深圳市2013—2015年MSM HIV新发感染状况分析

HIV incidence among men who have sex with men in Shenzhen,2013-2015

目的了解深圳市MSM HIV新发感染率及其变化趋势。方法应用时间场所抽样(time-location sampling,TLS)和同伴推动抽样(respondent-driven sampling,RDS)方法对深圳市MSM开展连续三年的调查,并利用BED HIV捕获酶联免疫法(BED-HIV capture enzyme immunoassay,BED-CEIA)对确证阳性样本进行HIV新发感染检测以获得新发感染率。结果共调查MSM 1 793人,其中,TLS方法和RDS方法分别调查936人和857人;25~29岁年龄组占35.8%;高中/中专学历占43.3%。三年共检测HIV阳性183人和HIV新发感染64人,HIV感染率和新发感染率分别为10.2%和7.46%。来源于RDS和TLS的MSM感染率分别为12.7%和7.9%,差异有统计学意义(P=0.001);感染率有随着年龄增高而增高的趋势(P<0.001);无男男商业性行为MSM感染率要明显高于有男男商业性行为者(P<0.001)。2013—2015年HIV新发感染率分别为6.44%、9.45%和6.54%,三年间比较差异无统计学意义(P=0.123);年龄越大,HIV新发感染率越高,各年龄组间差异有统计学意义(P<0.001)。无男男商业性行为者新发感染率(9.91%)明显高于有男男商业性行为者(2.18%)(P<0.001)。结论深圳市MSM HIV新发感染率处于较高水平,应加大干预力度,并加强RDS检测力度。

Objective To understand the HIV incidence and its variation tendency among men who have sex with men（MSM）in Shenzhen City from 2013 to 2015.MethodsA continuous investigation of three years was conducted by timelocation sampling（TLS）and respondent-driven sampling（RDS）methods.The human immunodeficiency virus（HIV）confirmatory samples were detected with BED-HIV capture enzyme immunoassay（BED-CEIA）to identify the recent HIV infections and obtain the incidence.ResultsA total of 1 793 MSM were investigated,and 936 and 857 of them were investigated by TLS and RDS methods respectively.The 25-29 years old group of the MSM accounted for 35.8% and the MSM with high school/technical secondary school education level accounted for 43.3%.The HIV prevalence rate and incidence were 10.2%（183 positive persons） and 7.46%（64 new infections）respectively.The prevalence rates from RDS and TLS were 12.7% and 7.9% respectively,and the difference had statistical significance between the two methods（P=0.001）.The prevalence rate increased with the age（P0.001） and it was higher in the non-male commercial sex group than that in the male commercial sex group（P0.001）.The HIV incidence rates were 6.44%,9.45% and 6.54% in Shenzhen City from 2013 to 2015 respectively,and there was no statistical difference among the three years（P=0.123）.The older the age,the higher the incidence of HIV,and the differences among the different age groups had a statistical significance（P〈0.001）.The HIV incidence of MSM without male commercial sex（9.91%）was significantly higher than that of MSM with male commercial sex（2.18%）（P〈0.001）.ConclusionThe HIV incidence among MSM is at a high level in Shenzhen City.Therefore,we should increase the intervention intensity and strengthen RDS detection.