绵阳市男男性行为人群艾滋病感染现状及影响因素

HIV Infection in MSM in Mianyang and Influencing Factors

目的了解男男性行为人群(MSM)艾滋病病毒(HIV)感染和筛查阳性追踪现状,分析HIV感染影响因素。方法2015-04/10,以四川省绵阳市辖9个县(市、区)MSM为对象,在知情同意下,用滚雪球抽样法,对调查对象进行行为学调查及血清学检测。结果共检测1 286例,HIV确证阳性率5.7%(73/1 286),地区间差异有统计学意义(P=0.000)。筛查阳性追踪到位率77.3%(68/88),其中45.0%(9/20)外出/外地、35.0%7电话不通(7/20)、20.0%(4/20)不愿意复查而未追踪到位。多因素分析结果,文化程度高中/中专、大专及以上,接受预防服务,认识当地MSM朋友数≥5人是HIV感染的保护因素,压力感受较大/很大、梅毒现症感染是危险因素(OR分别为0.276、0.181、0.206、0.318、3.385和5.814,P均<0.05)。结论绵阳市MSM HIV感染处于较高水平,地区差异明显,人群流动和联系方式失真降低了筛查阳性有效追踪。低文化程度、社会活动网络小、压力感受大及梅毒感染增大了HIV感染风险。

Objective To investigate the status of HIV infec- tion in men who have sex with men （MSM） in Mianyang and follow - up of MSM with positive screening results and analyze influencing factors of HIV infection. Methods MSN people were recruited by snowball sampling method from 9 counties （ cities, districts） during the period from April to October of 2015. A behavioral investigation was conducted and serological tests were carried out. Ke- suits Among 1 286 MSM people, the confirmed positive HIV rate was 5.71% （73/1 286）, with statistically significant differences among different regions （ P = 0.000）. Follow - up rate of MSM with positive screening results was 77.3 % （68/88） and, among those who were lost to follow - up, the causes of loss to follow - up included migration to other places in 45.0% （9/20）, failure to contact by telephone in 35.0% （7/20） and unwillingness to accept reexamination in 20. 0% （4/20）. Multivariate analysis showed that holding an educa- tional degree of high school/technical secondary school, junior college and above, receiving preventive services and having≥5 MSM friends were protective factors against HIV infection, while heavy/very heavy stress sensa- tion and current syphilis infection were risk factors （ OR values were 0. 276, 0. 181,0. 206, 0. 318, 3.385 and 5. 814, respectively; all P values were 〈0.05）. Conclusion The HIV infection in MSM is at a high level in Mianyang, with significant regional differences. Migration of people and false contact ways have affected effec- tive follow - up of people with positive screening results. Low educational degrees, small social circles, heavy stress sensation and syphilis infection have increased the risk of HIV infection.