HIV抗体阳性MSM的性病感染状况及其影响因素

Prevalence and risk factors of sexually transmitted infections among MSM infected with HIV

目的了解艾滋病病毒(HIV)抗体阳性的男男性行为者(MSM)的性病感染状况及其影响因素,为MSM的艾滋病防治策略提供科学依据。方法 2016年8-11月,采用方便抽样的方法,在上海、济南两地两家医院内,抽取正在进行抗病毒治疗的HIV阳性MSM进行问卷调查和实验室检测。结果共调查380例HIV阳性MSM,其中梅毒感染者63例,感染率16.6%[95%可信区间(CI):12.9%~20.5%];尖锐湿疣50例,感染率13.2%(95%CI:10.0%~17.1%);生殖器疱疹和淋球菌感染各1例,感染率各为0.3%(95%CI:0~0.8%);未检出生殖道衣原体阳性者。总的性病感染者有98例,感染率为25.8%(95%CI:21.6%~30.0%)。影响性病感染的多因素Logistic回归分析显示,年龄≤29岁[比值比(OR)=4.94,95%CI:1.02~24.47]、CD4^+T淋巴细胞水平低于正常值(OR=2.20,95%CI:1.34~3.60)和不知晓性病知识(OR=1.82,95%CI:1.15~3.25),是感染性病的危险因素。结论抗病毒治疗门诊中的HIV抗体阳性MSM的性病感染率相对较高,建议进一步加强对该人群的性病防范宣传教育以及性病的筛查和诊疗服务,将有助于降低性病感染率,从而减少HIV的传播。

Objective To study the prevalence and risk factors of sexually transmitted infections（STIs）among men who have sex with men（MSM）infected with HIV,and to provide information for developing the strategies of AIDS prevention and control.Methods From August to November,2016,a cross-sectional study was conducted among the HIV infected MSM treated by highly active antiretroviral therapy in two hospitals in Shanghai and Jinan,and the data analyzed by non-conditional logistic regression model.Results Of the 380 HIV infected MSM,63（16.6%,95%CI 12.9%-20.5%）cases were infected with syphilis,50（13.2%,95%CI 10.0%-17.1%） cases with condyloma acuminatum,1 case（0.3%,95%CI 0.0%-0.8%）with genital herpes,1（0.3%,95%CI 0.0%-0.8%） case with neisseria gonorrhoeae,and no genital chlamydia infection was detected.98（25.8%,95%CI21.6%-30.0%） cases were infected with at least one kind of STIs.Multivariate logistic regression analysis showed that the factors significantly associated with STIs infection included younger age（OR4.94,95%CI：1.02-24.47）,subnormal CD4 cell count（OR 2.20,95CI：1.34-3.60）,and unawareness of STIs（OR 1.82,95 CI 1.15-3.25）.Conclusion The prevalence of STIs among HIV infected MSM is relatively high.Given that STIs can drive the spread of HIV,we suggest to further strengthen the health education of STIs and the STIs screening,diagnosis and treatment services,which will help reduce STIs prevalence and AIDS spreading.