used to recruit MSM from 2005 to 2015in Shenzhen.Questionnaire-based interviews were conducted on a one-on-one basis to collect data of socio-demographic information,self-identified sexual orientation and role in homosexual behavior.5ml blood samples were taken and tested for treponema pallidum and HIV antibodies.The trends of syphilis/HIV prevalence from 2005 to 2015and annual percent changes were analyzed by joinpoint regression program.Results A total of 7510 MSM were recruited and received voluntary counseling and testing.There was a statistically significant increase in syphilis infection rate with an annual percent change（APC）of 56.36%from 2005 to 2007（Z=9.02,P〈0.01）.Then the syphilis infection rate slightly decreased with an APC of-8.17%from 2007 to 2011（Z=-3.44,P=0.04）and kept stable from 2011 to 2015（Z=0.14,P=0.90）among MSM.There was a statistically significant increase in HIV infection rate with an APC of 65.73%from 2005 to 2008（Z=3.95,P=0.01）and the HIV infection rate also increased with an APC of 6.47%from 2008 to 2015（Z=1.83,P=0.12）but not significantly among MSM in Shenzhen.Conclusion The infection rate of syphilis among MSM in Shenzhen is relatively stable and that of HIV infection shows a statistically significant increase year after year.It is necessary to strengthen HIV health education and behavioral interventions targeted to MSM and expand the coverage of free treatment for syphilis/HIV infection.